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Lung cancer



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What is lung cancer?

Lung cancer is the leading cause of cancer death and the fifth most common cancer diagnosed in Australia1. It is responsible for almost one in five cancer deaths in Australia.

In 2013, 11,174 new cases of lung cancer (including small cell and non-small cell lung cancers) were diagnosed in Australia. This accounts for close to 9% of all cancers diagnosed. The risk of being diagnosed with lung cancer in Australia by age 85 is 1 in 13 for men and 1 in 22 for women.

The five year survival rate for people diagnosed with lung cancer is less than 14%.

In 2013, there were 8217 deaths caused by lung cancer in Australia.  

There are two main types of lung cancer:

Non-small cell lung cancer (NSCLC)

Non-small cell lung cancer is the most common type of lung cancer, accounting for around 80% of cases. There are sub-types of non-small cell lung cancer. The most common are:

  • adenocarcinoma – begin in mucus-producing cells and makes up about 40% of lung cancers. While this type of lung cancer is most commonly diagnosed in current or former smokers, it is also the most common lung cancer in non-smokers.
  • squamous cell (epidermoid) carcinoma – commonly develops in the larger airways of the lung.
  • large cell undifferentiated carcinoma – can appear in any part of the lung and are not clearly squamous cell or adenocarcinoma.

Small cell lung cancer (SCLC) 

Small cell lung cancer usually begins in the middle of the lungs and spreads more quickly than non-small cell lung cancer. It accounts for between 15 and 20% of lung cancers.


Lung cancer symptoms

Symptoms of lung cancer may include:

  • shortness of breath and wheezing
  • hoarseness
  • chest pain
  • coughing or spitting up blood
  • a new cough that does not go away
  • recurring bronchitis or pneumonia
  • loss of appetite
  • unexplained weight loss
  • fatigue.
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Causes of lung cancer

Factors that can increase your risk of lung cancer include:

  • smoking tobacco
  • second-hand smoke
  • exposure to asbestos
  • exposure to radon
  • exposure to occupational substances such as uranium, chromium, nickel, diesel fumes and soot
  • HIV infection
  • family history
  • history of come lung diseases such as lung fibrosis or emphysema.

Diagnosis for lung cancer

You may have a number of tests to determine if you have lung cancer.

Chest X-ray

An X-ray can show larger tumours (more than 1cm wide).

CT scan

A computerised tomography (CT) scan uses X-ray beams to take pictures inside your body and create a cross-sectional image. A CT scan is able to detect smaller tumours as well as providing information about the tumour and lymph nodes. 

PET scan

A positron emission tomography (PET) scan is used to stage lung cancer after a diagnosis.

Biopsy

A small sample of tissue will be taken if a tumour is suspected after a CT scan or X-ray. There are different types of biopsy including a bronchoscopy, CT-guided core biopsy and endobronchial ultrasound.

Sputum cytology

The sputum (mucus) from your lungs will be examined under a microscope to check for abnormal cells.


Treatment for lung cancer

Treatment will depend on the type of lung cancer you have, how advanced it is and your general health.

Staging 

Staging is based on the TNM system and classified by the size of the primary tumour, or whether it has spread to the draining lymph nodes or more widely, particularly to the liver, bones, adrenal glands and brain.

Treatment for non-small cell lung cancer

Surgery

If you have early stage non-small cell lung cancer you will most likely have surgery to remove the tumour. There are three main types of surgery:

  • lobectomy – a lobe is removed
  • wedge resection – part of the lobe is removed
  • pneumonectomy – a whole lung is removed.

Radiotherapy

Radiotherapy uses X-rays to kill or damage cancer cells and may be offered alone or in combination with surgery or chemotherapy. Radiotherapy can be used to treat locally advanced (stage III) non-small cell lung cancer. You may have radiotherapy for early stage lung cancer if surgery is not an option. Radiotherapy may also be used after surgery or as a palliative treatment.

Thermal ablation

If surgery or radiotherapy are not suitable, you may be offered ablation treatment for localised, stage I non-small cell lung cancer. You will have needles inserted into the cancer to destroy cancer cells by heating them.

Chemotherapy

Chemotherapy uses anti-cancer drugs to destroy cancer cells. Chemotherapy may be used before surgery to shrink a tumour. It may be used before or in conjunction with radiotherapy to improve its effectiveness, or after surgery to reduce the risk of cancer coming back.

Immunotherapy

Immunotherapy uses specific drugs to stimulate the body’s immune system and can be used to treat some forms of non-small cell lung cancer.

Targeted therapy

Targeted therapy or personalised medicine targets specific mutations in cancer cells. Targeted therapy is generally uses for advanced non-small cell lung cancer or if the cancer has returned.

Treatment for small cell lung cancer

Surgery is rarely used to treat small cell lung cancer. The main treatment for small cell lung cancer is chemotherapy. In addition, radiotherapy can be used to treat stages I-III small cell lung cancer.  

Palliative care

Palliative care seeks to improve quality of life by reducing cancer symptoms without aiming to cure the disease. Palliative treatment can be used at any stage of advanced lung cancer to assist with managing symptoms such as pain and nausea as well as slow the spread of the cancer.

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Screening for lung cancer

There is currently no routine screening test for lung cancer in Australia. There is some evidence to support annual screening for people at high risk of lung cancer using low-dose computed tomography. Individuals at “high risk” are currently identified as adults aged 55 to 80 years who have a smoking history of 30 pack-years and currently smoke or have quit within the past 15 years. However, health authorities in Australia agree that there are a number of unresolved issues requiring further consideration before lung cancer screening could be feasible in Australia.


Prognosis for lung cancer

An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis.


Preventing lung cancer  

The most comprehensive study of cancer causation in Australia estimated that 81% of lung cancers in 2010 were caused by tobacco smoking.

While there is no proven way to prevent lung cancer you can greatly reduce your risk by not smoking or quitting smoking tobacco, avoiding second-hand smoke and avoiding cancer-causing agents (carcinogens) at work.  


Source

Understanding Lung Cancer, Cancer Council Australia, ©2016. Last medical review of this booklet: November 2016.

Australian Institute of Health and Welfare. ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW.

Australian Institute of Health and Welfare (AIHW) 2017. Cancer in Australia 2017. Cancer series no. 101. Cat. no. CAN 100. Canberra: AIHW.

1) Excluding non-melanoma skin cancer, which is the most commonly diagnosed cancer according to general practice and hospital data. However, there is no reporting of cases to cancer registries.

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For more information

Booklets      

Includes additional information on treatment, making decisions around treatment and managing side effects of lung cancer treatment.

Also included, detailed information on looking after yourself during and after treatment, and links to both professional and community support.

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This page was last updated on: Tuesday, June 27, 2017

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