Lung cancer
Also called: Bronchogenic carcinoma, NSCLC, SCLC
Cancer arising from the cells lining the airways or lung tissue. It is the leading cause of cancer death worldwide, mostly caused by smoking, and often found late — which is why screening of high-risk smokers is recommended.
Condition-specific references are below. Individual claims and this page have not been clinically reviewed. Read about this content.
About 2.5 million new cases a year worldwide.
What happens in the body
Carcinogens cause accumulating DNA mutations (e.g. in EGFR, KRAS, ALK, TP53). Non-small-cell types (adenocarcinoma, squamous) make up about 85%; small-cell cancer grows fast and spreads early.
Causes
- Tobacco smoking (about 85% of cases)
- Radon gas
- Asbestos and occupational carcinogens
- Air pollution
- Genetic factors in never-smokers
Risk factors
- Smoking and second-hand smoke
- Age
- Radon exposure
- Asbestos
- Family history
- Previous lung disease
Symptoms
- Persistent cough or change in a chronic cough
- Coughing blood
- Breathlessness
- Chest pain
- Weight loss and fatigue
- Hoarse voice
- Recurrent chest infections
Diagnosis — tests and examinations
- Chest X-ray, then contrast CT
- PET-CT for staging
- Biopsy by bronchoscopy, EBUS or CT guidance
- Molecular testing for targetable mutations and PD-L1
Treatment
Medicines and medical treatment
- Targeted drugs for driver mutations (osimertinib for EGFR, alectinib for ALK and others)
- Immunotherapy (pembrolizumab, nivolumab, atezolizumab)
- Chemotherapy
- Radiotherapy including stereotactic ablative radiotherapy (SABR)
Operations and procedures
- Surgical resection (lobectomy) for early stages
- Stenting or laser for airway obstruction
Self-care, home remedies and lifestyle
- Stop smoking — it improves treatment results
- Nutrition and physical activity support
- Palliative care alongside treatment for symptoms
Possible complications
- Spread to brain, bone, liver and adrenal glands
- Pleural effusion
- Superior vena cava obstruction
- Paraneoplastic syndromes (e.g. high calcium, SIADH)
Prevention
- Not smoking
- Testing homes for radon
- Low-dose CT screening for eligible current and former heavy smokers
Outlook
Early-stage disease treated with surgery is often curable; advanced disease has improved markedly with targeted and immunotherapies.
When to see a doctor
See a doctor for a cough lasting more than 3 weeks, coughing blood or unexplained weight loss.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
Educational overview, not medical advice. Treatment varies by person and location. Consult a qualified health professional for diagnosis or care. Read our content and model notes and privacy information.