Lung cancer is the leading cause of cancer death: know the signs

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A graphic using two forests and rivers to represent human lungs

Around 14,000 new cases of lung cancer are diagnosed in Australia each year, where it is the leading cause of cancer death.

In Queensland between 2014 and 2018, lung cancer was the fourth leading cause of death—after coronary heart disease, dementia (including Alzheimer’s), and cerebrovascular disease.

It was the number two cause of death for Queensland men, and number four for women. (The health of Queenslanders—The Report of the Chief Health Officer Queensland 2020)

What is lung cancer?

Cancer begins when abnormal cells begin to grow and multiply uncontrollably somewhere in the body. There are two types of lung cancer. Primary lung cancer and secondary (or metastatic) lung cancer. Primary lung cancer is when the cancer begins in the lungs. Secondary or metastatic lung cancer is when the cancer begins in another part of the body and spreads to the lungs.

There are two main types of lung cancer: non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC).

Small-cell lung cancer (SCLC)

Small-cell lung cancer starts in the middle of the lungs and is faster spreading than non-small cell. It makes up about 15% of all lung cancers.

Non-small-cell lung cancer (NSCLC)

This is the most common type of lung cancer and is found in around 85% of cases. It is most commonly found in smokers or former smokers, but it’s also the most common lung cancer in non-smokers. It has three sub-types:

  • Squamous cell carcinoma—develops in the larger airways
  • Adenocarcinoma—appears in mucous producing cells. Adenocarcinoma represents about 40% of all lung cancers.
  • Large cell undifferentiated carcinoma—appears in any part of the lung and is not obviously one of the other two types.

Am I at risk?

There are a range of factors than can increase your risk of lung cancer:

  • smoking tobacco
  • second-hand (passive) smoking
  • exposure to asbestos
  • exposure to radon (radioactive gas)
  • exposure to occupational substances such as arsenic, cadmium, nickel, diesel fumes and soot
  • HIV infection
  • family history
  • history of lung diseases such as lung fibrosis or emphysema
  • older age.

Have I got any signs of lung cancer?

  • shortness of breath
  • changes to the voice such as hoarseness
  • chest pain
  • coughing or spitting up blood
  • a new cough that does not go away
  • recurring bronchitis or pneumonia
  • enlarged fingertips
  • loss of appetite
  • unexplained weight loss
  • tiredness.

How is lung cancer diagnosed?

Larger tumours may be detected by x-ray, and smaller ones by CT (computerised tomography) scan. If a tumour is found, PET (positron emission tomography) scanning can provide an indication of what stage the cancer may be at. If a tumour is suspected a biopsy of the tumour may be taken by bronchoscopy. Doctors may also use a microscope to look for abnormal cells in mucous from your lungs (sputum).

How will I get tested?

There is no routine screening for lung cancer in Australia. If you have any signs or concerns, visit your GP, who may ask for:

  • Blood test
  • Chest x-ray
  • CT scan
  • PET scan
  • Lung function test
  • Biopsy
  • Sputum cytology
  • Bronchoscopy

My results are positive ... what happens next?

Your GP will refer you to a specialist service.

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

  • Surgery
  • Staging
  • Radiation therapy
  • Ablation – heat or radiation
  • Chemotherapy
  • Immunotherapy or targeted therapies
  • Supportive management

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