Lung cancer is one of the most common and serious types of cancer.

Symptoms of lung cancer include:

• coughing
• unexplained weight loss
• shortness of breath
• chest pain

Read more about the symptoms of lung cancer.

The lungs

The lungs have two main purposes:

• to transfer oxygen into the blood when you breathe in
• to expel carbon dioxide out of the blood when you breathe out

The lungs are made up of a series of sections called lobes. The left lung consists of two lobes. The right lung is larger and consists of three lobes.

Types of lung cancer

Cancer that begins in the lungs is called primary lung cancer. Cancer that begins in another part of the body and spreads to the lungs is known as secondary lung cancer. This topic is about primary lung cancer.

There are two main types of primary lung cancer. These are classified by the type of cells in which the cancer starts. They are:

• non-small cell lung cancer (of which there are three different types, called squamous cell carcinoma, adenocarcinoma and large cell carcinoma)
• small cell lung cancer

Non-small cell lung cancer

Non-small cell lung cancer is the most common type of lung cancer, accounting for around 88% of all cases.

Small cell lung cancer

Small cell lung cancer accounts for around 12% of all cases. Small cell lung cancer is more aggressive than non-small cell lung cancer, and it usually spreads faster.

How common is lung cancer?

Lung cancer is the second most common cancer (after breast cancer) in England and Wales. An estimated 40,800 new cases are diagnosed every year.

Lung cancer mainly affects older people. It is rare in people under 40 years old, but the rates of lung cancer rise sharply with age. Lung cancer is most commonly diagnosed in people who are 70–74 years old.

Smoking causes 85–90% of lung cancers. People who smoke are 15 times more likely to die from lung cancer than people who have never smoked. 

Read more about the causes of lung cancer.

Outlook

Lung cancer does not usually cause noticeable symptoms until it has spread through much of the lungs or into other parts of the body. This is known as advanced or metastatic lung cancer. This means that the outlook for lung cancer is poor compared with other types of cancer.

Only 27% of men and 30% of women with lung cancer will survive for at least a year after being diagnosed. Just 7% of men and 9% of women will survive for at least five years.

However, survival rates can vary widely depending on how far the cancer has spread (the stage of the cancer) at the time of the diagnosis. Early diagnosis can make a big difference.

Read more about diagnosing lung cancer.

Lung cancer is usually treated with a combination of chemotherapy, radiotherapy and surgery.

Read more about the treating lung cancer.

There are usually no signs or symptoms in the early stages of lung cancer. However, symptoms develop as the disease progresses.

The main symptoms of lung cancer are listed below. If you have any of these, you must see your GP:

• a cough that doesn’t go away after two to three weeks
• a long-standing cough that gets worse
• persistent chest infections
• coughing up blood
• unexplained persistent breathlessness
• unexplained persistent tiredness or lack of energy
• unexplained persistent weight loss
• persistent chest or shoulder pain

Less common symptoms of lung cancer include:

• changes in the appearance of your fingers, such as becoming more curved or their ends becoming larger (this is known as finger clubbing)
• a high temperature (fever) of 38C (100.4F) or above 
• difficulty swallowing or pain when swallowing
• wheezing
• a hoarse voice 
• swelling of your face

Want to know more?

• Cancer Research UK: symptoms of lung cancer
• Macmillan: symptoms of lung cancer

Smoking

Smoking cigarettes is the single biggest risk factor for lung cancer. It is responsible for about 90% of all cases.

Tobacco smoke contains more than 60 different toxic substances, which can lead to the development of cancer. These substances are known to be carcinogenic (cancer-producing).

If you smoke more than 25 cigarettes a day, you are 25 times more likely to get lung cancer than a non-smoker.

While smoking cigarettes is the biggest risk factor, using other types of tobacco products can also increase your risk of developing lung cancer and other types of cancer, such as oesophageal cancer and mouth cancer. These products include:

• cigars 
• pipe tobacco 
• snuff (a powdered form of tobacco) 
• chewing tobacco

Smoking cannabis has also been linked to an increased risk of lung cancer. Most cannabis smokers mix their cannabis with tobacco. While they tend to smoke less than tobacco smokers, they usually inhale more deeply and hold the smoke in their lungs for longer.

One researcher has estimated that smoking four joints (homemade cigarettes mixed with cannabis) may be as damaging to the lungs as smoking 20 cigarettes.

Even smoking cannabis without mixing it with tobacco is potentially dangerous. This is because cannabis also contains substances that can cause cancer.

