Lung Cancer 101:Symptoms, Prevention, Diagnosis, and Treatment

Lung cancer is a serious disease that puts a significant disease and mortality burden on Australians. Lung cancer is the fifth most common type of cancer diagnosed in Australia and is a leading cause of cancer-related deaths among Australians. Read on to learn about lung cancer, its causes, risk factors, and symptoms. We’ll review the impact of lung cancer on Australians, diagnosis and treatment options, and how you can reduce your risk of developing lung cancer. We’ll also share some tips and useful support organisations that can help you or a loved one living with the impacts of lung cancer.

What is lung cancer?

Lung cancer is when the cells in your lungs start to grow and multiply in an uncontrolled and abnormal way. Your lungs are a pair of porous, spongey organs located in your chest beneath your ribcage. The lungs are responsible for controlling your breathing, taking in oxygen when you inhale, and releasing carbon dioxide when you exhale. Lung cancer is serious and can impair your ability to breathe normally. Lung cancer is the leading cause of cancer deaths worldwide. When lung cancer originates in the lung tissue, it is known as primary lung cancer. Cancer that begins elsewhere in the body and then travels to the lungs is called secondary or metastatic cancer in the lung. 

Lung cancer can spread from the lungs to other areas of the body, including the lymph nodes and other organs such as the brain. The process of cancer cells migrating from one organ to another is called metastases. Detecting and treating lung cancer as early as possible can prevent further metastases and protect your other organs from being affected by travelling lung cancer cells.

Lung cancer in Australia

More Australians die from lung cancer than any other type of cancer, excluding non-melanoma cancers. Lung cancer is Australia’s fifth most common type, accounting for 9% of all cancer diagnoses. Approximately 13,810 lung cancer diagnoses were made in Australia in 2021, and Australians have a 1 in 18 chance of having lung cancer by the time they reach 90 years old. This is predicted to increase to 14,529 new lung cancer diagnoses in 2022, affecting slightly more men (7,707) than women (6,822). Men are also slightly more likely to die from lung cancer in Australia than women, with approximately 4,855 men and 3,809 women dying from this disease in 2022. While treatments are improving for lung cancers all the time, lung cancer is still very difficult to treat. The chance of surviving 5 years after being diagnosed with lung cancer was 22% between 2014 and 2018. 

Types of lung cancer

There are two main types of lung cancer, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). There are also other types of cancers that can travel to the lungs and affect your lung health and function. The main two types of lung cancer are explained in more detail below.

Small cell lung cancer (SCLC)

Small cell lung cancer is less common than non-small cell lung cancer, making up about 15% of all lung cancer diagnoses. Small cell lung cancer (SCLC) normally originates in the middle of the lungs before spreading to other areas of the lungs or other organs. SCLC spreads faster than non-small cell lung cancer, making early detection vital.

Non-small cell lung cancer (NSCLC)

Non-small cell lung cancer is the most common type of lung cancer, accounting for about 85% of cases. The three most common types of non-small cell lung cancer (NSCLC) are:

Adenocarcinoma

This type of NSCLC is the most common type of lung cancer, accounting for around 40% of all lung cancers. Adenocarcinomas originate in mucus-producing cells within the lungs and the lining of your airways. Adenocarcinomas are most common in smokers. However, they are frequently found in non-smokers as well.

Squamous cell (epidermoid) carcinoma

This type of lung cancer most often begins developing in the larger lung airways. Squamous cell carcinomas tend to grow near the centre of your lungs, and cancer cells of this type appear flat when observed under a microscope.

Large cell undifferentiated carcinoma

This category of lung cancer comprises several types of NSCLC, which can originate in any part of your lung but are not clearly identifiable as either a squamous cell or adenocarcinoma lung cancer. These cancer cells appear round and large under a microscope.

Signs and symptoms of lung cancer

One reason lung cancer is so difficult to detect early is that it often produces no symptoms in its earliest stages. By the time a person with lung cancer starts to experience symptoms, the disease has often progressed to a moderate or advanced stage. Some signs and symptoms of lung cancer include the following:

• A new cough that doesn’t go away or gets worse
• Coughing up blood, even a small amount
• Coughing up rust-coloured sputum (spit or phlegm)
• Shortness of breath
• Chest pain, which often gets worse with deep breathing, coughing, or laughing
• Hoarseness
• Losing weight without trying or for unexplained reasons
• Pain in your bones
• Headaches
• A chest infection that lasts longer than three weeks or is recurring
• Enlarged fingertips
• Loss of appetite
• Tiredness and fatigue.

If you or someone close to you experiences any of these symptoms, seek urgent medical attention.

Lung cancer risk factors and causes: what causes lung cancer?

Lung cancer is unpredictable, and we don’t always know why some people will develop this disease while others do not. However, there are several risk factors that are associated with a higher risk of developing lung cancer. These risk factors can be grouped into modifiable risk factors, meaning you have the ability to make changes to reduce your risk.

Modifiable risk factors for lung cancer

Some risk factors can be changed to help reduce your risk of developing lung cancer. These are sometimes also referred to as lifestyle risk factors. Common modifiable lung cancer risk factors include the following:

• Smoking tobacco
• Passive (secondhand) smoking
• Exposure to radon, asbestos, diesel fumes, and soot, often in occupational settings.

Non-modifiable risk factors for lung cancer

Some risk factors cannot be changed, including hereditary and genetic lung cancer risk factors. While you can’t change the fact that you have some of these risk factors, it can be helpful to note if you are at an increased risk of lung cancer so that you can get regular screenings and medical check-ups. Non-modifiable risk factors for lung cancer include:

• Exposure to substances like radon, asbestos, diesel fumes, nickel, and cadmium
• HIV infection
• Family history of lung cancer
• History of other lung conditions like emphysema or lung fibrosis
• Older age
• Previous radiation therapy.

