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About lung cancer
Learn about primary lung cancer, its causes, symptoms, and how it can affect other parts of the body.
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What is lung cancer?
Lung cancer begins when abnormal cells grow and multiply in an uncontrolled way in the lungs. Cancer that starts in the lungs is called primary lung cancer. It can spread throughout the lungs, and to the lymph nodes, pleura, brain, adrenal glands, liver and bones.
When cancer spreads to the lungs from another part of the body (e.g. breast or bowel), this is known as secondary or metastatic lung cancer.
This information is about primary lung cancer only.
The lungs
The lungs are 2 sponge-like organs that are used for breathing. They are part of the respiratory system, which also includes the nose, mouth, trachea (windpipe) and airways (tubes) to each lung.
There are large airways known as bronchi (singular: bronchus) and small airways called bronchioles. The lungs sit in the chest and are protected by the rib cage.
Lobes
Each lung is made up of sections called lobes – the left lung has 2 lobes, and the right lung has 3 lobes.
Diaphragm
The lungs rest on the diaphragm, which is a wide, thin muscle that helps with breathing, and separates the chest from the abdomen (belly).
Mediastinum
The space between the lungs is called the mediastinum. A number of important structures lie in this space, including:
- the heart and large blood vessels
- the trachea – the tube that carries air into the lungs
- the oesophagus – the tube that carries food to the stomach
- lymph nodes – small, bean-shaped structures that collect and destroy bacteria and viruses.
Pleura
The lungs are covered by 2 thin layers of tissue called the pleura. The inner layer (visceral pleura) lines the lung surface, and the outer layer (parietal pleura) lines the chest wall, mediastinum and diaphragm. The layers are separated by a small amount of fluid that lets them smoothly slide over each other when you breathe.
The pleural cavity is the potential space between the 2 layers; there is no space between the layers when the lungs are healthy.
The respiratory system
How breathing works
When you breathe in (inhale), your diaphragm moves down and air goes down the trachea and into the bronchi and bronchioles. When the inhaled air reaches the tiny air sacs called alveoli, oxygen passes through the small blood vessels (capillaries) and into the blood.
When you breathe out (exhale), your diaphragm relaxes and moves back up, and a waste gas called carbon dioxide is removed from the body and released into the air.
The different types of lung cancer
There are 2 main types of primary lung cancer: non-small cell lung cancer and small cell lung cancer.
Types of lung cancer
non-small cell lung cancer (NSCLC) |
NSCLC (about 85% of lung cancers) may be classified as:
Other, rarer types of non-small cell lung cancer are adenosquamous carcinoma, sarcomatoid carcinoma, salivary gland carcinoma and carcinoid tumours. |
small cell lung cancer (SCLC) | SCLCs (about 15% of lung cancers) tend to start in the middle of the lungs and usually spread faster than NSCLCs. |
Pleural mesothelioma is a type of cancer that affects the covering of the lung (the pleura). It is different from lung cancer and is usually caused by exposure to asbestos.
Other types of cancer, like cancers that start in the chest wall, and lung diseases such as silicosis may also affect the lungs and have similar symptoms but are not considered lung cancer.
Learn more about pleural mesothelioma.
What causes lung cancer?
A risk factor is anything that increases a person’s chances of developing a certain condition, such as cancer. It is possible to avoid or reduce the impact of some risk factors. Some people develop lung cancer without having any risk factors.
The following factors are known to increase the risk of lung cancer. This does not mean you will develop lung cancer, but if you are concerned, talk to your doctor.
Lifestyle factors
Tobacco smoking – Most cases of lung cancer are caused by tobacco smoking. The earlier a person starts smoking, the longer they smoke and the more they smoke, the higher their risk of developing lung cancer.
People who have never smoked can also get lung cancer. About 15% of cases occur in men who have never smoked, and about 30% of cases occur in women who have never smoked.
Environmental or work-related factors
Second-hand smoking – Breathing in other people’s tobacco smoke (second-hand smoke) may cause lung cancer. Living with someone who smokes is estimated to increase the risk of lung cancer by up to 30% in people who don’t smoke.
Exposure to asbestos – People who are exposed to asbestos are more likely to develop lung cancer or pleural mesothelioma. Although the use of asbestos in building materials has been banned in Australia since 2004, asbestos may still be found in some older buildings and fences.
Exposure to other elements – People who have been exposed to radioactive gas (radon), such as uranium miners, have an increased risk of lung cancer. Outdoor and indoor air pollution (e.g. exposure to household air pollution from gas, oil, or wood-burning cooking or heating) is another risk factor. Contact with the processing of arsenic, cadmium, steel and nickel, and exposure to diesel engine exhaust and welding fumes while working may also be risk factors.
Working with materials containing crystalline silica (e.g. stone, sand, rock, bricks, tiles, concrete, artificial stone) can generate silica dust, which may cause a lung disease called silicosis when breathed in and is a risk factor for lung cancer. The use of engineered stone has been banned in Australia since July 2024.
Personal factors
Older age – Lung cancer is diagnosed mostly in people aged over 60 years, although it can occur in younger people.
Family history – You may be at a slightly higher risk if a family member has been diagnosed with lung cancer.
Other conditions – Having another lung disease – lung fibrosis, chronic bronchitis, pulmonary tuberculosis, emphysema or COPD (chronic obstructive pulmonary disease) – or human immunodeficiency virus (HIV) may increase the risk of lung cancer.
Who gets lung cancer?
About 15,000 Australians are diagnosed with lung cancer each year. The average age at diagnosis is around 72 years. More men than women develop lung cancer, but since the early 1980s rates have been steadily decreasing among men and increasing among women.
→ READ MORE: Lung cancer symptoms
More resources
Dr Malinda Itchins, Thoracic Medical Oncologist, Royal North Shore Hospital and Chris O’Brien Lifehouse, NSW; Dr Cynleen Kai, Radiation Oncologist, GenesisCare, VIC; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Hospital, Epworth Richmond, and Monash Medical Centre, VIC; Helen Benny, Consumer; Dr Rachael Dodd, Senior Research Fellow, The Daffodil Centre, NSW; Kim Greco, Specialist Lung Cancer Nurse Consultant, Flinders Medical Centre, SA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Marco Salvador, Consumer; Janene Shelton, Lung Foundation Australia – Specialist Lung Cancer Nurse, Darling Downs Health, QLD; Prof Emily Stone, Respiratory Physician, Department of Thoracic Medicine and Lung Transplantation, St Vincent’s Hospital Sydney, NSW; A/Prof Marianne Weber, Stream Lead, Lung Cancer Policy and Evaluation, The Daffodil Centre, NSW.
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