Lung cancer

Lung cancer - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Lung cancer Lung cancer About lung cancer Symptoms of lung cancer Causes of lung cancer Diagnosing lung cancer Treating lung cancer Living with lung cancer Preventing lung cancer About lung cancer Lung cancer is one of the most common and serious types of cancer. There are usually no signs or symptoms in the early stages of lung cancer, but many people with the condition eventually develop symptoms including: a persistent cough coughing up blood persistent breathlessness unexplained tiredness and weight loss an ache or pain when breathing or coughing You should speak to your GP if you have these symptoms. Read more about the symptoms of lung cancer Types of lung cancer Cancer that begins in the lungs is called primary lung cancer. Cancer that spreads from the lungs to another place in the body is known as secondary lung cancer. Thispage is aboutprimary lung cancer. There are 2 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  the most common type, accounting for more than 80% of cases; can be eithersquamous cell carcinoma, adenocarcinoma or large-cell carcinoma small-cell lung cancer a less common type thatusually spreadsfaster than non-small-cell lung cancer The type of lung cancer you have determines which treatments are recommended. Read more about diagnosing lung cancer Whos affected Lung cancer mainly affects older people.Itsrare in people younger than 40, and the rates of lung cancer rise sharply with age. Lung cancer is most commonlydiagnosed in people aged 70to 74. Although people who have never smoked can develop lung cancer, smoking is the main cause (accounting for over 85% of cases). This is because smoking involves regularly inhaling a number of different toxic substances. Read more about: causes of lung cancer preventing lung cancer Treating lung cancer Treatment depends on the type of cancer, how far its spread and how good your general health is. If the condition is diagnosed early and the cancerous cells are confined to a small area, surgery to remove the affected area of lung is usually recommended. If surgery is unsuitable due to your general health, radiotherapy to destroy the cancerous cells may be recommended instead. If the cancer has spread too far for surgery or radiotherapy to be effective, chemotherapy is usually used. Read more about treating lung cancer Symptoms of lung cancer Symptoms of lung cancer develop as the condition progresses and there are usually no signs or symptoms in the early stages. The main symptoms of lung cancer are: a cough that doesnt go away after 2 or 3 weeks a long-standing cough thatgets worse persistent chest infections coughing up blood an ache or pain when breathing or coughing persistent breathlessness persistent tiredness or lack of energy loss of appetite or unexplained weight loss 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 or neck persistent chest or shoulder pain If you have any of these, you should speak to your GP. Read further information: Cancer Research UK: Symptoms of lung cancer Macmillan Cancer Support: Signs and Symptoms of lung cancer Causes of lung cancer Most cases of lung cancer are caused by smoking, although people who have never smoked can also develop the condition. Smoking Smoking cigarettes is the single biggest risk factor for lung cancer.Its responsible for more than 85% of all cases. Tobacco smoke contains more than 60 different toxic substances, which canlead tothe 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. Its beenestimated that smoking 4 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 If you dont smoke, frequent exposure to other peoples 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 thatcomes from tiny amounts of uranium present in all rocks and soils. It can sometimes be found in buildings. If radon is breathed in, it can damage your lungs, particularly if youre a smoker. Occupational exposure and pollution Exposure to certain chemicals and substances 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 nickel Read more information about asbestosis and silicosis. Researchalso suggests that being exposed to large amounts of diesel fumes for many years may increase your risk of developing lung cancer by up to 50%. One study has shown that your risk of developing lung cancer increases by about a third if you live in an area with high levels of nitrogen oxide gases (mostly produced by cars and other vehicles). Read further information about the causes and risk factors for lung cancer Diagnosing lung cancer Speak to your GP if you have symptoms of lung cancer , such as breathlessness or a persistent cough. Your GP will ask about your general health and what symptoms youve been experiencing. They may examine you and ask you to breathe into a device called a spirometer, which measures how much air you breathe in and out. You may be asked to have a blood test to rule out some of the possible causes of your symptoms, such as a chest infection . In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of lung cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected lung cancer. Chest X-ray A chest X-ray is usually the first test used to diagnose lung cancer. Most lung tumours show up on X-rays as a white-grey mass. However, chest X-rays cant give a definitive diagnosis because they often cant distinguish between cancer and other conditions, such as a lung abscess (a collection of pus that forms in the lungs). If your chest X-ray suggests you may have lung cancer, you should be referred to a specialist (if you havent already) in chest conditions such as lung cancer. A specialist can carry out more tests to investigate whether you have lung cancer and, if you do,what type it isand how much its spread. CT scan A computerised tomography (CT) scan is usually carried out after a chest X-ray. A CT scanuses X-rays and a computer to create detailed images of the inside of your body. Before having a CT scan, youll be given an injection of a contrast medium. This is a liquid containing a dye that makes the lungs show up more clearly on the scan. The scan is painless and takes 10 to 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 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. Before having a PET-CT scan, youll be injected with a slightly radioactive material. Youll be asked to lie down on a table, which slides into the PET scanner. The scan is painless and takes around 30 to 60 minutes. Bronchoscopy and biopsy If the CT scan shows there might be cancer in the central part of your chest, youll have a bronchoscopy. A bronchoscopy is a procedurethat allowsa doctor or nurse toremove a small sample of 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 your mouth or nose, down your throat and into the airways of your lungs. The procedure may be uncomfortable, but youll be given a mild sedative beforehand to help you relax and a local anaesthetic to make your throat numb. The procedure is very quick and only takes a few minutes. Other types of biopsy If youre not able to have one of the biopsies described above, or youve had one and the results werent clear, you may be offered a different type of biopsy. This may be a type of surgical biopsy such as a thoracoscopy or a mediastinoscopy, or a biopsy carried out using a needle inserted through your skin. 