Lung Cancer

Lung cancer is one of the most common and serious types of cancer. Over 41,000 people are diagnosed with the condition every year in the UK.

There are usually no signs or symptoms in the early stages of lung cancer, but many people with the condition will eventually develop symptoms including:

  • a persistent cough
  • coughing up blood
  • persistent breathlessness
  • unexplained tiredness and weight loss
  • an ache or pain when breathing or coughing

You should see your GP if you have these symptoms.

Types of lung cancer

Cancer that begins in the lungs is called primary lung cancer. Cancer that begins in another part of the body and spreads to the lungs is known as secondary lung cancer. This page is about primary lung cancer.

There are two main types of primary lung cancer. These are classified by the type of cells in which the cancer starts. They are:

  • non-small-cell lung cancer – the most common type, accounting for more than 80% of cases; can be either squamous cell carcinoma, adenocarcinoma or large-cell carcinoma
  • small-cell lung cancer – a less common type that usually spreads faster than non-small-cell lung cancer

The type of lung cancer you have will determine which treatments are recommended.

Who is affected

Lung cancer mainly affects older people. It is rare in people younger than 40, but the rates of lung cancer rise sharply with age. Lung cancer is most commonly diagnosed in people aged 70-74 years.

Although people who have never smoked can develop lung cancer, smoking is the main cause (about 90% of cases). This is because smoking involves regularly inhaling a number of different toxic substances.

Treating lung cancer

The treatment for lung cancer depends on the type of cancer, how far it has spread and how good your general health is.

If the condition is diagnosed early and the cancerous cells are confined to a small area, surgery to remove the affected area of lung is usually recommended.

If surgery is unsuitable due to your general health, radiotherapy to destroy the cancerous cells may be recommended instead.

If the cancer has spread too far for surgery or radiotherapy to be effective, chemotherapy is usually used

Outlook

As lung cancer does not usually cause noticeable symptoms until it has spread through much of the lungs or into other parts of the body, the outlook for the condition is not as good as many other types of cancer.

Overall, about 1 in 3 people with the condition will live for at least a year after they are diagnosed and fewer than 1 in 10 people will live at least five years.

However, survival rates can vary widely depending on how far the cancer has spread at the time of the diagnosis. Early diagnosis can make a big difference.

Oesophageal cancer Explained

Cancer of the oesophagus, also known as oesophageal cancer, is an uncommon but serious type of cancer that affects the oesophagus (gullet).

The oesophagus is the medical name for the gullet, which is part of the digestive system. The oesophagus is the long tube that carries food from the throat to the stomach. The top part of the oesophagus lies behind the windpipe (trachea). The bottom part runs down through the chest between the spine and the heart.

Symptoms of oesophageal cancer include:

  • difficulties swallowing (dysphagia)
  • weight loss
  • throat pain
  • persistent cough

See your GP if you have any of these symptoms. They don’t necessarily mean that you have oesophageal cancer, but they will need to be investigated.

Your GP will take a detailed look at your medical history before carrying out a physical examination to check for any signs of abnormalities, such as a lump in your abdomen that may indicate a tumour.

If your GP still suspects oesophageal cancer you will be referred for further tests.

Types of oesophageal cancer

There are two main types of oesophageal cancer:

  • Squamous cell carcinoma forms in the upper part of the oesophagus. It occurs when cells on the inside lining of the oesophagus multiply abnormally.
  • Adenocarcinoma of the oesophagus forms in the lower part of the oesophagus. It occurs when cells inside the mucous glands that line the oesophagus multiply abnormally. The mucous glands produce a slimy substance to help food slide down the oesophagus more easily.

How common is oesophageal cancer?

Oesophageal cancer is uncommon, but it is not rare. It is the ninth most common type of cancer in the UK, with more than 8,500 new cases diagnosed each year.

Oesophageal cancer most commonly affects people over the age of 60, with the average age at diagnosis being 72. The condition is more common in men than in women.

Smoking and drinking alcohol are two of the biggest risk factors for oesophageal cancer, particularly if both activities are combined. People who drink heavily but do not smoke are four times more likely to develop oesophageal cancer than non-drinkers, and people who smoke and do not drink alcohol are twice as likely to develop oesophageal cancer.

However, people who smoke and drink heavily (more than 30 units a week) are eight times more likely to develop oesophageal cancer than those who do not smoke or drink.

Treating oesophageal cancer

Oesophageal cancer does not usually cause any noticeable symptoms until the cancer has spread beyond the oesophagus and into nearby tissue. For this reason it can be more difficult to cure compared with other types of cancer.

On average, 40% of people with oesophageal cancer will live for one year after the diagnosis, and 13% will live for five years after the diagnosis. The outlook can improve greatly if the cancer is diagnosed and treated at an early stage, or where a cure is possible.

Attempting to cure oesophageal cancer involves having a course of chemotherapy (and radiotherapy as well in some cases) followed by surgery to remove the cancerous section of the oesophagus.

If a cure is not achievable, it is usually still possible to relieve symptoms and slow the spread of the cancer using a combination of radiotherapy, chemotherapy and surgery.

Non-Hodgkin Lymphoma Explained

Non-Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system, which is a network of vessels and glands spread throughout your body.

The lymphatic system is part of your immune system. Clear fluid called lymph flows through the lymphatic vessels and contains infection-fighting white blood cells known as lymphocytes.

In non-Hodgkin lymphoma, the affected lymphocytes start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes (glands). The affected lymphocytes lose their infection-fighting properties, making you more vulnerable to infection.

The most common symptom of non-Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin.

Who is affected

About 80% of all lymphomas diagnosed are non-Hodgkin lymphoma. In the UK, more than 12,000 cases are diagnosed each year.

Non-Hodgkin lymphoma can occur at any age, but your chances of developing the condition increase as you get older, with most cases diagnosed in people over 65. Slightly more men than women are affected.

What causes non-Hodgkin lymphoma?

The exact cause of non-Hodgkin lymphoma is unknown.

However, your risk of developing the condition is increased if you have a medical condition that weakens your immune system, you take immunosuppressant medication or you have previously been exposed to a common virus called the Epstein-Barr virus (which causesglandular fever).

You may also have a slightly increased risk of developing non-Hodgkin lymphoma if a first-degree relative (such as a parent or sibling) has had the condition.

How non-Hodgkin lymphoma is diagnosed

The only way to confirm a diagnosis of non-Hodgkin lymphoma is by carrying out a biopsy.

This is a minor surgical procedure where a sample of affected lymph node tissue is removed and studied in a laboratory.

Treatment and outlook

There are many subtypes of non-Hodgkin lymphoma, but they can generally be put into one of two broad categories:

  • high-grade or aggressive non-Hodgkin lymphoma is where the cancer develops quickly and aggressively
  • low-grade or indolent non-Hodgkin lymphoma is where the cancer develops slowly, and you may not experience any symptoms for many years

The outlook for non-Hodgkin lymphoma varies greatly depending on the exact type, grade and extent of the lymphoma, and the person’s age.

Low-grade tumours do not necessarily require immediate medical treatment, but are harder to completely cure. High-grade lymphomas need to be treated straightaway but tend to respond much better to treatment and can often be cured.

The main treatments used for non-Hodgkin lymphoma are chemotherapy, radiotherapy and a type of targeted treatment called monoclonal antibody therapy.

Overall, most cases of non-Hodgkin lymphoma are considered very treatable. More than half of those with high grade disease are cured and about half of those with low grade disease will live at least 10 years.

However, there is a risk of long-term problems after treatment, including infertility and an increased risk of developing another type of cancer in the future.