Passive smoking

Even if you do not smoke, frequent exposure to other people’s tobacco smoke (passive smoking) can increase your risk of developing lung cancer.
For example, research has found that non-smoking women who share their house with a smoking partner are 25% more likely to develop lung cancer than non-smoking women who live with a non-smoking partner.

Radon

Radon is a naturally occurring radioactive gas that can seep up from the ground into buildings. If radon is breathed in, it can damage your lungs, particularly if you are a smoker. Radon is estimated to be responsible for about 3% of all lung cancer deaths in England.

Occupational exposure

Exposure to certain chemicals and substances that are used in several occupations and industries has been linked to a slightly higher risk of developing lung cancer. These chemicals and substances include arsenic, asbestos, beryllium, cadmium, coal and coke fumes, silica and nickel.

Want to know more?

• Cancer Research UK: smoking and lung cancer
• Macmillan: causes and risk factors for lung cancer

If you have symptoms such as breathing difficulties and a persistent, long-term cough, your GP will carry out some routine tests to rule out possible causes other than lung cancer, such as a chest infection.

 Two tests that you are likely to have are:

• a blood test 
• a urine test

If you have been coughing up blood, you should be referred directly for a chest X-ray.

Chest X-ray

A chest X-ray is usually the first test that is used to diagnose lung cancer. Most lung tumours show up on X-rays as a white-grey mass.

However, chest X-rays cannot give a definitive diagnosis because they often cannot distinguish between cancer and other conditions, such as a lung abscess (a collection of pus that forms in the lungs).

You will have more tests to investigate whether it is lung cancer and, if it is, how big it is and how much it has spread.

CT scan

A computerised tomography (CT) scan is usually carried out after a chest X-ray.

Before having a CT scan, you will be given a drink or injected with a slightly radioactive dye. The dye makes the lungs show up more clearly on the scan. The scan is painless and takes 10–30 minutes to complete.

PET-CT scan

A PET-CT scan (which stands for positron emission tomography-computerised tomography) may be carried out if the results of the CT scan show that you have cancer at an early stage.

The PET-CT scan can show where there are active cancer cells. This can help with diagnosis and treatment.

As with a CT scan, before having a PET-CT scan, you will be injected with a slightly radioactive material. You will be asked to lie down on a table, which will be pushed into the PET scanner. The scan is painless and takes around 30 minutes to complete.  

Bronchoscopy and biopsy

If the CT scan shows that there might be cancer in the central part of your chest, you will have a bronchoscopy. A bronchoscopy is a procedure that allows a doctor or nurse to take some cells from inside your lungs.

During a bronchoscopy, a thin tube called a bronchoscope is used to examine your lungs and take a sample of cells (biopsy). The bronchoscope is passed through either your mouth or nose, down through your throat and into the airways of your lungs.

The procedure may be uncomfortable, but you will be given a mild sedative before to help you relax and a local anaesthetic to make your throat numb. The procedure is very quick and only takes a few minutes.

Sputum cytology

If for some reason you cannot have a bronchoscopy, you may have sputum cytology instead. This involves taking a sample of your phlegm. This will then be checked for the presence of cancer under a microscope.

Percutaneous needle biopsy

A percutaneous needle biopsy involves removing a sample from a suspected tumour to test it at a laboratory for cancerous cells.

The doctor carrying out the biopsy will use a CT scanner to guide a needle to the site of a suspected tumour through the skin. A local anaesthetic is used to numb the surrounding skin, and the needle is passed through your skin and into your lungs. The needle will then be used to remove a sample of tissue for testing.

Thoracoscopy

A thoracoscopy is a procedure that allows the doctor to examine a particular area of your chest and take tissue and fluid samples.

You are likely to need a general anaesthetic before having a thoracoscopy. Two or three small cuts will be made in your chest to pass a tube (similar to a bronchoscope) into your chest. The doctor will use the tube to look inside your chest and take samples. The samples will then be sent away for tests.

After a thoracoscopy, you may need to stay in hospital overnight while any further fluid in your lungs is drained out.

Mediastinoscopy

A mediastinoscopy allows the doctor to examine the area between your lungs at the centre of your chest (mediastinum).

For this test, you will need to have a general anaesthetic and stay in hospital for a couple of days. The doctor will make a small cut at the bottom of your neck so that they can pass a thin tube into your chest.

