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Lung Cancer

Lung cancer is caused by abnormal and uncontrolled cell growth in either one or both lungs.

Last modified: November 2, 2021

Quick facts about lung cancerQuick facts

  • About 1 in 60 Malaysian males and 1 in 138 Malaysian females develop lung cancer each year.
  • Lung cancer is the third most common cancer in Malaysia.
  • Lung cancer is the leading cause of cancer deaths in Malaysia.

Types of lung cancerTypes of lung cancer

Lung cancer is either classified as non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC).

Non-small cell lung cancer (NSCLC) Small cell lung cancer (SCLC)

Non-small cell lung cancer (NSCLC)

This is the most common form of lung cancer, making up 85% of all lung cancer cases. NSCLC can be classified into:

  • Adenocarcinoma – Typically found on the outer area of the lungs, in cells that produce mucus.
  • Squamous cell carcinoma – Typically found in the airways of the lungs.
  • Large cell undifferentiated carcinoma – This type of cancer cannot be classified as either adenocarcinoma or squamous cell carcinoma, and is therefore grouped into its own subcategory.

Small cell lung cancer (SCLC)

This type of lung cancer tends to spread faster than NSCLC. SCLC is less common than NSCLC, accounting for 15% of all lung cancers.

Signs and symptoms of lung cancerSigns and symptoms

As signs and symptoms for lung cancer can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a lung cancer diagnosis.

Symptoms may include:

  • Wheezing, coughing or difficulty breathing

  • Difficulty swallowing

  • Coughing up blood

  • Unexplained tiredness or fatigue

  • Swollen face or enlarged veins in the neck

  • A chronic (ongoing) cough that doesn’t go away

  • Shoulder or chest pain that may be worse with breathing

  • Chronic infections such as bronchitis or pneumonia

Stages of lung cancerStages

The TNM system is used to stage lung cancer, and it helps doctors understand what your cancer looks like. The TNM stands for:

  • Tumour (T) – Describes the size of the tumour and the extent the cancer has spread into the tissue of the lung. The tumour can be graded from T1a (which describes a tumour under 1cm) to T4 (which describes a tumour larger than 7cm).
  • Nodes (N) – Describes whether the tumour has spread to nearby lymph nodes. Nodes can be graded from N0, where there has been no spread, through to N3, where the cancer has spread to other areas of the body, such as the other side of the chest or collarbone.
  • Metastasis (M) – Describes whether the cancer has spread to other areas of the body outside of the lung. Metastasis can be graded from M0, where there has been no spread through to M1c, where the cancer has spread to other organs of the body and produced additional tumours.

The TNM information, along with other tests, helps determine the stage of your lung cancer using the guidelines below:

Stage I lung cancer Stage II lung cancer Stage III lung cancer Stage IV lung cancer

Stage I

The tumour is 5cm or less across, affects the main branches of the bronchi and has not spread beyond the lungs.

Stage II

The tumour is 7cm or less across and has spread to nearby lymph nodes. Alternatively, there may be one separate tumour nodule present.

Stage III

The tumour can be any size and has spread to the lymph nodes. It may have also spread to surrounding areas. Two or more separate tumours are present in different lobes of the same lung.

Stage IV

The tumour in the lung can be any size and has spread to distant organs within the body.

Treatment for lung cancer

There are many different types of treatment for lung cancer. Your treatment will depend on you and your cancer.

Learn more

Frequently asked questions about lung cancerFAQs

Is lung cancer hereditary?

For most lung cancer cases, genetic mutations are somatic (meaning they happen in cells only specific to that individual and are not inherited). In rare cases, genetics can play a role in the development of lung cancer, particularly for people who have inherited gene mutations on chromosome 6 (which accounts for approximately 6% of all DNA in cells). However, the most common cause of lung cancer is cigarette smoking.

What causes lung cancer?

Exact causes of lung cancer are not fully known, especially in people who develop lung cancer without any known risk factors. However, factors have been found to increase the risk of developing lung cancer include:

  • Smoking – Cigarette smoking carries a significantly higher risk of developing lung cancer when compared with non-smokers. It is estimated that lung cancer cases as a result of cigarette smoking contribute to 90% of all cases in men and 65% in women.
  • Second-hand smoking – There is an increased risk for non-smoking people who breath in the cigarette smoke of others. Living with someone who smokes can increase your risk for lung cancer by approximately 20-30%.
  • Exposure to asbestos and other toxins – People who have been exposed to asbestos (traditionally used in building materials) and other toxins such as radon (a radioactive gas used in the mining industry) have an increased risk of developing lung cancer.
  • Age – The risk of developing lung cancer increases as people age. Most lung cancers are diagnosed in people over the age of 60.
  • Medical history – People who have a medical history of lung disease such as emphysema or fibrosis of the lung may have an increased risk of developing lung cancer.
How common is lung cancer?

