What is lung cancer?

Different types

Lung cancer is a cancer of the trachea (windpipe), bronchi (airways) or lung air sacs (alveoli).

The two most common types of lung cancer are:

  • Non-small cell lung cancer (NSCLC)
    Around 70–80% of people with lung cancer have NSCLC. The most common forms of NSCLC are adenocarcinoma or squamous cell carcinoma.
  • Small cell lung cancer (SCLC)
    Around 20% of people with lung cancer have SCLC.

Rarer forms of lung cancer are covered in our rare lung cancers factsheet.

Information on mesothelioma, a type of cancer that grows in the lining around the lungs usually caused by asbestos dust, can be found here occupational lung disease.

Symptoms

The most common signs and symptoms of lung cancer are:

  • Chronic cough (lasts 3+ weeks)
  • Coughing up blood, or flecks of blood, in phlegm
  • Losing weight for no reason
  • Being out of breath for no reason
  • Not feeling hungry
  • Fatigue
  • Pain in the chest / bones / shoulder
  • Swelling in the neck
  • Muscle weakness
  • Hoarseness (weak, raspy or strained voice)
  • Stridor (high pitched wheezing due to airway blockage)
  • Clubbing (swelling) of the fingers and toes

Early symptoms are often not picked up as they are linked to other common conditions. Some people do not have any symptoms at all.

The earlier lung cancer is picked up the easier it is to treat. Visit your doctor if you have any concerns at all, particularly if you are at a higher risk – see our ‘Causes’ section.

Causes

How does lung cancer develop?

While smoking tobacco is linked to more than 80% of all lung cancer cases, many people that have never smoked or been exposed to passive smoke develop lung cancer. See our information on the risk factors for tobacco smoking and passive smoking and our Smokehaz website.

Other causes include exposure to: air pollution (including diesel exhaust fumes), work materials (to asbestos, wood dust, welding fumes, arsenic, industrial metals e.g. beryllium and chromium) and indoor air pollution (to radon, coal smoke). There may be other causes, and more will likely be found in the future.

Having the following conditions can also increase your risk of developing lung cancer:

Genes can also play a role in some lung cancers. If there is a history of lung cancer in your family, you could be more likely to develop the condition, but this is not the same for everyone.

Diagnosis

“When the doctor tells someone they have lung cancer they will find it almost impossible to take in any further information. It can be good to have a carer or someone to accompany you so that they can be your ears.” Dan, Ireland, caregiver

Generally, the process of being diagnosed with lung cancer is as follows:

An X-ray and a computerised tomography (CT) scan (where your body is X-rayed at a number of angles before a computer puts together a detailed image) of your chest will first be done to show if there is a lung tumour.

Your doctor may confirm the diagnosis of cancer by taking some samples of the cells from your tumour or your glands or second tumour away from your lung tumour (metastasis) and testing them (this is called a biopsy). A biopsy can be carried out in a number of ways, most of which are done as an outpatient (you do not stay over):

      • Using an endoscopic camera test (a camera that goes inside your lungs) called a bronchoscopy. This uses a flexible tube that has a video camera at the end (called a bronchoscope). The tube is inserted through your nose or mouth. You will receive a sedative to relax you and a spray to numb your throat. See our bronchoscopy factsheet for more information.
      • Endobronchial ultrasound (EBUS) – this is similar to a bronchoscopy. The bronchoscope is fitted with a small ultrasound probe to help guide the physician to the right area to take a sample. This area is usually the area between the two lungs where your glands sit (called mediastinum)
      • CT-guided biopsy (where you go through the CT scanner and the X-ray images guide the physician to the right area).
      • Surgery (only on rare occasions)

If your doctor has a high suspicion that you have lung cancer, they will request some tests that can show how far the cancer has spread. This process is called staging and could involve further CT scans of the abdomen (stomach area) and brain, or a positron emission tomography CT (PET CT) scan (where a CT scan is combined with a PET scan, which involves a small amount of radioactive dye being injected into your veins to show up anything abnormal in your tissues).

On some rare occasions, your doctor may suggest that you have a biopsy of your axillary (armpit) and neck lymph nodes.

Staging tests also give useful information as to which is the most appropriate site to take a biopsy from.

Stages

How will I know what stage my lung cancer is at?

The stage of your lung cancer is one of the factors that will help your healthcare professionals to decide on the best kind of treatment to offer you.

Your doctor will be able to give you information on the stage of the cancer. This is based on:

  • Tumour size
  • How much it has spread into your lymph nodes/glands, and
  • Whether there is another tumour in your body that the doctor thinks is related to the main tumour in your lung (metastasis)

This staging process is sometimes referred to as TNM (tumour, node, metastasis).

