Lung Cancer

Specialist technicians and doctors look at your sample under a microscope. They can identify and count different types of blood cells. Note, there is no blood test to diagnose lung cancer.

These are breathing tests.  You blow into a mouthpiece to check how well your lungs work.

[Read more about these tests]

This is a type of X-ray that gives a detailed picture of the lung.

[Read more about CT scans]

This is a type of X-ray that gives a detailed picture of the lung.

A type of bronchoscopy that uses an ultrasound probe to look at the lungs and surrounding lymph nodes. Biopsy (tissue) samples from the lung or lymph nodes can be taken by passing a needle through the tube. This is called a transbronchial needle aspiration (TBNA).

[Read more about this type of test here]

During a bronchoscopy, EBUS or CT scan, your doctor can take small amounts of tissue samples from your lung. These are called biopsies. Biopsies are sent to a laboratory and looked at under a microscope. These biopsies will be examined to see if there are any gene mutations or proteins on the cancer that specific treatments can target.

Results of all these tests are usually available within a month. The clinic will contact you to come back to the clinic for your results.

Most lung cancers are this type. 

There are 4 main types of NSCLC: 

• Adenocarcinoma: This is the most common type of lung cancer and is often found in the mucous glands that line the airways. 
• Squamous cell carcinoma: This type of cancer is found in squamous cells, which are flat cells that line the inside of the airways in your lungs. 
• Large cell carcinoma: This cancer may appear in any part of your lung. The cells are large and round when viewed under the microscope. 
• Not otherwise specified (NOS): This is when the doctors cannot be sure which type of non-small cell lung cancer it is.

Some NSCLC cancers have genetic changes (mutations), which are not inherited. When these mutations occur in cells in the lungs, they affect the normal activity of the gene, and lung cancer can develop. Mutations in the EGFR, KRAS, ROS1 and ALK genes can happen in lung cancers – particularly in adenocarcinomas and in patients who have had little or no exposure to smoking.

About 1 in 7 of all lung cancers is the small cell type. 

Small cell lung cancer begins in cells around the bronchi (airways) called neuroendocrine cells (NETs). SCLC cells appear small and round when looked at under a microscope and tend to grow quickly. 

SCLC is an aggressive cancer with the potential to grow and spread rapidly. It often spread to lymph nodes and other areas such as your bones, brain, adrenal glands and liver

This rare cancer affects the protective linings that cover your lungs. Usually it happens when someone is exposed to a chemical called asbestos.

[Read more about Mesothelioma]

The staging system normally used  is called TNM. This stands for:

Tumour (T)
Describes the tumour size and where it is located in the lungs.

Node (N)
Whether there is cancer in the lymph nodes: 

• N0: No lymph nodes are affected. 

• N1: Some lymph nodes near where the airways join the lungs are affected. 

• N2: Some lymph nodes in the centre of the chest or where the trachea enters the lung are affected. 

• N3: Some lymph nodes on the opposite side of your chest to where the tumour is, or near your collarbone, are affected 

Metastasis (M)

Whether the cancer has spread to other parts of the body: 

• M0: The cancer has not spread. 

• M1: The cancer has spread.

Your doctor often uses this information to give your cancer a number stage – from 1 to 4.

In general, the lower the number, the less the cancer has spread.

What are the stages of lung cancer?

Stage 1
The cancer is inside the lung (localised) and has not spread to nearby lymph nodes. 

Stage 2 and 3
The cancer may be larger and may affect the nearby lymph nodes or surrounding tissue.

Stage 4
The cancer has spread to a distant part of the body such as the liver, bones or the brain.

More and more doctors are using the TNM and number staging system to stage small cell lung cancer. However, some will describe your cancer as a limited stage disease or extensive stage disease.

• Limited stage: This usually means the cancer is in one lung and may be in nearby lymph nodes.
• Extensive stage: This means the cancer may have spread to the other lung, to more distant lymph nodes or to other parts of your body.