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. Youre 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, youll 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 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. Theyll also be able to take samples of your cells and lymph nodes at the same time. The lymph nodes are tested because theyre usually the first place that lung cancer spreads to. Staging Once tests have been completed, it should be possible to work out what stage your cancer is, what this meansfor your treatment and whether its possible tocompletely cure the cancer. Non-small-cell lung cancer Non-small-cell lung cancer (the most common type)usually spreads more slowly than small-cell lung cancer and responds differently to treatment. Stage 1 The cancer is contained within the lung and hasnt 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 (1.2 inches) stage 1B  the tumour is 3-5cm (1.2-2 inches) Stage 2 Stage 2 is divided into 2 sub-stages: 2A and 2B. In stage 2A lung cancer, either: the tumour is 5to 7cm the tumour is less than 5cmand cancerous cells have spread to nearby lymph nodes In stage 2B lung cancer, either: the tumour is larger than 7cm the tumour is 5to 7cm and cancerous cells have spread to nearby lymph nodes the cancer hasnt spread to lymph nodes, but has spread to surroundingmuscles 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 2 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 either spread to both lungs or to another part of the body (such as the bones, liver or brain), or the cancer has caused fluid-containing cancer cells to build up around your heart or lungs. Small-cell lung cancer Small-cell lung cancer is less common than non-small-cell lung cancer. The cancerous cells responsible for the condition are smaller in size when examined under a microscope than the cells that cause non-small-cell lung cancer. Small-cell lung cancer onlyhas 2 possible stages: limited disease  the cancer has not spread beyond the lung extensive disease  the cancer has spread beyond the lung Cancer Research UK has further information on types of lung cancer . Treating lung cancer Treatment for lung cancer is carried out by a team of specialists who will work together to provide the best possible treatment. This team contains all the specialists required to make a proper diagnosis, to stage your cancer and to plan the best treatment. If you want to know more, ask your specialist about this. The type of treatment youll receive for lung cancer depends on several factors, including: the type of lung cancer you have (non-small-cell or small-cell cancer) 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. The main treatment options include surgery, radiotherapy and chemotherapy . Depending on your type of cancer and how advanced it is, you may receive a combination of these treatments. Your treatment plan Your treatment plan depends on whether you have non-small-cell lung cancer or small-cell lung cancer. Non-small-cell lung cancer If you have non-small-cell lung cancer thats confined to one lung and youre in good general health, youll probably have surgery to remove the cancerous cells. This may be followed by a course of chemotherapy to destroy any cancer cells that may have remained in the body. If the cancer hasnt spread too far but surgery isnt possible (for example, if your general health means you have an increased risk of developing complications), radiotherapy to destroy the cancerous cells will usually be recommended. In some cases, this may be combined with chemotherapy (known as chemoradiotherapy). If the cancer has spread too far for surgery or radiotherapy to be effective, chemotherapy is usually recommended. If the cancer starts to grow again after initial chemotherapy treatment, another course of treatment may be recommended. In some cases, a treatment called biological or targeted therapy may be recommended as an alternative to chemotherapy, or after chemotherapy. Biological therapies are medications that can control or stop the growth of cancer cells. Small-cell lung cancer Small-cell lung cancer is usually treated with chemotherapy, either on its own or in combination with radiotherapy. This can help to prolong life and relieve symptoms. Surgery isnt usually used to treat this type of lung cancer. This isbecause the cancer has often already spread to other areas of the body by the time its diagnosed. However, if the cancer is found very early, surgery may be used. In these cases, chemotherapy or radiotherapy may be given after surgery to help reduce the risk of the cancer returning. Surgery There are3 types of lung cancer surgery: lobectomy whereoneor more large parts of the lung (called lobes) are removed  your doctors will suggest this operation if the cancer is just in 1 section of 1 lung pneumonectomy  where 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  where a small piece of the lung is removed (this procedure isonly suitable for a small number of patients, as it is only used if your doctors think your cancer is small and limited to one area of the lung  this isusually very early-stage non-small-cell lung cancer) People are naturally concerned that they wontbe able to breathe if some or all of a lung is removed, but its possible to breathe normally with 1 lung. However, if you have breathing problems before the operation, such as breathlessness, its likely that these symptoms will continue after surgery. Tests before surgery Before surgery can take place, youll need to have a number of tests to check your general state of health and your lung function. These may include: