Lung Cancer

Each year, more than 43,000 people are diagnosed with lung cancer in the UK. It is the third most common cancer in the UK, affecting mainly older people. It's rare in people younger than 40. More than 4 out of 10 people diagnosed with lung cancer in the UK are aged 75 and older.

Smoking is the main cause of lung cancer, although it can still develop in those who have never smoked.

LUNG CANCER IN OUR AREA

Overall, in the North West, lung cancer rates are 19% higher than the rest of England. In Merseyside, rates are 51% higher than the national benchmark, while Greater Manchester experiences rates 23% higher than the English average.

Communities in Cheshire and North Wales are also significantly affected. Lung cancer is 10% more prevalent in Cheshire compared with the rest of England, and incidences in North Wales have risen from 2% to 7% above the national average in recent years.

TYPES

There are two main types of primary lung cancer.  They are:

• non-small-cell lung cancer – the most common type, accounting for more than 80% of cases; 

• small-cell lung cancer – a less common type that usually spreads faster than non-small-cell lung cancer

The type of lung cancer you have determines which treatments are recommended.

SYMPTOMS

There are usually no signs or symptoms in the early stages of lung cancer. Symptoms develop as the condition progresses and can include:

• a cough lasting longer than 3 weeks

• coughing up blood

• persistent breathlessness or chest infections

• regular tiredness and lack of energy

• aches or pains when breathing or coughing

• loss of appetite or unexplained weight loss

There are also less common symptoms, such as changes in the appearance of your fingers, difficulty swallowing, wheezing, a hoarse voice, swelling of the face or neck, and persistent chest or shoulder pain.

Contact your GP if you have any of the main or less common symptoms.

CAUSES

You may be more likely to develop lung cancer if you:

• Smoke

• Inhale passive smoke

• Have been exposed to asbestos, radon gas, occupational chemicals or air pollution

• Have a family history of lung cancer

If you are between 55 and 74 and have ever smoked, you may be offered a free NHS lung health check that could detect cancer at an earlier stage.

DIAGNOSIS

There are several ways doctors can diagnose lung cancer.

A chest X-ray is usually the first test used to diagnose lung cancer. Most lung tumours show up on X-rays as a white-grey mass. However, chest X-rays can't always give a definitive diagnosis so you may be referred to a specialist.

A specialist can carry out more tests to investigate whether you have lung cancer and, if you do, what type it is and how much it's spread.

A CT scan is usually carried out after a chest X-ray. A CT scan uses X-rays and a computer to create detailed images of the inside of your body. A PET-CT scan may be carried out if the results of the CT scan show you have cancer at an early stage. The PET-CT scan can show where there are active cancer cells. This can help with diagnosis and treatment.

If the CT scan shows there might be cancer in the central part of your chest, you'll have a bronchoscopy. This is a procedure that allows a doctor or nurse to see inside your airways and remove a small sample of cells.

You may also be offered a different type of biopsy. This may be a type of surgical biopsy such as a thoracoscopy or a mediastinoscopy, or a biopsy carried out using a needle inserted through your skin.

TREATMENT

Lung cancer treatment depends on the type you have and number of other factors. A team of specialists will work together to recommend the best treatment for you. Common treatments include surgery, radiotherapy, chemotherapy, and immunotherapy, and you may have one or a combination of these.

For non‑small‑cell lung cancer, surgery is often used if the cancer is only in one lung. You may also have treatment like chemotherapy or immunotherapy before or after surgery. If surgery isn’t suitable, radiotherapy might be offered instead. For more advanced cancer, chemotherapy, immunotherapy or targeted medicines are usually used.

Small‑cell lung cancer is usually treated with chemotherapy, sometimes along with radiotherapy or immunotherapy, because it tends to spread quickly.

PREVENTION

If you smoke, the best way to prevent lung cancer and other serious conditions is to stop smoking as soon as possible.

Every year you don't smoke decreases your risk of getting serious illnesses, such as lung cancer.

NHS Smokefree can offer advice and support to help you quit smoking. You can also search for local stop-smoking support services here.

Improving your diet and doing more exercise can also help to prevent developing lung cancer.

If you have any concerns about the signs and symptoms of lung cancer, please visit your GP.