Lung cancer is the 5th most common cancer in Ireland, with almost 2,600 people being diagnosed each year. It affects both women and men, usually over the age of 50.
- Lung cancer can be treated with surgery, drug therapies and radiotherapy, depending on the type and where it is found.
- Smoking causes nearly 9 out of 10 lung cancers
- The is the average age when a person is diagnosed is about 70. Lung cancer usually affects people over 40
What is lung cancer?
Lung cancer is when the cells in your lung change and start to grow out of control. These cells increase to form a tumour. Cells from this tumour may spread to other parts of the body. Almost 2,600 people are diagnosed with lung cancer each year in Ireland.* Secondary cancer in the lung (lung metastases) Sometimes cancer spreads to the lungs from somewhere else in your body, for example, from the breast or bowel. This is treated differently to cancer that starts in the lung (primary lung cancer). If you want to know about a cancer that has spread to the lung, please find that cancer type.What are the lungs and what do they do?
The lungs are two organs found in your chest and form part of your respiratory system. This system is responsible for your breathing. Your right lung is slightly bigger than your left and has three areas called lobes. Your left lung has two lobes. When you breathe in, air passes through your nose or mouth into your trachea (windpipe), which separates into two further tubes called bronchi. Each bronchus (left and right) connects to a lung. The bronchus divides even further into much smaller tubes called bronchioles. Air passes through these bronchioles and into tiny air sacs called alveoli. In the alveoli, oxygen from inhaled air passes into your bloodstream and is sent around your body. The lungs are covered by a lining called the pleura, which has two layers. The pleural cavity also contains pleural fluid, which acts as a lubricant and allows the layers to slide effortlessly against each other during respiratory movements. The cavity between the two lungs is called the mediastinum. This cavity contains the heart, the oesophagus (food pipe), the trachea (windpipe), large blood vessels and lymph nodes. Oxygen is needed in every cell of your body for various activities. During these activities, the waste gas, carbon dioxide, is made. It passes back through the alveoli and leaves your body when you breathe out.Risk and prevention of lung cancer
- Smoking: Smoking causes about 7 in every 10 lung cancers. The risk increases with the amount of time you have smoked, the number of cigarettes you have smoked and if you started young. Low-tar cigarettes do not reduce your risk. Those who smoke pipes and cigars have a lower risk of lung cancer than cigarette smokers, but they are at a much greater risk than non-smokers.
Smoking is the cause of most lung cancers. However, it is possible to get lung cancer even if you have never smoked.
- Passive smoking: Inhaling other people’s cigarette smoke increases the risk of lung disease and cancer. But the risk is still much less than if you smoke yourself.
- Chemicals: Certain chemicals such as asbestos, uranium, metal dust and fumes, nickel, paints, diesel exhaust, nitrogen oxides. These risks are higher if you smoke as well.
- Air pollution: May be a cause in countries where it is particularly bad.
- Radon gas: Radon is a radioactive gas found naturally in the soil. But if your home traps it inside, it can build up and cause harm. You can check the level of radon in your area on the Environmental Protection Agency website.
- Family history: If you have a parent, brother or sister who has had cancer which started in their lung, your risk is doubled.
Symptoms and diagnosis of lung cancer
Symptoms of lung cancer
- Wheezing or difficulty breathing
- A cough that doesn’t go away, or a change in a long-term cough
- Repeated chest infections that won’t go away, even after antibiotics
- Coughing up blood-stained phlegm
- Pain in your chest, especially when you cough or breathe in
- Swelling around your face and neck
- Difficulty swallowing
- Feeling more tired than usual
- Loss of appetite / weight loss
Can I be screened for lung cancer?
Testing for lung cancer when you have no symptoms is called screening. Currently there is no national screening programme for lung cancer in Ireland, if you notice any of the symptoms above or if you have any concerns we recommend that you speak with your GP.Diagnosing lung cancer
Your family doctor (GP) will talk to you about your symptoms. Your GP may organise for you to have a chest X ray, to check your lungs for any abnormal changes. If you doctor thinks you need more tests, he or she will refer you a rapid access lung clinic. These are consultant-led assessment and diagnostic services for patients with suspected lung disease. There are eight rapid access clinics located around the country. Your GP will send you to your nearest one.Tests you might have include:
- Blood tests
- Pulmonary function tests
- CT scan
- Bronchoscopy
- EBUS
- Lung biopsy
What are the types of lung cancer?
Non-small cell lung cancer (NSCLC)
Most lung cancers are this type. Some NSCLC cancers are linked to genetic changes (mutations) – which are not inherited. When these mutations occur, they affect the normal activity of the gene and lung cancer can develop. Mutations in the EGFR, KRAS, ROS1 and ALK genes are common in lung cancers – particularly in adenocarcinomas (see below). There are four main types of NSCLC:- Adenocarcinoma: This is the most common type of lung cancer and is often found in the mucous-making glands that line the airways.
- Squamous cell carcinoma: This type of cancer starts in squamous cells, which are flat cells that line the inside of the airways.
- Large cell carcinoma: This cancer may appear in any part of your lung. The cells are large and round when viewed under the microscope.
- Not otherwise specified (NOS): This is when the doctors cannot be sure which type of non-small cell lung cancer it is.
Small cell lung cancer is nearly always caused by smoking.
- Mesothelioma