The tube has a camera at the end, which enables the doctor to see inside your chest. They will also be able to take samples of your cells and lymph nodes at the same time. The lymph nodes are tested because they are usually the first place that lung cancer spreads to.

Want to know more?

• Macmillan: how lung cancer is diagnosed
• Cancer Research UK: lung cancer tests

Staging

Once the above tests have been completed, it should be possible to work out what stage your cancer is, what this means for your treatment and whether it's possible to completely cure the cancer.

Non-small cell lung cancer

The stages of non-small lung cancer are outlined below.

Stage 1
The cancer is contained within the lung and has not spread to nearby lymph nodes. Stage 1 can also be divided into two sub-stages:

• stage 1A – the tumour is less than 3cm in size (1.1 inches) 
• stage 1B – the tumour is 3–5cm (1.1–2 inches)

Stage 2
Stage 2 is divided into two sub-stages: 2A and 2B.

In stage 2A lung cancer:

• the tumour is 5–7cm 
• the cancer is less than 5cm and cancerous cells have spread to nearby lymph nodes

In stage 2B lung cancer:

• the tumour is larger than 7cm 
• the tumour is 5–7cm and cancerous cells have spread to nearby lymph nodes 
• the cancer has not spread to lymph nodes but has spread to surrounding  muscles or tissue 
• the cancer has spread to one of the main airways (bronchus) 
• the cancer has caused the lung to collapse 
• there are multiple small tumours in the lung

Stage 3
Stage 3 is divided into two sub-stages: 3A and 3B.

In stage 3A lung cancer, the cancer has either spread to the lymph nodes in the middle of the chest or into the surrounding tissue. This can be:

• the covering of the lung (the pleura) 
• the chest wall 
• the middle of the chest 
• other lymph nodes near the affected lung

In stage 3B lung cancer, the cancer has spread to either of the following:

• lymph nodes on either side of the chest,
  above the collarbones 
• another important part of the body, such as the gullet (oesophagus), windpipe (trachea), heart or into a main blood vessel

Stage 4
In stage 4 lung cancer, the cancer has spread to a remote part of the body, such as the bones, liver or brain.

Small cell lung cancer

Small cell lung cancer only has two possible stages:

• limited disease – the cancer has not spread beyond the lung 
• extensive disease – the cancer has spread beyond the lung 

Biopsy

A biopsy is a test that involves taking a small sample of tissue from the body so it can be examined.

Lymph nodes

Lymph nodes are small oval tissues that remove unwanted bacteria and particles from the body. They are part of the immune system.

Cancer treatment team

Your treatment for lung cancer should be overseen by a group of specialists called a multi-disciplinary team (MDT). This team will contain all the specialists required to make a proper diagnosis, to stage your cancer and plan the best treatment. If you want to know more, ask your specialist about this.

The type of treatment you will receive for lung cancer depends on several factors, including:

• the type of lung cancer you have (non-small cell or small cell) 
• the size and position of the cancer 
• how far advanced your cancer is (the stage) 
• your overall health

Deciding what treatment is best for you can be difficult. Your cancer team will make recommendations, but the final decision will be yours.

Treatment options include:

• surgery
• radiotherapy
• chemotherapy

Depending on your type of cancer and how advanced it is, you may receive a combination of these treatments.

Your treatment plan

Non-small cell and small cell lung cancers are treated differently.

Non-small cell lung cancer

Non-small cell lung cancer may be treated using surgery, chemotherapy and radiotherapy.

Small tumours (stages 1 or 2) can often be removed with surgery. You may have chemotherapy after your surgery to reduce the chances of the cancer returning. If you're not fit enough for surgery, radiotherapy may be used as an alternative. 

Larger tumours (stage 3) may also be suitable for surgery. If so, you may have chemotherapy and/or radiotherapy before or after your surgery. However, if the tumour is too large to be removed, surgery won't be performed, and radiotherapy and/or chemotherapy will be used. If the cancer has spread to other parts of the lung or elsewhere in your body (stage 4), chemotherapy or radiotherapy will be used to try and shrink the tumour.

A new group of drugs is emerging, which work in a different way to chemotherapy. They are given in tablet form, and are known as "targeted agents" because they block certain processes in the cancer cells. These include erlotinib and gefitinib. Your doctor may send off your tumour biopsy to see if targeted drugs are likely to be successful in your case.

Small cell lung cancer

Small cell lung cancer is usually treated with chemotherapy, either on its own or in combination with radiotherapy. This often prolongs life and relieves symptoms.

