Chapter 01
What is lung cancer?
The lungs are the main organs for breathing and are part of the respiratory system that includes the nose, mouth, windpipe and airways (large airways, bronchi; smaller airways, bronchioles) to each lung.1 Lung cancer is a cancerous tumour in the tissue of one or both of the lungs.1 Lung cancer was the 5th most commonly diagnosed cancer in Australia in 2019, with data indicating this will remain the same for 2023.2
Primary lung cancer starts in the lungs.1
Secondary or metastatic lung cancer can start somewhere else in the body and spread to the lungs.1
Mesothelioma is a rare type of cancer that affects the covering of the lung, called the pleura. It’s almost always caused by exposure to asbestos.1, 3
Cancers that start in the chest wall may affect the lungs, but are not thought of as lung cancer.1
Primary lung cancer is split into two groups:1,4
Non-small cell lung cancer (NSCLC) – the most common type of lung cancer (about 85% of lung cancers) and includes:1,4
- Adenocarcinoma – starts in the cells that make mucus in the outer part of the lungs
- Squamous cell carcinoma – mainly affects the cells that line the tubes into the lungs. It tends to grow in the centre of the lung. It’s linked to a history of smoking.
- Large cell carcinoma or undifferentiated carcinoma – where the cancer cells are not clearly one of the two subtypes above
Small cell lung cancer (SCLC) – Approximately 15% of lung cancers are SCLSC. SCLC tends to start in the middle of the lungs and usually spreads more quickly than NSCLC.1, 4
Chapter 02
Symptoms
Common lung cancer symptoms may include:
- Coughing up blood
- A new or changed cough that doesn’t go away
- Chest pain and/or shoulder pain or discomfort – which might be worse when coughing or breathing deeply
- Trouble breathing or shortness of breath
- Trouble swallowing
- Hoarse voice
- Weight loss
- Loss of appetite
- Chest infection that doesn’t go away
- Tiredness or weakness 2
If you are experiencing any of these symptoms and they are persistent, it is recommended to make an appointment with your GP.
Chapter 03
Potential risk factors for lung cancer
Learn more about potential risk factors for lung cancer
There can be a range of potential risk factors that may increase the potential risk of lung cancer diagnosis. These risk factors may include:1
- Increasing age
- Tobacco smoking – either current or former
- Exposure to second-hand smoke (also known as passive smoking)
- Occupational substance exposure, which may include asbestos, silica, diesel exhaust, arsenic, cadmium, nickel, soot, and radon
- Family history of lung cancer
- Infection with HIV
- Past chronic lung disease, including for example chronic obstructive pulmonary disease and pulmonary fibrosis
- History of cancer including lung and head and neck cancers
It’s important to note that if you have any or multiple of the above risk factors, it doesn’t necessarily mean that you have lung cancer.1 It is suggested to make an appointment with your GP or specialist to discuss any concerns or questions that you may have.
Screening for lung cancer
A National lung cancer screening program will begin in July 2025. It will target high-risk individuals to detect lung cancer in its early stages to increase the likelihood of successful treatment and improve lung cancer outcomes.5
To learn more about the National Lung Cancer Screening Program, click to our blog post here.
Chapter 04
Diagnosing lung cancer
A range of tests may be performed to analyse symptoms and to diagnose lung cancer (and to determine the type and stage of lung cancer). Following a physical examination, further tests may include:1
- Imaging tests: such tests may include a chest X-ray, computerised tomography (CT) scan, positron emission tomography (PET) scan or a magnetic resonance imaging (MRI) scan. The objective of imaging-based tests is to understand more about the size and location of the tumour
- Blood or tissue laboratory tests
- Lung biopsy: this involves the removal of a small sample of tissue or fluid to be examined under a microscope
- Sputum cytology: a sample of sputum is examined under a microscope
- Bronchoscopy: A thin tube is inserted via the nose or mouth with the aim being to view the inside of the trachea and large airways in the lungs
Lung cancer can be classified by stage which looks at the size of the tumour and whether it has spread to lymph nodes or other parts of the body. Two systems may be used:1
