What should you know about primary lung cancer?

Primary lung cancer starts in the lung and needs assessment to identify its type, extent and most suitable treatment. Primary lung cancer starts in lung tissue rather than spreading there from another organ. Doctors assess its cell type, location and stage before discussing care.

The diagnosis may refer to non-small-cell or small-cell lung cancer, among other less common types. Tests can include chest imaging, examination of a tissue sample and scans to look for disease elsewhere. A persistent cough, breathlessness, chest discomfort, coughing blood, unexplained weight loss or a hoarse voice can occur, but these symptoms also have non-cancer causes. Hoarse voice is one symptom worth discussing with a clinician.

The stage describes whether the cancer is confined to the lung, involves nearby structures or has spread. Spread to the brain is called brain metastases and may change the treatment plan.

Arrange a review with the oncology team to confirm the pathology and stage. Genomic tumour profiling may identify changes that help guide targeted treatment. Depending on the findings, care may include surgery such as lung lobectomy, radiotherapy, chemotherapy or combinations of these. Palliative care can help with symptoms and quality of life at any stage, alongside cancer treatment.

Contact your care team promptly for new or worsening breathlessness, chest pain, coughing blood, confusion, severe weakness or inability to keep fluids down. Seek emergency help for severe breathing difficulty, heavy bleeding, sudden weakness or a seizure. These symptoms need urgent assessment regardless of the cancer stage.

Which type and stage is present? Is tissue testing complete? Would genomic tumour profiling change treatment? What is the purpose and timing of surgery, radiotherapy or chemotherapy? Which symptoms should trigger an urgent call?