Surgery isn't usually used to treat this type of lung cancer. This is because often the cancer has already spread to other areas of the body by the time it's diagnosed. However, if the cancer is found very early, surgery may be used. If so, chemotherapy or radiotherapy may be given after surgery to help reduce the risk of the cancer returning.

Surgery

There are three types of lung cancer surgery:

• Lobectomy – one or, in the case of the right lung, two lobes are removed. Your doctors will suggest this operation if the cancer is just in one part of one lung. 
• Pneumonectomy – the entire lung is removed. This is used when the cancer is located in the middle of the lung or has spread throughout the lung.
• Wedge resection or segmentectomy – a small piece of the lung is removed. This procedure is used only if your doctors think that your cancer is small and limited to one area of the lung. This is usually very early-stage non-small cell lung cancer. This operation is only suitable for a small number of patients.

People are naturally concerned that they will not be able to breathe if some or all of a lung is removed. But it is possible to breathe normally with one lung. However, if you have breathing problems before the operation, such as breathlessness, it is likely that these symptoms will continue after surgery.

Before surgery can take place, you will need to have a number of tests to check your general state of health and your lung function. These tests may include:

• An electrocardiograph (ECG) – electrodes are used to monitor the electrical activity of your heart. 
• Spirometry – you will breathe into a machine called a siprometer, which measures how much air your lungs can breathe in and out.

Surgery is usually performed by making an incision (cut) in your chest or side, and removing a section or all of the affected lung. Nearby lymph nodes may also be removed if it is thought that the cancer may have spread to them.

In some cases, an alternative to this approach, called video-assisted thoracoscopic surgery (VATS), may be suitable. VATS is a type of keyhole surgery, where small incisions are made in the chest. A small fibre-optic camera is inserted into one of the incisions. This then transmits images of the inside of your chest to a monitor.

You will probably be ready to go home 5–10 days after your operation. However, it can take many weeks to recover fully from a lung operation. After your operation, you will be encouraged to start moving about as soon as possible. Even if you have to stay in bed, you will need to keep doing regular leg movements to help your circulation and prevent blood clots from forming. A physiotherapist will show you breathing exercises to help prevent complications.

When you go home, you will need to exercise gently to build up your strength and fitness. Walking and swimming are good forms of exercise that are suitable for most people after treatment for lung cancer. Talk to your care team about which types of exercise are suitable for you.

As with all surgery, lung surgery carries a risk of complications. These are estimated to occur in one out of every five cases. These complications can usually be treated using medication or additional surgery. This might mean that you have to stay longer in hospital.

Complications of lung surgery can include:

• inflammation or infection of the lung (pneumonia) 
• excessive bleeding 
• a leak of air from the lung wall 
• a blood clot in the leg (deep vein thrombosis), which could potentially travel up to the lung (pulmonary embolism)

Chemotherapy

Chemotherapy uses powerful cancer-killing medication to treat cancer. There are several different ways that chemotherapy can be used to treat lung cancer. For example, it can be:

• given before surgery to shrink a tumour, which can increase the chance of successful surgery 
• given after surgery to prevent the cancer returning 
• used to relieve symptoms and slow the spread of cancer when a cure is not possible 
• combined with radiotherapy (chemoradiation), which can be given before and after surgery or to relieve symptoms

Chemotherapy treatments are usually given in cycles. A cycle involves taking the chemotherapy medication for several days, then having a break for a few weeks to let your body recover from the effects of the treatment.

The number of cycles of chemotherapy that you need will depend on the type and the grade of your lung cancer. Most people require 4–6 courses of treatment over 3–6 months.

Chemotherapy for lung cancer involves taking a combination of different medications. The medications are usually delivered through a drip into your vein, or into a tube that is connected to one of the blood vessels in your chest.

Side effects of chemotherapy can include:

• fatigue 
• nausea
• vomiting 
• mouth ulcers
• hair loss

These side effects should gradually pass once your treatment has finished, or you may be able to take other medicines to make you feel better during your chemotherapy.

Chemotherapy can also weaken your immune system, making you more vulnerable to infection. Tell your care team or GP as soon as possible if you have the possible signs of an infection, such as:

• a high temperature (fever) of 38C (100.4F) or higher 
• suddenly feeling generally unwell

Targeted agents

Several newer therapies for lung cancer have recently been approved for use in non-small cell lung cancer. These include growth factor inhibitors called erlotinib and gefitinib. These therapies work by disrupting the growth of the cancer cells. However, they are only suitable for certain people. Your doctor may be able to request tests on your biopsy samples to determine whether targeted agents are likely to be suitable for you.

