Lung Cancer

Lung cancer is the third most common form of cancer in the UK ^{Footnote [1]} .  As with all forms of cancer, it’s a serious condition, but several treatment options are available.

If you think you may have lung cancer, it’s important to seek medical advice as soon as you can, as clinical outcomes are better the earlier a cancer is detected.

If you have lung cancer, you may not have any symptoms at first. Once you do have symptoms, they could include ^{Footnote [2]} :

• A cough that won’t go away or keeps coming back.
• Coughing up blood.
• Frequent chest infections.
• Feeling tired all the time.
• Weight loss or losing your appetite.
• Being out of breath for no reason.
• Aches and pains when breathing or coughing.

The following symptoms are less common but sometimes associated with lung cancer:

• Swollen fingers and nails (known as ‘finger clubbing’).
• Difficulty swallowing.
• Noisy breathing or a hoarse voice.
• Chest or shoulder pain that doesn’t go away.

These symptoms could also be caused by other illnesses. Having some or all of these doesn’t necessarily mean you have lung cancer. However, if you have any of these symptoms, you should seek medical advice.

Cancer is an abnormal growth of cells that form tumours. Lung cancer can start in your windpipe (trachea), large airways (left or right bronchus) or in the lung tissue.

If it isn’t treated quickly, lung cancer can spread locally in your lungs and surrounding areas or to distant organs in your body. When cancer starts in the lungs, it's known as primary lung cancer. If it starts elsewhere and spreads to your lungs, it’s called secondary lung cancer.

Survival rates vary depending on the stage of cancer and on how far it has spread. Many people with lung cancer get better with treatment, especially when it’s found early, and there are several ways to treat it.

If you have lung cancer, you might not have symptoms until it has already spread throughout your lungs. Because of this, it's more difficult to diagnose it early.

If you think you may have lung cancer, write down the details of any symptoms you have and speak to your GP as soon as possible. They’ll ask you some questions about your symptoms and may also examine you to see if you have any signs of lung cancer. 

Afterwards, they may order a chest x-ray to see if there are any signs of cancer. They might also refer you to a respiratory physician who will consider the need for extra tests, including:

• CT, PET, MRI, or ultrasound scans to provide more detailed examination of your lungs and to look for spread elsewhere.
• A bronchoscopy, where a small tube called a bronchoscope is used to examine your airways.
• A surgical biopsy or needle biopsy to take a sample of your lung for testing.
• A mediastinoscopy, where a thin tube is used to view the centre of your chest, between your lungs.

Should lung cancer be confirmed, it's treated differently depending on how far it has spread, the type of cancer, and your overall health. A multidisciplinary team of medical and surgical specialists will discuss which are the best treatment options to recommend for you.

Treatments include:^{Footnote [3]}

• Surgery to remove the cancer.
• Chemotherapy drugs to destroy cancer cells throughout your body.
• Radiotherapy treatment to destroy cancer cells.
• Both chemotherapy and radiotherapy at the same time (known as chemoradiotherapy).
• Immunotherapy. This treatment helps your body’s immune system to fight cancer.

You may also be given medicine to prevent the cancer spreading (known as targeted therapy). This medicine affects the way the cancer grows. It can’t cure lung cancer, but it can slow its growth and spread.

Treatment to help you breathe with lung cancer

If your lung cancer has spread, you could find it difficult to breathe. You'll be offered treatments to clear the cancer from your lungs or airways.

Treatments include: 

• Cryotherapy. This treatment is used to freeze a tumour in the airways to shrink it.
• Diathermy, which uses electrical current to help remove tissue in cancer surgery.
• Radiofrequency ablation (RFA). This treatment heats cancer cells to kill them.
• Laser therapy, which uses lasers to kill cancer cells.
• Microwave ablation, which uses energy waves to kill cancer cells.

You may also be offered a tube that can be put into your airway to help to keep it open. This is known as a stent.

There are two main types of lung cancer ^{Footnote [4]} .

Non-small cell lung cancer (NSCLC)

There are a few types of cancer that are collectively called NSCLC. Most lung cancers are NSCLC, the majority of these are known as adenocarcinoma followed by squamous cell cancer.

NSCLC can be difficult to cure with radiation therapy and chemotherapy. It's usually only cured by surgery if that’s possible, which can sometimes be followed by chemotherapy.

Small cell lung cancer (SCLC)

SCLC (also known as oat cell cancer) grows and spreads faster than NSCLC. Usually, once the cancer is found, it's already spread.

It can be treated well with radiation therapy and chemotherapy. However, it often comes back at a later point.

Doctors use stages   ^{Footnote [5]}  to describe how large a cancer is and where it has spread.

Stage 1 lung cancer

The cancer is no larger than 4cm across, and it has not spread.

Stage 2 lung cancer

The cancer may have spread around the lung, and it could be one of a few different sizes.

Stage 3 lung cancer

The cancer may be spreading to other parts of the lung, the airway or the lymph nodes on the other side but not to the other lung. It can be any size.

Stage 4 lung cancer

The cancer may have spread to both lungs or another part of the body. This stage is also known as metastatic lung cancer.

The single biggest cause of lung cancer is smoking tobacco. Around 7 out of 10 lung cancers in the UK are caused by smoking  ^{Footnote [6]} . This is because tobacco releases toxic substances when it is burned. 

There are many other causes of lung cancer, including:

• Second-hand smoke. Being exposed to other peoples tobacco smoke can increase your risk of developing lung cancer.
• Chemicals, including diesel engine exhaust fumes, asbestos and silica. Some people are exposed to these chemicals at work.
• Radon gas exposure. It's a natural gas found in all soil and rocks, but it can gather in buildings.

The single biggest thing you can do to prevent lung cancer is to avoid smoking. If you do smoke, work towards stopping completely. If you don’t smoke, avoid second-hand smoke from other people’s cigarettes.

Some areas of the UK have high levels of radon, a gas which can cause lung cancer. You can have the radon levels in your home professionally tested or test them yourself using a kit. If they are high, you may want to have a radon sump or home ventilation installed, which can lower your home’s radon levels.

If your workplace exposes you to toxic chemicals, there should be safety guidelines to protect you from them, such as face masks. Make sure you follow these. 

Learning about lung cancer can be a lot to take in. If you’re worried about lung cancer, talking to your GP or your hospital team is a good first step.

You could use your health insurance cover to claim for treatment for lung cancer. First, get a referral from your GP, or through our Aviva Digital GP app^. Then you can make a claim through MyAviva, online or call us. 

If we confirm your claim meets the terms of your policy, we’ll pay for the treatment directly. Just be sure to tell us if you need more tests or treatment, or if your hospital or specialist changes.

It’s good to have one less thing to worry about. It takes Aviva.

^ These services are non-contractual and can be withdrawn or amended by Aviva at any time.