Recognising and managing lung cancer
Lung cancer affects Australians of all ages, although it’s more likely in people aged over 60 years.1,2 A person has an estimated 5% risk of receiving a diagnosis of lung cancer by the time they reach 85 years of age.1 The primary risk factor for developing lung cancer is current or former tobacco smoking, although not all smokers will get lung cancer and nonsmokers can still get lung cancer.2,3 The most common type of lung cancer is non-small cell lung cancer (NSCLC) adenocarcinoma, which develops in the small, mucus-secreting cells in the deep parts of the lungs.3
In this blog, we’ll review some key information about lung cancer, including signs and symptoms to look out for, investigations used for diagnosis, and potential treatment options.
What are the signs and symptoms of lung cancer?
Lung cancer may present with a range of signs and symptoms including:2,3
- Persistent new cough or change to an existing cough
- Coughing or spitting up blood
- Chest and/or shoulder pain that gets worse when coughing or breathing deeply
- Feeling breathless or short of breath
- Persistent or recurrent chest infection
- Difficulty swallowing
- Hoarse voice
- Weight loss and/or decreased appetite
- Tiredness or weakness
In its early stages, lung cancer may not cause any symptoms, and the signs and symptoms described above can also be associated with many other conditions. If you experience any of these symptoms, especially anything that does not go away on its own, it’s important to see your doctor as soon as possible.2,3
How is lung cancer diagnosed?
Lung cancer can be investigated using a range of different tests, which may vary among patients. After a doctor reviews a patient’s symptoms and medical history and performs a physical examination, further testing may include:2,3
- Imaging studies such as a chest x-ray, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or bone scan, which are used to gather information about the size and location of the lung cancer
- Blood tests to check blood cells and kidney and liver function
- Lung biopsy where a small sample of cells taken from the lungs is examined under a microscope to look for and describe the cancer cells
- Lung function tests (spirometry) to assess how well the lungs are working to fill with air and empty
- Sputum cytology where a sample of mucus coughed up from the lungs is examined under a microscope to look for cancer cells
- Bronchoscopy where a thin tube with a camera is inserted into the lungs via the nose or mouth to look for changes in the airway passages and sometimes take biopsies
- Thoracoscopy or mediastinoscopy where a thin tube with a camera is inserted into the chest or area between the lungs via a small surgical cut to look for changes in the body and sometimes take biopsies
As well as confirming a diagnosis of lung cancer, these tests may also be used to determine the type of lung cancer, the stage of disease, and whether it has spread to the lymph nodes or other parts of the body. This information is important for planning the best treatment options for each individual patient.2,3
What are the treatment options for lung cancer?
Treatment plans for lung cancer depend on the type, stage, and location of lung cancer, as well as each individual patient’s overall health, symptom severity, and personal preferences.2,3 Some treatments may be given with the aim of getting rid of all signs and symptoms of the lung cancer, called curative intent, while other treatments aim to control the growth and spread of the cancer to manage symptoms and maintain quality of life, called palliative treatment.2
Treatment options that may be used for lung cancer include:2,3
- Surgery may be suitable for some patients, typically with early-stage lung cancer, and involves removing different amounts and parts of lung tissue that contain the cancer cells
- Radiation therapy uses controlled radiation to kill or slow growth of the cancer cells and may be used as the main treatment or in combination with other treatments, it is typically delivered as external beam radiation therapy (EBRT) and may be used in different ways depending on disease stage and features
- Chemotherapy may be used at different disease stages as the main treatment or in combination with other treatments, and is typically given as an intravenous infusion of the chemotherapy drug, which kills or slows growth of the cancer cells
- Targeted therapy uses medicines specially designed to attack certain features of cancer cells (e.g., how they grow, increase in number, or interact with other cells) while limiting harm to normal cells; targeted therapy is only used when a cancer has the specific feature (e.g., gene mutation) that the drug is targeted towards
- Immunotherapy uses medicines that help the body’s own immune system attack and fight the cancer cells and may be used alone or in combination with other treatments, depending on cancer type and features ancer cells and may be used as the main treatment or in combination with other treatments, it is typically delivered as external beam radiation therapy (EBRT) and may be used in different ways depending on disease stage and features
- Chemotherapy may be used at different disease stages as the main treatment or in combination with other treatments, and is typically given as an intravenous infusion of the chemotherapy drug, which kills or slows growth of the cancer cells
- Targeted therapy uses medicines specially designed to attack certain features of cancer cells (e.g., how they grow, increase in number, or interact with other cells) while limiting harm to normal cells; targeted therapy is only used when a cancer has the specific feature (e.g., gene mutation) that the drug is targeted towards
- Immunotherapy uses medicines that help the body’s own immune system attack and fight the cancer cells and may be used alone or in combination with other treatments, depending on cancer type and features
Lung cancer is a serious condition that affects many people, but each person’s journey through diagnosis and treatment of lung cancer will be unique. If you or a loved one has received a lung cancer diagnosis, or you have any questions or concerns about symptoms, risk factors, or treatment options, please talk to your doctor.