Page last updated: May 2024
The information on this webpage was adapted from Understanding Lung Cancer - A guide for people with cancer, their families and friends (2022 edition). This webpage was last updated in May 2024.
Expert content reviewers:
This information was developed based on Australian and international clinical practice guidelines, and with the help of a range of health professionals and people affected by lung cancer:
- A/Prof Brett Hughes, Senior Staff Specialist Medical Oncologist, Royal Brisbane and Women’s Hospital, The Prince Charles Hospital and The University of Queensland, QLD
- Dr Brendan Dougherty, Respiratory and Sleep Medicine Specialist, Flinders Medical Centre, SA
- Kim Greco, Nurse Consultant – Lung Cancer, Flinders Medical Centre, SA
- Dr Susan Harden, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC
- A/Prof Rohit Joshi, Medical Oncologist, GenesisCare and Lyell McEwin Hospital, Director, Cancer Research SA
- Kathlene Robson, 13 11 20 Consultant, Cancer Council ACT
- Peter Spolc, Consumer
- Nicole Taylor, Lung Cancer and Mesothelioma Cancer Specialist Nurse, Canberra Hospital, ACT
- Rosemary Taylor, Consumer
- A/Prof Gavin M Wright, Director of Surgical Oncology, St Vincent’s Hospital and Research and Education Lead – Lung Cancer, Victorian Comprehensive Cancer Centre, VIC.
What is lung cancer?
Lung cancer begins when abnormal cells grow and multiply in an uncontrolled way in one or both lungs.
Cancer that starts in the lungs is known as primary lung cancer. It can spread to other parts of the body such as the lymph nodes, brain, adrenal glands, liver and bones.
When cancer starts in another part of the body and spreads to the lungs, it is called secondary or metastatic cancer in the lung.
How common is lung cancer?
Each year, about 14,500 Australians are diagnosed with lung cancer. The average age at diagnosis is 72 years. It is the fifth most common cancer in Australia and accounts for 9% of all cancers diagnosed.
More men than women develop lung cancer, but since the early 1980s rates have been steadily decreasing among men and increasing among women.
More lung cancer statistics and trends
The lungs
The lungs are two 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 two lobes, and the right lung has three 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 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 two 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 two layers; there is no space between the layers when the lungs are healthy.
How breathing works
When you breathe in (inhale), air goes into the nose or mouth, down the trachea and into the bronchi and bronchioles. At the end of the bronchioles, tiny air sacs called alveoli are surrounded by small blood vessels (capillaries).
When the inhaled air reaches the alveoli, oxygen passes into the blood in the capillaries, and waste gas (carbon dioxide) passes out. When you breathe out (exhale), carbon dioxide is removed from the body and released into the air.
Your guide to best cancer care
A lot can happen in a hurry when you’re diagnosed with cancer. The g uide to best cancer care for lung cancer can help you make sense of what should happen.
It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.
Read the guide
Types of lung cancer
There are two main types of primary lung cancer: non-small cell lung cancer and small cell lung cancer.
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, may also affect the lungs but are not considered lung cancer.
Non-small cell lung cancer (NSCLC)
NSCLC makes up about 85% of lung cancers. It may be classified as:
- adenocarcinoma – begins in mucus-producing cells, more often found in the outer part of the lungs.
- squamous cell carcinoma – begins in thin, flat cells, most often found in the larger airways.
- large cell undifferentiated carcinoma – the cancer cells are not clearly squamous or adenocarcinoma.
Small cell lung cancer (SCLC)
SCLC makes up about 15% of lung cancers. It tends to start in the middle of the lungs, and usually spreads more quickly than NSCLC.
Risk factors for lung cancer
A risk factor is anything that is known to increase a person’s chances of developing a certain condition, such as cancer. Not all causes of lung cancer are fully understood, and some people develop lung cancer without having any known risk factors.
It’s possible to avoid or reduce the impact of some risk factors. These are called modifiable risk factors. Other risk factors, such as having a family history of lung cancer, can’t be avoided. These are called non-modifiable risk factors.
Tobacco smoking
In Australia, about 85% of lung cancer cases in males and 70% in females are estimated to be a result of tobacco smoking.
The earlier a person starts smoking, the longer they smoke and the more cigarettes they smoke, the higher the risk of developing lung cancer.
About 15% of cases of lung cancer occur in men who have never smoked, and about 30% of cases occur in women who have never smoked.
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Environmental or work-related factors
- Second-hand smoking – Breathing in other people's tobacco smoke (passive or second-hand smoke) can cause lung cancer. Living with a smoker increases a non-smoker's risk by up to 30%.
- 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 across Australia since 2004, there is still asbestos in some older buildings and fences.
- Exposure to other elements – People exposed to radioactive gas (radon) in the workplace, such as uranium miners, have an increased risk of lung cancer. Air pollution, contact with the processing of arsenic, cadmium, steel and nickel, and exposure to diesel in the workplace may also be risk factors.
- Family history – You may be at a higher risk if a family member has been diagnosed with lung cancer.
- Personal history – Having another lung disease (e.g. lung fibrosis, chronic bronchitis, pulmonary tuberculosis, emphysema) or HIV may increase the risk of lung tumours.
- Older age – Lung cancer is most commonly diagnosed over the age of 60 years, though it can occur in younger people.
Lung cancer symptoms
The main symptoms of lung cancer are:
- a persistent new cough lasting more than three weeks or a change in a cough you've had for a long time
- breathlessness
- chest and/or shoulder pain
- a chest infection that lasts more than three weeks or that keeps coming back.
- coughing or spitting up blood.
Other symptoms include fatigue, weight loss, hoarse voice, wheezing, difficulty swallowing, abdominal or joint pain, and enlarged fingertips (finger clubbing). Having any one of these symptoms does not necessarily mean that you have lung cancer.
Some of these symptoms may be caused by other conditions or from the side effects of smoking. However, if you have symptoms, you should see your doctor without delay.
Lung cancer symptoms can be vague and the disease is often discovered when it has spread to other parts of the body. Sometimes, there are no symptoms and the cancer is found during routine tests (often an x-ray or CT scan) for other conditions.
Contact cancer support
When you call the Cancer Council support line on 13 11 20, you’ll talk to a cancer nurse and get the support you need.
It’s free, confidential, and available for anyone affected by cancer who has a question – those diagnosed as well as their family, friends, and carers.
Get support
Health professionals you will see
Your general practitioner (GP) will organise the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a respiratory physician, who will arrange further tests.
If lung cancer is diagnosed, the specialist will consider treatment options. Often these will be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting.
During and after treatment you will see a range of health professionals, which may include a thoracic surgeon, medical oncologist, dietician and psychologist, who specialise in different aspects of your care.
The health professionals you see will depend on whether the lung cancer has spread.
Find support services in your area