Smoking is by far the leading cause of lung cancers and is a contributing factor to a majority of lung cancer diagnoses. This includes people who smoke themselves and those who have significant exposure to secondhand or passive smoking. However, some people who have never smoked or had excessive passive smoking exposure are also diagnosed with lung cancer. In these cases, we may not always know the exact cause of lung cancer developing.

How does smoking cause lung cancer?

Doctors suggest that smoking tobacco leads to lung cancer by damaging the cells in the lining of the lungs. Cigarette smoke is full of carcinogens (cancer-causing substances), which change the nature of your lung tissue cells almost immediately when inhaled. In small doses, your body can usually repair and heal from the damage caused by cigarette smoke. But if you smoke for several years, repeated exposure to carcinogens causes more and more damage to your lungs. Over time, this damage can no longer be repaired, and your lung cells can start to grow and multiply abnormally, leading to cancer. 

How is lung cancer diagnosed?

Because lung cancer can develop without producing symptoms, people who are otherwise healthy may choose to undergo screening for lung cancer. Those with risk factors for lung cancer can get annual lung cancer screening using low-dose CT scans. Lung cancer screening is often recommended for older adults who have smoked heavily within the previous 15 years, even if they have since quit. If you are considering getting lung cancer screenings, discuss your concerns and risk factors with your doctor to determine if it is suitable for you. If your doctor thinks you could be at risk of lung cancer, there are many different types of tests that can be used to diagnose you. These include the following:

• Imaging tests (CT scans and X-rays)
• Sputum cytology (observing sputum from your lungs under a microscope)
• Biopsy (tissue samples) 
• MRIs
• Bone scans
• Positron emission tomography.

Not every test is required or appropriate for every person. Some are mostly used to detect any lung cancer, and others are used to determine the extent of the lung cancer’s progression. Getting an accurate picture of lung cancer’s severity can also help inform the most suitable and effective treatment plan.

How is lung cancer treated?

Lung cancer treatment is a highly individual and personalised process. The right treatment plan for you will depend on the type and severity of your lung cancer, your overall health status, and your personal preferences. Some people with lung cancer choose not to undergo treatment because they determine that the risks or side effects of treatment outweigh the potential benefits. In these cases, milder treatment options can be used to minimise symptoms and increase the person’s comfort and quality of life.

In other cases, the potential for treatment to effectively slow or address lung cancer outweighs the risks and side effects. A range of options exists for people who choose to actively pursue lung cancer treatment, such as:

• Surgery is used to remove the section of your lungs that contain the cancer cells. A small amount of healthy lung tissue is usually also removed as a precaution. This type of surgical treatment is called a wedge resection or a segmental resection when a larger amount of lung tissue is removed. A lobectomy is when an entire lung lobe is removed, and a pneumonectomy is when an entire lung is removed.
• Radiation therapy uses high-power beams to kill cancer cells in your lung tissue. Radiation therapy is often used in combination with chemotherapy and surgery.
• Chemotherapy uses drugs (chemicals) to kill cancer cells. These drugs can be administered orally or via an intravenous drip (IV). Chemotherapy can be used before surgery to shrink the cancer cells or after therapy to kill any remaining cancer cells. 
• Stereotactic body radiotherapy, also known as radiosurgery, is an intense radiation treatment that targets cancer cells from multiple angles. It is commonly used for people with small lung cancers who cannot undergo surgery.
• Targeted drug therapy is used to treat specific abnormalities in cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Many targeted therapy drugs are used to treat lung cancer, though most are reserved for people with advanced or recurrent cancer.
• Immunotherapy works by working with your immune system to help your body better fight of abnormal cancer cells.
• Supportive or palliative care minimises signs and symptoms and reduces lung cancer’s impact on your quality of life. While palliative care does not directly treat cancer itself, having less pain and more enjoyable life can improve outcomes and life expectancy.

How can I prevent myself from getting lung cancer?

The best way to avoid developing lung cancer is to never smoke cigarettes. If you currently smoke, quitting smoking will immediately start to improve your lung health and function. Every cigarette you smoke damages your lungs, but conversely, every cigarette you don’t smoke reduces your risk of lung cancer and other diseases. If you don’t smoke, you should also be careful to avoid or minimise your exposure to secondhand or passive smoke. You should also pay attention to the air quality in your home or wherever else you spend a lot of time. Be careful at work, and be mindful of occupational exposure to harmful chemicals that can increase your risk of lung cancer. 

Get support to manage your lung cancer

Lung cancer changes every part of your life. Living with lung cancer, or supporting a loved one with lung cancer, can be extremely challenging. Don’t try to handle it all alone. Lung cancer’s physical, financial, and emotional impacts can feel a little easier with the right support. Homage’s team of highly trained, compassionate, and professional Care Pros are ready to help. Our trained nurses can provide basic medical care and nursing support from the comfort and privacy of your own home. We also have dedicated nurses specially trained in providing cancer care at home, so you can spend more time with your loved ones and less time in the hospital. Find out more about our home care and nursing services, or read our useful resources to learn about cancer.

If you are concerned about a loved one living with lung cancer, your family doctor or general practitioner (GP) is always a useful first point of call. Call triple zero (000) in any medical emergency and ask for an ambulance. 

The Australian government has established various support organisations for people living with cancer and their loved ones. The Cancer Council of Australia is the central source of information and support about many types of cancer. The Cancer Council also has local branches in your state and territory, so you and your loved ones can access the timely support you need wherever you live.

Reach out to the South Australian Cancer Council branch here: Cancer Council SA

Reach out to the Victorian Cancer Council branch here: Cancer Council Victoria

Reach out to the West Australian Cancer Council branch here: Cancer Council WA