Lung cancer is the leading cancer cause of death among South African men. The biggest reason? Smoking. About 60% of all lung cancer deaths in South Africa are due to tobacco smoking. Second-hand smoke is equally dangerous, while pollution is another culprit.
Lung cancer often takes a long time to develop, with tumours too small to be detected by X-ray for years. It is a life-threatening disease because it often spreads to other parts of the body before it is found.

Types of lung cancer
There are two main types of lung cancer and they are treated differently.

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

In mixed small cell/large cell cancer, features of both are present.

Non-small cell lung cancer (NSCLC)
The majority of lung cancers are of the non-small cell type. There are three sub-types:
Squamous cell carcinoma: linked to smoking, and usually found in the middle of the lungs, near a bronchus.
Adenocarcinoma: usually found in the outer part of the lung.
Large-cell (undifferentiated) carcinoma: can start in any part of the lung. It tends to grow and spread quickly, which makes it harder to treat.

Small cell lung cancer (SCLC)
About 10% of all lung cancers are SCLC, also known as oat cell carcinoma. Although the cancer cells are small, they can multiply quickly and form large tumours that can spread widely. This means that surgery is rarely an option. Treatment must include drugs to kill the widespread disease. This kind of cancer is almost always caused by smoking.

Other types
Along with the two main types of lung cancer, other tumours can be found in the lungs. Sometimes cancer that starts in other organs can spread to the lungs, and this is not the same as lung cancer. For example, cancer that starts in the breast and spreads to the lungs is still breast cancer, not lung cancer.

Risk factors
Smoking is by far the leading cause. People who quit will see their risk decline by up to 50% over time.
Second-hand smoke increases lung cancer risk by 30%.
Long-term exposure to certain substances such as arsenic, uranium, asbestos and radon.
Previous radiation therapy to the breasts or chest area.

Treatment
Your options may include surgery, radiation therapy, chemotherapy, or targeted therapy. More than one kind of treatment may be used, depending on the stage of your cancer.

Prevention
If you’re a smoker, quit. There are various approaches to quitting, and your doctor can discuss these with you. Take care of yourself through a healthy lifestyle. Keep your weight at a healthy point, and eat at least five servings of fruits and vegetables a day.

Signs and symptoms

• Chronic cough
• Chest pain, often made worse by deep breathing, coughing, or laughing 
• Hoarseness 
• Weight loss and loss of appetite 
• Bloody or rust-coloured sputum (spit or phlegm) 
• Shortness of breath 
• New onset of wheezing