What is lung cancer?

Lung cancer can start in the cells lining the trachea, the main airway, the lung tissue, and even the pleura.

How the lungs work

When we breathe in, air is drawn down the windpipe (trachea), which divides into two tubes (airways), one going to each lung. These tubes are known as the right and left bronchus and divide further into smaller tubes called bronchioles, which ultimately end in millions of tiny air sacs called alveoli.The lungs are covered by the pleura, a membrane with an inner layer (which covers the lungs) and an outer layer (which lines the ribcage and diaphragm). Fluid produced by the pleura acts as a lubricant and helps the lungs to contract and expand smoothly during respiration.

Lung cancer – facts and figures

Cancer Research UK figures for 2012 reveal that lung cancer is the most common cause of cancer death in the UK, accounting for more than 1 in 5 cancer deaths. In 2012, 35,371 people died from lung cancer in the UK – that’s 97 people every day

Lung cancer is also the second most common cancer in the UK after breast cancer. There were around 44,500 new cases of lung cancer reported in 2012 (equating to 122 people every day), and 43% of cases are diagnosed in people aged 75 and over.

Smoking is the single greatest cause of lung cancer, accounting for one in four of all deaths from cancer in the UK. The incidence of lung cancer in Scotland is one of the highest in the world, due to the prevalence of smoking.

The highest mortality rates due to lung cancer occur in older men and women. Cancer Research UK state that between 2010 and 2012 around 48% of lung cancer deaths in the UK were people aged 75 years and over, and 89% were in the 60+ age group.

Types of lung cancer

Primary lung cancer

Cancer which begins in the lungs is called primary lung cancer.

There are two main types of primary lung cancer, classified according to the type of cells in which the cancer starts:

1. Non-small cell lung cancer (NSCLC)

NSCLC is the most common type of lung cancer, accounting for about 80% of all cases. There are three main types of NSCLC:

• Squamous cell carcinoma : often caused by smoking, this is the most common type of lung cancer and develops in the cells that line the airways.
• Adenocarcinoma: becoming more common, this type of cancer develops in the cells that produce mucus in the lining of the airways.
• Large cell carcinoma : sometimes known as undifferentiated carcinoma.

2. Small cell lung cancer (SCLC)

SCLC is less common (around 15% of lung cancers), is fast growing and typically spreads faster than NSCLC. It is usually caused by smoking.

Secondary lung cancer

This type of cancer (also called metastatic cancer) is caused by cancer cells which have spread to the lungs from a different part of the body, such as the bowel, breast or bones.

Symptoms of lung cancer

In the early stages of lung cancer, there may be no discernible signs of the disease, but as the disease progresses, symptoms may develop such as:

• persistent cough
• coughing up blood
• breathlessness
• unexplained tiredness and weight loss
• discomfort or pain when breathing or coughing.

#TackleLungCancer campaign – the importance of early diagnosis

With its #TackleLungCancer campaign, the British Lung Foundation (BLF) is calling for the government to fund a lung cancer screening programme to help people who are at higher risk of developing lung cancer.

A third of all people with lung cancer are diagnosed too late by presenting at hospital in an emergency with severe symptoms and advanced cancer.

Clearly, an earlier diagnosis of lung cancer will mean more treatment options will be available, and the greater the chance for living longer. At the moment, only 10% of people survive for at least 5 years after diagnosis of lung cancer, compared to 80% in people with breast and prostate cancer.

How is lung cancer treated?

Lung cancer can be difficult to treat, as it is often diagnosed at a late stage. It also tends to occur in older people, who may be dealing with a range of other medical conditions.

Treatment for lung cancer will depend on what type of cancer is diagnosed, how big the cancer is and whether or not it has spread to other parts of the body.

The most common treatments are:

• Surgery to remove the affected area, if there is an early diagnosis early and the cancer is confined to a small area.
• Radiotherapy to destroy cancerous cells may be recommended if the patient’s general health is unsuitable for surgery.
• Chemotherapy may be used if the cancer has spread and surgery/ radiotherapy would be ineffective.
• Biological therapy covers several drug treatments, which can control or stop the growth of cancer cells.

More details on lung cancer treatment can be found on the NHS website.  For more detailed information on biological therapy, see the Cancer Research UK website.

Specialist support for lung cancer

Dealing with cancer can be extremely difficult and worrying. It’s important to get a good understanding of the diagnosis and treatment options available from your medical team.

Here are some other organisations that can help:

Cancer Research UK: Cancer information nurses are on hand to answer queries Monday to Friday during office hours via the Helpline – 0808 800 4040. In addition, you can also email questions via the website here.

British Lung Foundation: The BLF website provides lots of information, useful resources, and a Helpline (03000 030 555). More information about how to contact the charity (including by letter, email, and text) can be found here. The BLF also runs an active web community including a 24-hour online forum.

 Macmillan Cancer Support: Macmillan Cancer Support provides a wide range of support and services to cancer patients.  It runs a helpline manned by Macmillan nurses on weekdays between 9am and 8pm – 0808 808 0000. In addition, the charity has local information centres – you can search for your nearest centre here.

Lung Cancer Forums  : Chatting with other lung cancer patients online can be very helpful. Two such forums can be found on the NHS website and the Roy Castle Lung Cancer Foundation.

Maggie’s Cancer Care Centres: The Maggie’s website offers a range of practical, emotional and social support for cancer patients. You can search for a local Maggie’s Cancer Care Centre or visit the online centre here.

Other useful articles by myageingparent.com

Cancer in older people

What you can do when an older parent has cancer