Lung adenocarcinoma: symptoms, diagnosis and treatment

Cancer Research UK explains that primary lung cancer is divided into two main groups: small cell lung cancer and non-small cell lung cancer, with non-small cell lung cancer accounting for around 80 to 85% of cases. The two main types of non-small cell cancer are squamous cell cancer and non-squamous cell cancer, and adenocarcinoma is the most common non-squamous type, along with large cell carcinoma.

Adenocarcinoma starts in the mucus-making gland cells in the lining of the airways. Knowing the type of cell the cancer began in helps doctors decide which treatment you need. In practice the diagnosis is made by examining a sample of tissue under the microscope, and sometimes extra tests are used to find out more about the cells.

The NHS lists common symptoms of lung cancer as a cough that is not going away, shortness of breath, coughing up blood, chest or shoulder pain, often having chest infections or an infection that is not getting better, losing weight without trying, not feeling hungry and feeling tired all the time. Less common symptoms include swelling of the face or neck, difficulty swallowing, a hoarse voice that does not go away and changes in the way the fingers look, known as clubbing.

It stresses that some of these symptoms are very common and can be caused by other conditions, so having them does not definitely mean you have lung cancer, but it is important to get checked. Finding it early may make it easier to treat.

The NHS advises seeing a GP if you have had a cough for longer than 3 weeks or have any other symptoms of lung cancer. It says to ask for an urgent GP appointment or get help from NHS 111 if you have coughed up blood or noticed blood on a tissue you have coughed into.

It advises calling 999 or going to A&E if you are struggling to breathe, choking, gasping and unable to speak, or have pain in your chest or upper back. At the GP appointment the doctor asks about symptoms, health and family history, may listen to your chest and may arrange a blood test or chest X-ray, with an urgent referral to a specialist if cancer is possible.

According to the NHS, treatment depends on the size of the cancer and where it is, the type of lung cancer, whether it has spread, whether the cancer has certain genetic changes, your general health and which options you decide are right for you. You may be offered a combination of surgery, chemotherapy, radiotherapy and targeted medicines.

Surgery removes cancer from the lung, sometimes with part or all of the lung. Chemotherapy may be given if surgery is not possible, if cancer has spread, before surgery to shrink the tumour or after it to stop the cancer coming back. Radiotherapy can be used in similar circumstances. Targeted medicines and immunotherapy are sometimes used to treat advanced lung cancer that has spread.

The mention of genetic changes matters especially for adenocarcinoma, because tests on tumour samples can identify features that determine whether a targeted medicine is suitable. Your specialist team will explain which tests apply to you.

The NHS says if you have been diagnosed with advanced lung cancer it may be hard to treat and not possible to cure, in which case the aim of treatment is to slow down the growth and spread of the cancer, help with symptoms and help you live longer. You are referred to a symptom control or palliative care team, who help you manage symptoms and make you feel more comfortable and can support your loved ones.

Cancer Research UK points to support from your clinical nurse specialist, cancer charities, community services and family and friends during and after treatment.