Squamous cell lung cancer: symptoms, diagnosis and treatment in the UK

Lung cancers are divided into two main groups: small cell lung cancer and non small cell lung cancer. Cancer Research UK says the most common is non small cell lung cancer, which makes up around 80 to 85 out of 100 lung cancers. Squamous cell cancer is one of its two main types, the other being non squamous cell cancer, which includes adenocarcinoma and large cell carcinoma.

Squamous cell lung cancer arises from the flat cells that cover the surface of the airways. Cancer Research UK says it tends to grow near the centre of the lung, which can mean it affects the larger airways. The type is established under the microscope from a tissue sample, which is why a biopsy matters so much in the diagnostic pathway.

Cancer Research UK also notes that if the cells look very undeveloped under the microscope, doctors may not be able to tell the type and may use other tests to learn more from the sample.

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 one that is not getting better, losing weight without trying, loss of appetite 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 (clubbing).

The NHS stresses that many of these symptoms are common and can be caused by other conditions, and that having them does not definitely mean lung cancer. It also says that if symptoms are caused by cancer, finding it early may make it easier to treat.

• See a GP if you have had a cough for longer than 3 weeks, or any other symptom of lung cancer (NHS).

• Ask for an urgent GP appointment or get help from NHS 111 if you have coughed up blood (NHS).

• Call 999 or go to A&E if you are struggling to breathe, or have pain in your chest or upper back (NHS).

The NHS says it is not always known what causes lung cancer, but that lifestyle, genetic changes and environmental factors can all play a part. It lists smoking, long-term exposure to other people's smoke, chronic obstructive pulmonary disease (COPD), a close relative with lung cancer, working in the building industry with possible asbestos exposure, long-term exposure to air pollution and long-term exposure to radon as factors that can raise the chance.

To lower the risk the NHS suggests quitting smoking, staying active and eating a healthy diet including at least 5 portions of fruit and vegetables a day.

At a GP appointment the NHS says the doctor will ask about your symptoms, general health, medical history and family history, may listen to your chest, and may ask for a blood test or a chest X-ray. If the GP thinks symptoms could be cancer you may be urgently referred for more tests, which does not definitely mean you have cancer.

The main tests the NHS describes are a CT scan and a bronchoscopy, where a thin flexible tube with a camera is passed down the throat into the lungs. If lung cancer is confirmed you may need an MRI, PET scan, biopsy, blood tests and genetic testing. These results show the type of cancer, how far it has spread and whether certain gene changes are present, which helps the specialist team decide what treatment you need.

Cancer Research UK says doctors use staging systems to describe how big the cancer is and whether it has spread, and that the type and stage together with your general health shape the treatment plan.

The NHS says the treatment you have depends on the size and position of the cancer, 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 surgery, chemotherapy, radiotherapy and targeted medicines.

Surgery removes cancer from the lung and may involve removing part or all of a lung. Chemotherapy may be used if you cannot have surgery, if the cancer has spread, before surgery to try to shrink a tumour, or after surgery to stop the cancer coming back. Radiotherapy may be used if you cannot have surgery, after surgery, or if the cancer has spread. Targeted medicines or immunotherapy are sometimes used for advanced lung cancer that has spread. Cancer Research UK has separate pages on each of these.

If the cancer cannot be cured, the NHS says the aim of treatment is to slow its growth and spread, help with symptoms and help you live longer, and a palliative care or symptom control team will help manage symptoms and support you and your family.

The NHS says being told you have lung cancer can feel overwhelming, and that a team of specialists, including a clinical nurse specialist who is your main point of contact, will help you through diagnosis and treatment. Macmillan Cancer Support, the Roy Castle Lung Cancer Foundation and Marie Curie are named by the NHS as sources of help and support. Ask your team about practical help too, such as support with symptoms, breathlessness and emotional wellbeing.

On the NHS the route usually runs from the GP to an urgent referral, scans and a bronchoscopy or biopsy, then a lung cancer multidisciplinary team that agrees the plan. Some people also see a private respiratory physician or oncologist for speed or a second opinion. Whichever route is used, the type, stage and genetic results should be shared between teams so that treatment decisions are made with the full picture.