Radiotherapy

Radiotherapy is a type of treatment that uses pulses of radiation to destroy cancer cells.

Radiotherapy can be used after surgery to treat lung cancer, or it can be used to control the symptoms and slow the spread of cancer when a cure is not possible (this is known as palliative radiotherapy).

A more intensive course of radiotherapy, known as radical radiotherapy, can be used to try to cure non-small cell lung cancer if the person is not healthy enough to have surgery.

A type of radiotherapy known as prophylactic cranial irradiation (PCI) is also used to treat small cell lung cancer. PCI involves directing high-energy pulses at your brain.

It is used as a preventative measure because there is a risk that small cell lung cancer will spread to your brain.

The two ways that radiotherapy can be given are described below.

• External beam radiotherapy – a machine is used to beam high-energy pulses of radiation at affected parts of your body. 
• Internal radiotherapy – a catheter (thin tube) is inserted down a bronchoscope and into your lung. A small piece of radioactive material is placed inside the catheter and positioned against the site of the tumour before being removed after a few minutes. This is often used if the cancer is blocking or partly blocking your airway.

A course of radiotherapy treatment can be planned in several different ways.

Radical radiotherapy is usually given five days a week, with a break at weekends. Each session of radiotherapy lasts 10–15 minutes. The course of radiotherapy usually lasts 3–7 weeks.

Continuous hyperfractionated accelerated radiotherapy (CHART) is an alternative method of delivering radical radiotherapy. CHART is given three times a day for 14 days in a row.

Palliative radiotherapy usually only requires one or two sessions to control your symptoms.

Side effects of radiotherapy include:

• chest pain 
• fatigue 
• persistent cough that may bring up blood-stained phlegm (this is normal and nothing to worry about) 
• difficulties swallowing (dysphagia) 
• redness and soreness of the skin, which looks and feels like sunburn 
• hair loss, which can occur on your chest and, if you are receiving PCI, on your head

Side effects should pass once the course of radiotherapy has been completed.

Radiofrequency ablation

Radiofrequency ablation is a new type of treatment that can treat stage 1 non-small cell lung cancer.

The doctor carrying out the treatment will use a CT scanner to guide a needle to the site of the tumour. The needle will be pressed into the tumour and radiowaves will be sent through the needle. These waves generate heat, which kills the cancer cells.

The most common complication of radiofrequency ablation is that a pocket of air gets trapped between the inner and outer layer of your lungs (pneumothorax). This can be treated by placing a tube into the lungs to drain away the trapped air.

Cryotherapy

Cryotherapy is a treatment that can be used if the cancer starts to block your airways. This is known as endobronchial obstruction, and it can cause symptoms such as:

• breathing problems 
• cough
• coughing up blood

Cryotherapy is performed in a similar way to internal radiotherapy, except that instead of using a radioactive source, a device known as a cryoprobe is placed against the tumour. The cryoprobe can generate very cold temperatures, which help shrink the tumour.

Photodynamic therapy

Photodynamic therapy (PDT) is a treatment that can be used to treat early-stage lung cancer when a person is unable or unwilling to have surgery. It can also be used to remove a tumour that is blocking the airways.

Photodynamic therapy is carried out in two stages. Firstly, you will be given an injection of a medication that will make the cells in your body very sensitive to light.

The next stage is carried out 24–72 hours later. A bronchoscope will be guided to the site of the tumour, and a laser will be beamed through it. The cancerous cells, which are now sensitive to light, will be destroyed by the laser beam.

Side effects of photodynamic therapy include:

• inflammation of the airways 
• a build-up of fluid in the lungs

Both these side effects can cause symptoms of breathlessness and lung and throat pain. However, these symptoms should gradually pass as your lungs recover from the effects of the treatment.

Read more about photodynamic therapy.

Chemotherapy

Chemotherapy is a treatment of an illness or disease with a chemical substance, such as in the treatment of cancer.

Radiotherapy

Radiation therapy uses X-rays to treat disease, especially cancer.

Not smoking is the most effective way to avoid getting lung cancer.

Stop smoking

If you are a smoker, the best way to prevent lung cancer and other serious conditions is to stop smoking as soon as possible.

However long you have been smoking, it is always worth quitting. Every year that you do not smoke, your risk of getting serious illnesses, such as lung cancer, will decrease. After 10 years of not smoking, your chances of developing lung cancer falls to half that of a smoker.