Being told that you have lung cancer can be devastating. Many people with lung cancer have told us that being able to talk to someone outside of their family, such as a counsellor or psychologist, can often help. If you feel this might be helpful for you, talk to your doctor about what services might be available.

Prognosis

Everyone is different - statistics may not reflect what will happen to you

Lung cancer is a serious illness, and unfortunately, the prognosis for many is not very good overall, mainly because it is not diagnosed early enough. However, lots of work is being done to develop new treatments to help people live longer and with a better quality of life with lung cancer.

Most prognosis information is given in terms of a ‘5-year survival rate’. This term is often used by healthcare professionals, and refers to the number of people studied in research who lived for 5 years or more after being diagnosed with this type of lung cancer.

It is important to remember that everyone is different, and that you may not have the same reaction to a treatment as another person. Statistics do not necessarily reflect what will happen to you. You should see your prognosis as a guide – and discuss it with your consultant or doctor.

Treatment

“It is very important that everyone has hope from the moment they are diagnosed. There are new treatments coming along all the time. The treatment that I am on wasn't available 3 years ago, so don't give up hope.” Tom, UK, living with lung cancer

Range of treatments for different types of lung cancer

There are several different types of lung cancer, requiring a range of different treatments.

Your treatment plan will be based on the type and stage of lung cancer you have, your general state of health, and your personal preferences.

Treatments may be focused on either curing your lung cancer (curative treatments), or on helping you live longer and with a better quality of life with lung cancer (palliative treatments).

The main forms of treatment are surgery, chemotherapy, radiotherapy, biological and targeted treatments (including immunotherapy). Your options will be discussed with you as not all treatments may be suitable for your type of lung cancer.

Feelings

“I mostly distanced myself from my emotions: there was anxiety but I did not let it through. I was emotionally suspended, focused on what had to be done. I did not cry as I felt I would not be able to stop.” Margaret, UK, living with lung cancer

Remember you are not alone in what you are going through

You may find that you experience negative, upsetting and confusing feelings. It is important to remember that you are not alone in what you are going through. There are many online and in-person support groups for people in your position where you can talk about and hear other people’s experiences with lung cancer and build up your own support group.

You may find it helpful to talk to friends and family about the way you are feeling. This is also a difficult time for them, and their feelings may be similar or different to your own.

It may also be useful to speak to a counsellor or psychologist for some help with dealing with your feelings. Sometimes it is easier to talk to a stranger (or you may not have friends and family around to support you). A counsellor/psychologist can give you space to talk and think about how you feel.

Ask your doctor to provide some guidance on dealing with your feelings and if there is any access to psychological support.

You can find useful links to support in your country on our In your language page.

Living with lung cancer

“Enjoy every day. I was always working too hard, but now that fatigue has slowed me down, I spend more time with my family. I also take more rest periods during the day.” Tom, UK, living with lung cancer

How to help yourself everyday

People who have experience of lung cancer and healthcare professionals recommend that, after a lung cancer diagnosis, or during treatment, you try to go on living your life as it was before as best you can.

There are a number of things you can do to help yourself on a daily basis:

Palliative care

"Attending the day hospice has helped my breathlessness and the pain is also much better. Talking with the palliative care nurse has helped me see that I still have a lot of life in me." Mary, Ireland, living with lung cancer

What is palliative care?

Palliative care (also called supportive care) aims to improve the quality of life of people affected by serious illness such as lung cancer and their family members.

Palliative care will not cure the condition but it can prevent and treat the symptoms and side effects experienced. It is offered alongside other therapies.

Accessing palliative care services can help people affected by lung cancer to live their life as best as possible even though they are ill.

Palliative care can be accessed at any stage from diagnosis onwards and can provide relief from pain, nausea and other symptoms and offer support and comfort to people affected by lung cancer. It involves caring for people's physical, emotional and spiritual needs in the best way possible.

Palliative care can be provided in many settings such as the hospital, community or hospice. Finding out what palliative care support is available for you can help you make decisions about how you want to be cared for now and in the future.

Talk things through with any of your healthcare professionals. Ask questions and tell them about any concerns you have now and for the future. You may also want to talk things through with your family and friends. If they know how you feel they might be better able to support you.

Advanced information on lung cancer from ERS

In-depth medical information​

You can find more in-depth medical information about lung cancer in the European Respiratory Society publications below.

This information is designed for healthcare professionals but will be of interest to some individuals in search of more advanced information.

Please note that some of the links below contain detailed information and survival rates for different stages of lung cancer.