Lung and respiratory

The lungs

The lungs are the part of the body that we use to breathe.

The lungs form part of the respiratory system which is made up of several parts:

  • Mouth and nose
  • Windpipe (trachea)
  • The right main bronchus and the left main bronchus (airways to each lung)
  • The lungs

The primary function of the respiratory system is to load blood with oxygen in order for the blood to deliver that oxygen to the body.

Facts and figures

  • Lung cancer is the second most common form of cancer in the UK (after breast cancer) and affects over 40,000 people a year.
  • There is a well-documented association with smoking which causes 86% of cases, with a further 3% of cases caused by passive smoking.
  • Lung cancer can also be caused by exposure to certain chemicals, air pollution, a family history and lowered immunity.

Signs and symptoms

Lung cancer develops in the cells of the lung and stops those cells from taking on oxygen and carrying it around the body. This can make breathing very painful and leave you feeling extremely fatigued.

The main symptoms for lung cancer are:

  • Persistent cough
  • Shortness of breath
  • Chest pain
  • Blood in sputum
  • Aches or pains when breathing or coughing
  • Recurring chest infections (despite treatment with antibiotics)

There are four main types of lung cancer that split into small cell (named after their appearance under the microscope) and non-small cell variations. These are treated differently. However, 80% of cases are non-small cell lung cancer.

Diagnosis

If the symptoms are suspicious, the GP will refer a patient to a consultant who will carry out a careful examination to determine the type, size, location and the character of the tumour along with together with any potential evidence of spread (metastasis).

Investigations that may be used to fully assess lung cancer may include:

  • Bronchoscopy
  • Full blood count
  • Liver function test
  • Chest x-ray
  • Biopsy (often done under a local anaesthetic using a flexible fibre optic bronchoscope)
  • CT scan
  • PET-CT scan

Metastases

Metastases occur when cancer cells break off and spread through the lymphatic channels or blood vessels to settle in other parts of the body. With lung cancer secondary tumours in the bone, liver and brain are the most common.

Treatment

The specialist will look at a number of factors to help plan the treatment. These include:

  • The type of lung cancer
  • Where the cancer is within the lung
  • General health
  • Whether the cancer has spread (the stage)
  • Results of the investigations

Small cell lung cancer is mainly treated with chemotherapy. A patient would only be suitable for surgery if there is no sign that the tumour has spread to the lymph glands in the middle of the chest. This is most likely if the cancer is diagnosed at a very early stage. If the person is generally fit, chemotherapy for small cell lung cancer may be followed by a course of radiotherapy or alternatively a combination of the two treatments could be prescribed.

For non-small cell lung cancer, the treatment is likely to be determined by the stage at which the cancer is diagnosed. Removing the tumour through surgery would normally be considered first. If surgery cannot be done, radiotherapy or radio frequency ablation may be considered in an early stage diagnosis. Radio frequency ablation is usually done under either a local or general anaesthetic – it is essentially radiowaves that create electrical energy to heat up a tumour and kill cancer cells. Following an operation, a consultant is likely to recommend chemotherapy, radiotherapy or a combination of both to lower the risk of the cancer returning. A course of radiotherapy may also be recommended if the consultant was unable to remove the whole tumour during the operation.

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Patient literature

Download the lung cancer patient information brochure.