NHS Smokefree can offer advice and encouragement to help you quit smoking. You can call them on 0800 0224 332 or visit their website.

Your GP or pharmacist can also give you help and advice about giving up smoking.

Diet

Research suggests that eating a low-fat, high-fibre diet, including at least five portions a day of fresh fruit and vegetables and plenty of whole grains, can help reduce your risk of lung cancer, as well as other types of cancer and heart disease.

Find out more information about diet and cancer.

Exercise

There is strong evidence to suggest that regular exercise can lower the risk of developing lung cancer and other types of cancer.

Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week.

Find out more information about health and fitness.

Breathlessness and other effects

Due to the effects of your lung cancer or its treatment, you may have problems with breathing.

If you've had surgery, the physiotherapist will show you breathing exercises to help you breathe more easily and prevent complications. Although breathlessness may be a sign that the cancer is spreading, there may be other causes.

Patients who've had lung cancer are more likely to get chest infections. Anxiety may also cause breathlessness, and relaxation exercises may help with this.

Sometimes, breathlessness may be due to a fluid build-up around the lungs (a pleural effusion). A pleural effusion occurs when cancer cells spread to the membranes around the lungs (the pleura), causing irritation and inflammation. This fluid then presses in on the lungs and makes it difficult to breathe.

Want to know more?

• Macmillan: managing breathlessness
• Cancer Research UK: coping with breathlessness
• The Roy Castle Lung Cancer Foundation: coping with breathlessness
• Macmillan: pleural effusion

Pain

Some people with lung cancer have pain, while others never have any. About one-third of people having cancer treatment experience some pain.

Pain isn't related to the severity of the cancer but varies from person to person. What causes cancer pain isn’t well understood, but there are ways of treating it so that the pain can be controlled.

Patients with advanced lung cancer may need treatment for pain as their cancer progresses. This can be part of palliative care (see below), and is often provided by doctors, nurses and other members of the palliative care team. You can have palliative care at home, in hospital, in a hospice or other care centre.

Want to know more?

• Macmillan: controlling cancer pain
• Macmillan: your pain management team

Emotional effects and relationships

Having cancer can lead to a range of emotions. These may include shock, anxiety, relief, sadness and depression.

People deal with serious problems in different ways. It's hard to predict how living with cancer will affect you.

Being open and honest about how you feel and what your family and friends can do to help you may put others at ease. But don't feel shy about telling people that you need some time to yourself, if that's what you need.

Want to know more?

• Macmillan: emotional effects

Talk to others

Your GP or specialist nurse may be able to reassure you if you have questions, or you may find it helpful to talk to a trained counsellor, psychologist or specialist phone helpline.

Your GP surgery will have information on these. You may find it helpful to talk about your experience of lung cancer with others in a similar position at a local support group. Patient organisations have local groups where you can meet other people who have been diagnosed with lung cancer and have had treatment.

If you have feelings of depression, talk to your GP. They can provide advice and support.

Want to know more?

• The Roy Castle Lung Cancer Foundation: lung cancer support groups
• Macmillan

Money and financial support

If you have to reduce or stop work because of cancer, you may find it hard to cope financially. If you have cancer or you are caring for someone with cancer, you may be entitled to financial support.

• If you have a job but cannot work because of your illness, you are entitled to Statutory Sick Pay from your employer. 
• If you do not have a job and cannot work because of your illness, you may be entitled to Employment and Support Allowance.
• If you are caring for someone with cancer, you may be entitled to Carer’s Allowance.  
• You may be eligible for other benefits if you have children living at home or you have a low household income.

It is a good idea to find out early on what help is available to you. You could ask to speak to the social worker at your hospital, who can give you the information you need.

Free prescriptions

People being treated for cancer are entitled to apply for an exemption certificate giving free prescriptions for all medication, including treatment for unrelated conditions.

The certificate is valid for five years and you can apply for a certificate by speaking to your GP or cancer specialist.

Want to know more?

• Directgov: ill or injured benefits
• Carers Direct: information, advice and support for carers
• Macmillan: financial issues
• Find your nearest Citizens Advice Bureau
• Cancer Research UK: free prescriptions for people with cancer
• News: Q&A on free prescriptions

Palliative care

If you have a lot of symptoms from your lung cancer, your GP and healthcare team will need to give you support and pain relief. This is called palliative care. Support is also available for your family and friends.

