Lung Cancer

There are a number of symptoms you should look out for, including:

• coughing up blood
• a new or changed cough that doesn’t go away
• pain in their chest or shoulder  
• being short of breath, or trouble breathing
• hoarse voice
• chest infection that won’t get better
• feeling very tired or weak
• not feeling hungry or losing weight without meaning to.

Anyone can get lung cancer, even people who have never smoked.

Having these symptoms may not mean you have cancer, but it’s important to check.

If you have any of these problems or are worried about any of these symptoms, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

You won’t know if you have lung cancer until your doctor has completed a physical examination r and done some tests.

Most people who have these tests find out they don’t have lung cancer, but it’s important to check.

The tests might include:

• a chest x-ray and other tests such as a CT scan or MRI scan to see what the inside of your chest and body looks like
• a bronchoscopy, where they put a thin tube through your throat into your windpipe to look at your lungs closely
• a lung biopsy, where they take a tiny bit of your lung while you’re having a bronchoscopy, and look at it with a microscope.

If you have lung cancer, you might be told it’s at a certain stage. This describes whether or not it has spread to other parts of your body, and how far.

Knowing the stage of the disease helps you and your doctors to decide on the best treatment for you.

Non–small cell lung cancer is divided into four stages, depending on whether the cancer has spread to other areas of the body:

• Occult (hidden) Stage: cancer cells are found in sputum which is a thick liquid coughed up from the lungs.

• Stage 0: the cancer is small and has not spread.

• Stages I – 3: these involve the cancer increasing in size, and in stages 2-3 spreading to nearby lymph nodes.

Stage 4: the cancer may have spread to other parts of the body. Small cell lung cancer is divided into two stages for the purposes of treatment:

• Limited stage: the cancer is in only 1 side of the chest (possibly including lymph nodes).

• Extensive stage: the cancer has spread to other parts of the body.

With all stages of lung cancer, there is plenty of treatment and support that can help you, including traditional medicine and practices like ceremony and being on Country. 

There are many ways to treat lung cancer. The main ones are:

• surgery
• radiotherapy
• chemotherapy
• targeted therapies
• immunotherapy

If you have lung cancer, you might need one of these, or a combination of them.

Your doctor will yarn with you about what treatments they recommend, and what options are best for you.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have. You can also discuss how to combine your medical treatment with traditional healing, bush medicine and cultural practices as part of your treatment plan.

Surgery

Surgery is a procedure done to take out the cancer and help to stop it from spreading to other parts of your body. Surgery involves staying in hospital and having an anaesthetic and an operation.

Depending on the extent of the cancer, some people have just part of a lung removed or the whole lung may be removed.

Many people with lung cancer have some of the lymph nodes in their chest or under their arms removed during surgery.

The doctor will talk to you beforehand about what is going to happen. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about surgery.

Radiotherapy

Radiotherapy, also called radiation therapy, uses X-rays to destroy cancer cells in one part of your body.

Most people who have radiotherapy have it every day (Monday to Friday) for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, assistance is available for travel and accommodation for you and your family.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker or social worker.

Read more about radiotherapy.

Chemotherapy

Chemotherapy, or ‘chemo’ involves you taking strong drugs to kill or slow the growth of the cancer cells.

Many people have chemo in cycles – usually two days every three weeks, or one day every three weeks. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic. But you usually don’t need to stay in hospital for chemo.

Your doctor may recommend that you need to have chemotherapy at the same time as you are having radiotherapy. This is usually given once a week as an injection before you have radiation therapy.

Most chemo comes as injections into your arm or hand that drip in over a few hours. Some chemo or medications come as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can do to help. Mob who have had chemo say that combining medical treatment with traditional healing, bush medicine, Men’s Business, Women’s Business and cultural practices and traditional practices to help with managing address side effects.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about chemotherapy and side effects.

Targeted therapies

Targeted therapies are newer drugs that try to stop the cancer growing. Targeted therapies attack cancer cells without harming healthy cells. If your doctor thinks they might help, here are some questions to ask. 

Read more about targeted therapy.

Immunotherapy

Immunotherapy is treatment with drugs that help your immune system attack the cancer cells.

Immunotherapy is given in your arm through a vein.  It is usually given in cycles of once every few weeks. You will need to go to a hospital or clinic to have this treatment.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker and ask to yarn with other mob who have had the treatment.

Read more about immunotherapy.

It is important for you to understand why you are getting the treatment your doctor chooses and how it is supposed to help you.  Different treatments try to do different things. It depends on what cancer you have, and whether it has spread to other parts of your body, and where you live, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it coming back, or
• won’t cure you, but is meant to prolong your life, or make you feel better.

Your doctors should yarn with you and explain this. You can yarn with them and tell them what you think, and what you want. Some people will want to try everything possible to kill the cancer to stay alive. Others want simpler treatments, or don’t want to leave family or Country for treatment, or don’t want any treatment. It’s your choice.

You can include traditional medicine and cultural practices. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, have someone else come to appointments to help remember information. Talk things over with your family, trusted friends, or Elders. It is important they are part of the process to support you. Treatment plans can also include traditional healing and cultural practices.

Yarn with your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander health worker.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different durations of time.

After treatment is finished, you might keep in touch with your doctors will keep in touch with you to for years so they can check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.

There are some features that are more common in people who develop lung cancer. These features are called ”risk factors”.

Having one or more risk factors does not mean that you will develop cancer. It can also be unclear whether a risk factor contributed to the development of the cancer in a person. However, by doing what we can to change these risk factors, we can reduce the risk of developing lung cancer.

The greatest risk factor for lung cancer is smoking, with the greatest risk for those that began smoking early in life and smoked more often or longer.

Risk factors for lung cancer you can change:

• avoid tobacco smoking (current or past smoking)
• avoid breathing in someone else’s tobacco smoke (passive smoking)

Risk factors for lung cancer you can’t change:

• increasing age (getting older)
• history of chronic lung disease over a long time, including chronic pulmonary disease and pulmonary fibrosis
• exposures through work to chemicals, such as asbestos, diesel exhaust and silica
• personal history of cancer, including lung cancer, head and neck cancer and bladder cancer
• breathing in air pollution

If you have any of these risk factors or you’re worried about your risk for lung cancer, yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker.

Clinical trials might be an option for you. Yarn with your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more detail on lung cancer here.