It is the third most common cancer type, with more men than women developing the disease, and the leading cause of cancer death in Malaysia.

What can I do to decrease my risk of lung cancer?

There are a number of lifestyle-related factors which can reduce your risk of developing lung cancer, including:

  • Quitting smoking – Cigarette smoking carries a significantly higher risk of developing lung cancer when compared with non-smokers. It’s estimated that lung cancer cases due to cigarette smoking contribute to 90% of all cases in men and 65% in women.
  • Avoiding second-hand smoke – There’s an increased risk for non-smoking people who breathe in the cigarette smoke of others. Living with someone who smokes can increase your risk for lung cancer by approximately 20-30%.
  • Avoiding exposure to asbestos and other toxins – People who have been exposed to asbestos (traditionally used in building materials) and other toxins like radon (a radioactive gas used in the mining industry) have an increased risk of developing lung cancer.
What are lung cancer syndromes?

Some lung cancers can also cause a collection of specific symptoms which are termed syndromes. Syndromes which have been associated with lung cancer include:

  • Superior Vena Cava (SVC) syndrome – The SVC is a large blood vessel that carries blood away from the head and arms to the heart. Tumours near the lung area can press against this large blood vessel causes swelling in the face and neck, chest and upper arm area.
  • Paraneoplastic syndromes – Some lung cancers make substances which act like hormones and can affect other tissues and organs in the body. Some paraneoplastic syndromes include:
    • Cushing Syndrome – Adrenal glands in the body may produce too much cortisol (due to cancer cells producing specific hormones), this can lead to weight gain, as well as symptoms of dizziness/tiredness and weakness.
    • SIADH (Syndrome of inappropriate anti-diuretic hormone) – Cancer cells can make a hormone which encourage the kidneys to hold onto water, reducing the amount of salt in the blood. Symptoms can include; cramps and muscle weakness, tiredness, nausea and/or vomiting. In severe cases without treatment, seizures and coma may occur.

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ReferencesReferences

For a full list of references, click here.
  1. Cancer Council. (2018). Lung Cancer. Retrieved on 22nd April 2019 from https://www.cancercouncil.com.au/lung-cancer/?gclid=EAIaIQobChMIhueBgeDk4QIVygorCh1USgkBEAAYASAAEgIrR_D_BwE#types
  2. American Cancer Society. (2016). What causes non-small cell lung cancer? Retrieved on 22nd April 2019 from https://www.cancer.org/cancer/non-small-cell-lung-cancer/causes-risks-prevention/what-causes.html
  3. Genetics Home Reference. (2019). Chromosome 6. Retrieved on 22nd April 2019 from https://ghr.nlm.nih.gov/chromosome/6#conditions
  4. Genetics Home Reference. (2019). Lung Cancer. Retrieved on 22nd April 2019 from https://ghr.nlm.nih.gov/condition/lung-cancer#genes
  5. Australian Government: Cancer Australia. (2018). Lung Cancer. Retrieved on 22nd April 2019 from https://lung-cancer.canceraustralia.gov.au/symptoms
  6.  American Cancer Society. (2016). Signs and Symptoms of Lung Cancer. Retrieved on 22nd April 2019 from https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection/signs-and-symptoms.html
  7. Cancer Council. (2018). Staging and prognosis for lung cancer. Retrieved on 22nd April 2019 from https://www.cancercouncil.com.au/lung-cancer/diagnosis/staging-prognosis/
  8. Australian Government: Cancer Australia. (2018). What are the risk factors for lung cancer? Retrieved on 25th April 2019 from https://lung-cancer.canceraustralia.gov.au/risk-factors
  9. Australian Government: Cancer Australia. (2014). Risk factors for lung cancer: an overview of the evidence. Retrieved on 25th April 2019 from https://canceraustralia.gov.au/system/tdf/publications/risk-factors-lung-cancer-overview-evidence/pdf/2014-risk_factors_for_lung_cancer_an_overview_final_lr.pdf?file=1&type=node&id=4062
  10. Australian Institute of Health and Welfare. (2011). Lung cancer in Australia: an overview. Retrieved on 7th November 2019 from https://www.aihw.gov.au/report/lung-cancer-in-australia-an-overview/contents/summary
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