As your cancer progresses, your doctor should work with you to establish a clear management plan based on your (and your carer's) wishes. This will include whether you'd prefer to go to hospital, a hospice or be looked after at home as you become more ill. It will take account of what services are available to you locally, what is clinically advisable and your personal circumstances.

Want to know more?

• NICE: supportive and palliative care (PDF, 53Kb)
• Macmillan: caring for someone with cancer
• Marie Curie Cancer Care: support for patients
• End of life care

Pain and swelling in his knees prompted Peter Quinn, 42, to visit his GP. This led to a diagnosis of lung cancer in May 2006.

“My symptoms were quite unusual for lung cancer. It began with a swelling on my knee, so I went to my GP who X-rayed them. There was nothing structurally wrong, so he gave me some anti-inflammatory drugs.

"It didn’t seem to improve the situation. I have two small children, so I’m up and down on my knees quite a bit, and it was becoming quite painful.

"I went to see a rheumatologist, who gave me a complete examination and checked my knees and my fingers. She noticed that my hands had digital clubbing, which is a swelling of the ends of the fingers.

"As a precaution, she ordered a chest X-ray, because this condition could be a sign of chest problems, such as bronchitis. Fifteen minutes later she came back with the X-ray, which showed I had a huge shadow on my right lung.

"I was referred to a chest physician, who did some further tests. Those confirmed I had a syndrome called Hyper Pulmonary OsteoArthritis (HPOA), where the lining of the bones becomes thick. It's often associated with non-small cell lung cancer.

"Lung cancer is statistically associated with smoking, and 80% of cases are linked with smoking. I smoked 15 years ago but I hadn’t smoked for many years because of the children. I didn't fit the typical profile of a lung cancer sufferer who smokes 20 to 40 cigarettes a day.

"In the right lung you have three lobes. Surgeons cut a hole in my back and removed one of the lobes and basically joined it back together. They probably removed about a third of my right lung. But about four weeks after surgery, I was feeling better.

"I didn’t have any major side effects from chemotherapy, so I was quite fit and active. But radiotherapy made my oesophagus very inflamed and it was incredibly painful for me to swallow.

"One of the things that I found most helpful was the cancer nurse specialists. They’re available at many hospitals and act as a support and link between you and the medical machinery. They were excellent at being sympathetic, answering questions and giving helpful advice.

"I would suggest that anyone going through the same thing should use all of the available resources and try to find something positive to focus on."

Shirley Smith, 65, went to her GP surgery after she had an allergic reaction to a wasp sting. While she was there, she mentioned that two weeks earlier she had coughed up a spot of blood.

She was immediately sent for an X-ray. Within a week, she'd had a scan in hospital and been diagnosed with terminal lung cancer.

Shirley received chemotherapy and radiotherapy to treat her cancer. Three years later, she is in remission and living life to the full, playing an active role in the lives of her five grandchildren and enjoying days out in London. 

"Two weeks before I went to the doctor, I coughed up a little bit of blood," says Shirley, "but it didn't really worry me. I told my brother, who was with me at the time. He was startled, but neither of us thought about the prospect of cancer.   

"When the scan confirmed that I had terminal lung cancer, it was extremely shocking for me and my family. I don’t think I quite believed it.

"The Macmillan nurse, who was absolutely brilliant, came to see me immediately after the diagnosis. She explained that I may only have 18 months to three years to live.

"Obviously, when I told my family there were tears and hugs, but they were extremely supportive."

Shirley began a course of chemotherapy followed by 10 days of radiotherapy.

"Before the chemotherapy, I got my hairdresser, who is also my next door neighbour, to shave my head. I knew I would feel more distressed waking up with clumps of hair on the pillow than by the treatment itself. I then had radiotherapy targeted at my brain, because there was a worry that the cancer could spread there. I didn’t have any problems at all with the chemotherapy or radiotherapy.

"The only thing I didn’t like was having to have a mask on for the radiotherapy. But even that was OK as the doctors and other staff were absolutely wonderful with me and made sure they did the radiotherapy on the brain quickly."

After the treatment, Shirley went on holiday with her daughter, son-in-law and their three children.

"As we didn’t know what the future held, we wanted to spend some time together," she says. "I was determined that I didn’t want the diagnosis to spoil anything about the lives we had."

It’s now over three years since Shirley found out about the lung cancer. She still has to go to hospital every three months for a check-up. She has been in the clear for the last few visits.

