Lung cancer begins when abnormal cells grow and multiply in an uncontrolled way in one or both of the lungs. Cancer that starts in the lungs is known as primary lung cancer. It can spread to other parts of the body such as the lymph nodes, brain, adrenal glands, liver and bones. If the primary cancer cells grow and form another tumour at a new site, it is called a secondary cancer or metastasis
There are two main types of lung cancer:
- Small cell lung cancer (SCLC)
- Non small cell lung cancer (NSCLC)
NSCLC may be further classified as adenocarcinoma, squamous cell carcinoma, or large undifferentiated carcinoma depending on the cell type where the cancer is identified.
Following diagnostic tests, lung cancer will be staged to assist in determination of best treatment options. These can be broadly classified into:
- Stage I and II (early)
- Stage III (locally advanced)
- Stage IV (advanced)
Pleural mesothelioma is a cancer that affects the covering of the lung (the pleura). It is different to lung cancer and is usually caused by exposure to asbestos.
Treatment for lung cancer will depend on the type of lung cancer you have, the stage of the cancer, how well you can breathe (your lung function) and your general health. NSCLC and SCLC are treated in different ways.
Generally, early stage or locally advanced NSCLC treatment will include surgery, and possibly radiotherapy or chemotherapy. In advanced NSCLC palliative radiotherapy or chemotherapy (designed to relieve symptoms) may be offered, and treatment is likely to be with targeted therapies or immunotherapy.
Generally, early stage SCLC will be treated with radiotherapy or chemotherapy, whereas in advanced SCLC palliative chemotherapy or radiation therapy will be offered to relieve symptoms.
New types of drugs known as targeted therapy target specific mutations within lung cancer cells. Some lung cancers produce particular proteins that stop immune cells from recognising and destroying the cancer cells. Immunotherapy drugs known as checkpoint inhibitors block these proteins. Once the proteins are blocked, the immune cells can attack the lung cancer. The role of immunotherapy is also being investigated in mesothelioma.
Clinical trials may offer other treatment options. Read more about clinical trials.
For an overview of what to expect during all stages of lung cancer care, visit Cancer Pathways.
For patient support services visit Lung Foundation.
- Lung cancer is the 5th most commonly diagnosed cancer, but accounts for the highest number of deaths due to cancer.
- Median 5 year survival for lung cancer in 2011 in Australia was just 19%.
- Outcomes are better when lung cancer is diagnosed at an early stage, but more than 40% of lung cancers are diagnosed at Stage IV when the cancer has already metastasised (spread). In contrast approx. 12% of lung cancers are diagnosed at Stage I, where median 5 year survival is 68%.
- US data has shown improvements in 5 year survival in recent years due to adv NSCLC treatments3. Australian data has not been published, but would be expected to show similar trends (Aus estimated data actually only shows a continuing increase)
- Over 80% of lung cancer deaths can be attributed to smoking4 so anti-tobacco strategies are an important preventative strategy, but lung cancer is not always due to smoking
- Lung cancer patients have suffered from stigma over the years
- thinking they ‘deserve’ their diagnosis,
- being too ashamed of their diagnosis or disheartened by statistics to seek treatment, or
- having to constantly explain that they are one of the 20% with a lung cancer diagnosis not attributable to cigarette smoking
Cancer data in Australia https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/cancer-rankings-data-visualisation accessed 22/01/21
Data sourced from AIHW Australian Cancer Database 2016.
Siegel et l.(2021) ‘Cancer Statistics, 2021’, CA: A Cancer Journal for Clinicians 7:33
4Islami F, Goding Sauer A, Miller KD, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable factors in the United States in 2014. CA Cancer J Clin. 2018;68:31‐54.