Lung cancer: symptoms, causes, tests and treatment

The NHS says you may not notice any symptoms in the early stages of lung cancer. When symptoms do occur, the common ones are listed below, followed by less common symptoms.

• A cough that is not going away.

• Shortness of breath.

• Coughing up blood.

• Chest or shoulder pain.

• Often having chest infections, or a chest infection that is not getting better.

• Losing weight without trying, not feeling hungry, and feeling tired all the time.

• Less commonly: swelling of the face or neck, difficulty swallowing, a hoarse voice that does not go away, and changes in the way your fingers look (clubbing), where fingertips may look wider than usual or curve downwards.

Some of these symptoms are very common and can be caused by other conditions. The NHS says having them does not definitely mean you have lung cancer, but it is important to get checked, because finding it early may mean it is easier to treat.

• See a GP if you have had a cough for longer than 3 weeks or have any other symptoms of lung cancer.

• 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.

• Call 999 or go to A&E if you are struggling to breathe, to the point of choking, gasping and unable to speak, or you have pain in your chest or upper back. The NHS says not to drive yourself.

Lung cancer is cancer that starts in the lung. Cancer Research UK calls this primary lung cancer, as opposed to secondary lung cancer, which is cancer that has spread to the lungs from somewhere else in the body. How serious lung cancer is depends on how big it is, whether it has spread and your general health, according to the NHS.

The type tells you which kind of cell the cancer started in, and helps doctors decide which treatment you need.

The NHS says it is not always known what causes lung cancer, but it can be caused by lifestyle, genetic changes and environmental factors, and having certain health conditions can make you more likely to get it.

• Smoking.

• Breathing in other people's smoke over a long period of time (passive smoking).

• Having chronic obstructive pulmonary disease (COPD).

• Having a close relative who has had lung cancer.

• Working or having worked in the building industry and breathing in asbestos fibres over a long period.

• Breathing in air pollution over a long period.

• Breathing in radon, a natural gas that is sometimes found at high levels inside buildings in some areas of the UK.

The NHS says the doctor will ask about your symptoms, general health, medical history and whether anyone in your family has had lung cancer. They may listen to your chest, and you may be asked to have a blood test or a chest X-ray. If they think your symptoms could be cancer you may get an urgent referral to a specialist, which does not definitely mean you have cancer.

The main tests the specialist uses are a CT scan and a bronchoscopy, where a thin, flexible tube with a small camera is passed down your throat and into your lungs. You may get some results the same day or after a few days or weeks.

If cancer is found, further tests may include an MRI scan, a PET scan, a biopsy, blood tests and genetic testing. The NHS says these show what type of cancer you have, how far it has spread and whether it is linked to certain gene changes, which helps your specialist team decide treatment.

The NHS says the treatment you have depends on the size of the cancer and where it is, the type of lung cancer, whether it has spread, whether it has certain genetic changes, your general health and which options you decide are right for you. You may be offered a combination of treatments.

The NHS says advanced lung cancer may be hard to treat and not possible to cure. The aim of treatment is then to slow down the growth and spread of the cancer, to help with symptoms and to help you live longer. You will be referred to a symptom control or palliative care team, who can also help you and your loved ones get other support.

You will be helped through diagnosis and treatment by a team of specialists that includes a clinical nurse specialist, who is your main point of contact. Macmillan Cancer Support runs a free helpline open every day from 8am to 8pm.

The NHS says that if you are aged between 55 and 74 and have ever smoked, you may be given the opportunity to take part in lung cancer screening with a lung health check. Lung health checks are currently only available in some parts of England as targeted screening is being rolled out.

At a lung health check a health professional asks about your breathing, lifestyle, and family and medical history. Depending on the result you may need no further action, be referred to your GP, or be offered a CT scan of your lungs. The NHS says you will get a letter with your results within 4 weeks of the CT scan.

The NHS says not to wait for a lung health check if you have symptoms such as a cough that does not go away after 3 weeks, a cough that changes or gets worse, repeated chest infections, coughing up blood or being short of breath a lot.

The NHS says you can lower your chances of lung cancer by quitting smoking, staying active and exercising regularly, and eating a healthy diet that includes at least 5 portions of fruit and vegetables a day. It adds that you should get any symptoms checked by a GP even if you do not think you fit a higher-risk group.

On the NHS, suspected lung cancer is usually assessed by a GP, who can arrange a chest X-ray and make an urgent referral to a specialist team for CT scanning and bronchoscopy. Treatment is planned by a multidisciplinary team, and a clinical nurse specialist is your main contact.

Private chest physicians, imaging services and cancer centres can offer scans and consultations, sometimes with shorter waits. If you use them, ask how results will be shared with your GP and whether your case will be reviewed by a multidisciplinary team, because treatment decisions for lung cancer are normally made that way.