"When I found out I could be dead within three years, my biggest fear was not being around to see my youngest daughter have her fourth child. It's now so wonderful to be here, and so wonderful when she went on to have another child. I’m just so glad to be around for them. 

"One of my granddaughters is about to take her 11-plus and I am so pleased I'm here to be involved. It’s all the little incidents in my children’s and grandchildren’s lives that I want to be a part of.

"I have been extremely lucky. But I would say to anyone else who is worried about possible symptoms: go to the doctor, go for check-ups and don’t refuse any help. The sooner you go, the better."

Image of Shirley Smith produced to support Essex Cancer Network activity.

Geoff Williams, 64, a retired language lecturer, was diagnosed with lung cancer in the summer of 1998.

Thirteen years on, after surgery, chemotherapy and radiotherapy, Geoff still plays an active role in his local community as a councillor, a position he's held since 1981. He also chairs his local choral society, where he continues to be in fine voice.

Geoff had always been aware of lung cancer, having lost his father to the disease in the late eighties. 

"Awareness of cancer was a lot different then," says Geoff. "My father was diagnosed after a spot on his lung was discovered. He went downhill fairly rapidly after that. It was such a horrendous time for all of us."

This awareness proved crucial for Geoff when he developed a persistent cough for several weeks and then started coughing blood.      

"With some persuasion from my wife Linda, I went to my GP to discuss my symptoms. He was excellent. He told me that there was something not quite right, so I was referred to a consultant.

"I had a biopsy and went on holiday for a fortnight. I felt fine and was convinced that everything was OK, and it was all a big mistake.

"Within a week I got the results back. This confirmed I had lung cancer. I had an operation to remove the tumour in September. Within another week I was home again and starting to get back into some sort of a routine, including travelling to Germany on business.

"However, I did need to start my chemotherapy in December that year. Luckily, I had my family around me to give support, particularly my cousin who was a nurse.

"The radiotherapy followed in the Spring, which did seem to knock me out for most of the time. But I got through it and continued to have fairly regular check-ups after the surgery. In the end, I think this was more for peace of mind after I had got the all clear."

Geoff now has type 2 diabetes and is currently having treatment for skin cancer. However, his message to others remains optimistic: "Early intervention is key. Go to your doctor if you suspect there's something not quite right with your cough. Don't put it off. Try to think of it as something that can be overcome and see your GP with a positive frame of mind.

"I love my singing, walking our dog, Jack, and spending time in my garden which I’m very proud of. My wife and I love getting away to Cornwall whenever we can, and I still enjoy having a role with my local council. My full quality of life has been back for a very long time now."

Image of Geoff Williams produced to support Essex Cancer Network activity.

Ann Long, 76, a retired social worker, was diagnosed with lung cancer in December 2003.

Ann had surgery to remove part of her lung. Eight years later, she is living life to the full. A keen traveller, Ann keeps fit with regular walks and plays an active role in her local community. 

Ann first noticed something was wrong one morning. "I was brushing my teeth," she says, "and as I swilled out my mouth, I noticed a tiny red spot, which I knew wasn’t fresh blood. I thought something wasn’t quite right and I should get it checked out." Ann had also recently developed a cough first thing in the morning.

"I immediately went to see my GP to discuss my symptoms and she sent me for a chest X-ray, which showed that there was a shadow on my lung. After that, I had a bronchoscopy and a CAT scan. It was confirmed that I had lung cancer.

"After I received the diagnosis, I discussed the different treatment options with the consultant. It was decided that the best treatment for me was to have half of my left lung removed. The surgery took place in January 2004 and I responded very well. I continued to have regular check-ups after the surgery, but now I no longer require any medical follow-ups.

"Every day I’m amazed at how fortunate I am. I'm thankful I went to the GP as soon I spotted symptoms that I knew were unusual. I would urge anybody who has the potential signs of lung cancer, such as a persistent cough, to visit their GP straight away. There is nothing to be nervous about, and you should not be afraid. The worst thing you can do is to leave your symptoms too long. Speed is the most important thing.

"I have always lived a very active life, and being diagnosed with lung cancer didn't stop that. I go on regular three-mile walks, I swim, I exercise, I go to the gym and I’m learning Tai Chi. I'm about to start Nordic walking. I also enjoy painting, playing bridge and I'm researching my family history.

"A few people speak to me now about lung cancer, and about symptoms they or their partners have, and I always encourage them to go to their GP. It's better to have these things checked out than to ignore them."