1. TNM which stands for tumour - nodes - metastasisa.
- Tumour - size of tumour and how far into the lung it goes
- Nodes - spread to nearby lymph nodes or not
- Metastasis - tumour has spread to other parts of the body
2. Two-stage system for small cell lung cancer
- Limited stage - cancer is on one side of the chest and in one part of the lung with only nearby lymph nodes affected (if any)
- Extensive stage - cancer present throughout the lung, spread to the other lung or lymph nodes on the other side of the chest or other parts of the body
Chapter 05
Treatment options for lung cancer
Your treating doctor will discuss the most appropriate option(s) for treatment with you. The options suggested to you may depend upon the stage of the cancer, your overall health, symptom severity, and your personal preference.1 Treatment options offered for lung cancer may include:
Radiation therapy uses high energy X-rays or other particles to treat cancer and can be used at all stages.6
Chemotherapy is an approach to cancer therapy which involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments.7
Surgery
Early-stage non-small cell lung cancer may be treated by surgery, with the aim being to remove the tumour. Generally, surgery isn’t recommended for the treatment of small cell lung cancer.1
Targeted Therapy
Targeted therapy refers to treatment with drugs that are designed to specifically attack cancer cells without harming normal cells. These types of drugs affect the way that cancer cells grow, divide, repair themselves or interact with other cells. 2
Immunotherapy
Immunotherapy is a type of treatment that is intended to help your own immune system fight cancer. There are different types of immunotherapy for cancer that work in different ways.2
Chapter 06
Potential Side Effects
Side effects of cancer treatment
All cancer treatments may have side effects. The type and severity of side effects will vary between individuals.8,9 You can ask your doctor for detailed information about the side effects which you may experience with any treatment recommended for you.
Recommendations to help you stay well during treatment:
- Get as much rest as possible 1,8,9
- Healthy eating is important 8,9 but you should also try to think about eating foods that interest you rather than what you think you should eat
- Appetite changes are common, and you may experience taste changes or nausea8
- It may help to eat smaller meals rather than three large ones throughout the day
- Drink lots of fluids - aim for at least 8–10 glasses of fluid per day (this can be from water, soups, smoothies, milk, fruit juices or ice cubes for example) 8
- Reach out to support groups and others who have had cancer treatment 9
- Record your side effects in a diary or journal 1
- Speak to your doctor about incorporating some gentle exercise into your weekly routine 8,9
- It is important to acknowledge when you are fatigued and rest when you need to 1
- Ask for and accept help from family, friends and neighbours 9
- Be open with employers about your treatment and discuss flexible working options if you need them. 9
Chapter 07
Learn more about patient care at GenesisCare
A cancer diagnosis can be life changing. Even before your initial encounter with the GenesisCare team, you may experience a wave of emotions. It’s natural to feel disbelief, anxiety, sadness, anger, and loneliness. 10 We strive to help strengthen your confidence, settle your emotions, and to design care experiences that offer the best possible clinical outcomes.
Our care team aims to know your name and to get to know who you are as a person. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to guide you and to help get the support you need which may include a psychologist, exercise physiologist, physiotherapist, and dietitian.
If you have any enquiries about our centres or services, please contact your local centre team. View a list of our centres here.
Chapter 08
Other helpful resources
Further lung cancer information, resources, and support services are available to help assist you during your cancer journey.
These may include:
- Cancer Council
T: 13 11 20
cancer.org.au - Australian Cancer Research Foundation
T: 02 9223 7833
Acrf.com.au - Lung Foundation Australia
T: 1800 654 301
lungfoundation.com.au
- Cancer Council. Understanding Lung cancer. Available from: https://www.cancercouncil.com.au/lung-cancer/about-lung-cancer/ (accessed May 2024).
- Cancer Australia. Lung cancer. Available from: https://www.canceraustralia.gov.au/cancer-types/lung-cancer/overview (accessed May 2024).
- Cancer Australia. Mesothelioma. Available from: https://www.canceraustralia.gov.au/cancer-types/mesothelioma-cancer/overview (accessed May 2024).
- American Cancer Society. About lung cancer. Available from: https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html (accessed May 2024).
- Cancer Australia. Lung cancer screening. Available from: https://www.canceraustralia.gov.au/about-us/lung-cancer-screening (accessed May 2024).
- National Cancer Institute. Radiation therapy to treat cancer. Updated Jan 8, 2019. Available from: https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy (accessed May 2024).
- National Cancer Institute, NCI dictionaries, Dictionary of cancer terms, ‘chemotherapy’. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/chemotherapy (accessed May 2024).
- Cancer Council. Nutrition for People Living with Cancer. Available from: https://www.cancer.org.au/assets/pdf/nutrition-and-cancer-booklet (accessed May 2024).
- Cancer Council. Exercise for people living with cancer. Available from: https://www.cancercouncil.com.au/cancer-information/living-well/exercise-cancer/ (accessed May 2024).
- Cancer Council. Emotions and cancer. Available from: https://www.cancer.org.au/assets/pdf/emotions-and-cancer-booklet (accessed May 2024).