November is Lung Cancer Awareness Month. As lung cancer is one of the most common and serious types of cancer, it’s important to help develop awareness and understanding of this deadly disease.
Did you know that lung cancer is the 3rd most common cancer in the UK? What’s more 79% of lung cancer cases are preventable1.
Often with lung cancer, there aren’t any noticeable symptoms until it's spread through the lungs or into other parts of the body. This leads to a poor outlook for people with this cancer compared to many other types of cancer. About 2 in 5 people with the condition live for at least 1 year after they're diagnosed, and about 1 in 10 people live at least 10 years2. But survival rates vary widely and early diagnosis can make a big difference.
To support this worthy cause and help increase knowledge of lung cancer, we’ve put together our patient’s most commonly asked questions and their answers.
Q1: How is lung cancer caused?
Not surprisingly, the main cause of lung cancer is smoking. It is responsible for more than 7 in 10 cases. What’s more, if you smoke over 25 cigarettes a day, you are 25 times more likely to get lung cancer than someone who does not smoke2.
Aside from smoking, the natural radioactive gas radon; occupational exposure to certain chemicals and substances such as arsenic, asbestos, beryllium, cadmium, coal and coke fumes, silica, and nickel; and air pollution and diesel fumes can cause lung cancer.
Q2: What are the early signs of lung cancer? How would I know I have it?
A: Some people with early lung cancer have signs. But often there are no symptoms of lung cancer at this stage. So, you may not know if you have it.
Signs and symptoms usually only start as the cancer advances and starts to spread. Moreover, these symptoms are not unique to lung cancer. This means they are often mistaken for other problems such as an infection or the long-term effects of smoking.
It is worthwhile being aware of lung cancer symptoms. Whilst most of these symptoms are more likely to be caused by something else, if you have any you should see a doctor right away.
Signs of lung cancer include:
• A cough that doesn’t go away
• Coughing up blood
• Shortness of breath
• Unexplained tiredness and weight loss
• An ache or pain when breathing or coughing.
Q3: How is lung cancer diagnosed?
A: There are several tests to help diagnose lung cancer.
Initially, your GP or doctor may ask about your medical history, perform a physical exam, measure how much air you breathe in and out using a Spirometer, and order blood tests to rule out possible symptom causes such as a chest infection.
You usually have a chest x-ray, CT scan and PET-CT scan to diagnose lung cancer. A chest X-ray looks for lung tumours. You then typically have a CT scan to make detailed images of your lungs, then a PET-CT scan if CT scan shows cancer. A PET-CT scan can show where there are active cancer cells to help with diagnosis and treatment.
You may also have a bronchoscopy and biopsy if your CT scan shows cancer might be in the central part of your chest. This looks inside of your airways and removes a small sample of cells.
Endobronchial ultrasound scan (EBUS) is a newer procedure that combines bronchoscopy with ultrasound. It allows a biopsy of your lymph nodes in the centre of the chest.
There are other biopsies too that may be recommended.
Q4: What are the different stages of lung cancer?
Doctors classify lung cancer by its stage. This is determined by how big the cancer has grown and how far it has spread. By knowing the stage, your doctors can advise the best treatment for you.
There are two main types of staging systems for cancer. These are the TNM (Tumour, Node, Metastasis) system and the number system.
The number system classifies lung cancer into stages:
Stage I - the cancer is no bigger than 4cm and has not spread outside the lung or to any lymph nodes. It is called early lung cancer or localised lung cancer.
Stage 2 - the cancer can be of different sizes and it may have spread to nearby lymph nodes, other parts of the lung, or areas just outside the lung. Stage 2 and 3 lung cancer is called locally advanced lung cancer.
Stage 3 - the cancer can be any size and has usually spread to lymph nodes. It may also be growing into other parts of the lung, the airway, and surrounding areas outside the lung. It may also have spread to tissues and structures further from the lung but it has not spread to other parts of the body.
Stage 4 - the cancer can be any size and has usually spread to lymph nodes. It is in one or more of the following: the lung on the other side, in fluid in the pleura or around the heart, and in another part of the body, such as the liver, bones or brain. Stage 4 lung cancer is called metastatic or secondary lung cancer.
Q5: What are the treatments for lung cancer?
A: Your cancer team will make recommendations on the treatments for your lung cancer. This will depend on the type of lung cancer you have (non-small-cell or small-cell mutations on the cancer), the size, position, and staging of the cancer, and your overall health. The final decision is yours.
The most common treatments for lung cancer include:
• Surgery – removes all or as much as possible of the cancer tumour
• Chemotherapy – cancer-killing medicine
• Radiotherapy – high-dose radiation to kill the cancer
• Immunotherapy - a medicine group that stimulates your immune system to target and kill cancer cells.
These treatments may be used separately or in combination.
Q6: Is lung cancer curable?
Some types of lung cancer are considered to be curable if diagnosed before they spread and if the cancer is fully removed.
Nevertheless, doctors don’t often say that cancer is cured. More often they say it is in remission where the cancer signs and symptoms have disappeared, or there is “no evidence of disease” (NED).
After a cancer diagnosis, you’ll typically be screened for several years. If you’re in remission or NED for five years or more, you might be considered cured. However, there is always a small chance that cancer cells could come back.
Q7: Is lung cancer always associated with smoking?
No, not always, but smoking is the main risk factor for lung cancer. Smoking is responsible for 72% of lung cancer cases in the UK. This is because smoking involves regularly inhaling many toxic substances.
Lung cancer can be caused by other risk factors too. These include having a family history of lung cancer, air pollution, ionising radiation, and exposure to asbestos, chromium, silica, nickel, arsenic, soot, or tar in the workplace and second-hand (other people’s) smoke.
Q8: How can I reduce my risk of lung cancer?
A: If you smoke, quitting is one of the best ways to reduce your risk of lung cancer.
You can also help lower your risk of this cancer by staying away from second-hand smoke, diesel exhaust and other air pollution, and workplace substances and pollutants such as asbestos, arsenic, and coal.
Get your home tested for radon and take steps to lower the radon level if it is high.
Unfortunately, some risk factors, such as a personal or family history of lung cancer, can’t be changed. If lung cancer runs in your family, talk to your doctor about lifestyle changes to reduce your risk of lung cancer. These may include eating a healthy diet and maintaining a healthy weight for you.
Q9: Should I be screened for lung cancer?
Currently, there is no national screening programme for lung cancer in the UK. Therefore, if you have any lung cancer symptoms you should see your doctor as soon as possible so that diagnostic tests can be arranged without delay.
You can book a lung health check privately at Ramsay Health Care UK. This can help detect lung cancer early when it is small and before it has spread. It is more likely to be treated successfully at this stage which means it saves lives.
A lung health check is a consultation with a respiratory consultant who will ask questions about your current health and medical history. Typically, they perform a painless and quick CT scan that can detect a cancer tumour, its location and size.
Ramsay Health Care UK is passionate about beating lung cancer together
At Ramsay, we have experienced and knowledgeable cancer care teams available nationwide. They are passionate about raising awareness and understanding of lung cancer and beating it together.
Every day our specialists clearly and compassionately answer patients’ questions and concerns to enable informed choices and the best treatment. They affirm that as with many other cancers, a key to surviving lung cancer is catching it in its earliest stages, when it is most treatable. Therefore, they encourage patients to have a lung health check or see a doctor if they have any symptoms, to support early diagnosis and treatment and save lives.