an electrocardiogram (ECG)  electrodes are used to monitor the electrical activity of your heart spirometry youll breathe into a machine called a spirometer, which measures how much air your lungs can breathe in and out How its performed Surgery is usually performed by making a cut (incision)in your chest or side, and removing a section or all of the affected lung. Nearby lymph nodes may also be removed if its 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, so the surgeon can see images of the inside of your cheston a monitor. After the operation Youll probably beable to go home 5 to 10 days after your operation. However, it can take many weeks to recover fully from a lung operation. After your operation, youll be encouraged to start moving about as soon as possible. Even if you have to stay in bed, youll 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, youll 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. Complications As with all surgery, lung surgery carries a risk of complications. These are estimated to occur in 1 out in 5 cases. These complications can usually be treated using medication or additional surgery, which may mean you need to stay in hospital for longer. Complications of lung surgery can include: inflammation or infection of the lung ( pneumonia ) excessive bleeding a blood clot in the leg ( deep vein thrombosis ), which could potentially travel up to the lung (pulmonary embolism) Radiotherapy Radiotherapy is a type of treatment that uses pulses of radiation to destroy cancer cells. There are a number of ways it can be used to treat people with lung cancer. An intensive course of radiotherapy, known as radical radiotherapy, can be used to try to cure non-small-cell lung cancer if the person isnt healthy enough for surgery. For very small tumours, a special type of radiotherapy called stereotactic radiotherapy may be used instead of surgery. Radiotherapy can also be used to control the symptoms and slow the spread of cancer when a cure isnt possible (this is known as palliative radiotherapy). A type of radiotherapy known as prophylactic cranial irradiation (PCI) is also sometimes used during the treatment of small-cell lung cancer. PCI involves treating the whole brain with a low dose of radiation. Its used as a preventative measure because theres a risk that small-cell lung cancer will spread to your brain. The 3 mainways that radiotherapy can be given are described below: conventional external beam radiotherapy  a machine is used to direct beams of radiation at affected parts of your body stereotactic radiotherapy  a more accurate type of external beam radiotherapy where several high-energy beams are used to deliver a higher dose of radiation to the tumour, while sparing the surrounding healthy tissue as much as possible internal radiotherapy  a catheter (thin tube) is inserted into your lung  asmall piece of radioactive material is placed inside the catheter and positioned against the site of the tumour before being removed after a few minutes For lung cancer, external beam radiotherapy is used more often than internal radiotherapy, particularly if its thought that a cure is possible. Stereotactic radiotherapy may be used to treat tumours that are very small, as its more effective than standard radiotherapy alone in these circumstances. Internal radiotherapy only tends to be used as a palliative treatment when the cancer is blocking or partly blocking your airway. Courses of treatment A course of radiotherapy treatment can be planned in several different ways. Radical radiotherapy is usually given 5 days a week, with a break at weekends. Each session of radiotherapy lasts 10to 15 minutes and the course usually lasts 4 to 7 weeks. Continuous hyperfractionated accelerated radiotherapy (CHART) is an alternative method of delivering radical radiotherapy. CHART is given 3 times a day for 12 days in a row. For stereotactic radiotherapy, fewer treatment sessions are needed because a higher dose of radiation is delivered with each treatment. People having conventional radical radiotherapy are likely to have around 20to 32 treatment sessions, whereas stereotactic radiotherapy typically only requires anything from 3 to 10 sessions. Palliative radiotherapy usually only requires 1 to 5 sessions to control your symptoms. Side effects Side effects of radiotherapy to the chestinclude: 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 losson your chest Side effects should pass once the course of radiotherapy has been completed. 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(this is usually only done as part of a clinical trial) given after surgery to prevent the cancer returning used to relieve symptoms and slow the spread of cancer when a cure isnt possible combined with radiotherapy 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 you need will depend on the type and the grade of your lung cancer. Most people require four to 6 courses of treatment over 3 to 6 months. Chemotherapy for lung cancer involves taking a combination of different medications. The medications are usually delivered through a drip into a vein (intravenously), or into a tube connected to one of the blood vessels in your chest. Some people may be given capsules or tablets to swallow instead. Side effects 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 possible signs of an infection, such as a high temperature (fever) of 38C (100.4F) or more, or you suddenly feel generally unwell. Other treatments As well as surgery, radiotherapy and chemotherapy, there are a number of other treatments that are sometimes used to treat lung cancer. Biological therapies Biological therapiesare newer medications. Theyre sometimes recommended as an alternative treatment to chemotherapy for non-small-cell cancer that has spread too far for surgery or radiotherapy to be effective. Examples of biological therapies includeerlotinib and gefitinib. These are also calledgrowth factor inhibitors because they work by disrupting the growth of the cancer cells. Biological therapies are only suitable for people who havecertain proteinsin their cancerous cells. Your doctor may be able to request tests ona smallsample of cells removed from your lung (biopsy) to determine whether these treatmentsare likely to be suitable for you. Radiofrequency ablation Radiofrequency ablation is a new type of treatment that can treat non-small-cell lung cancer diagnosed at an early stage. The doctor carrying out the treatment uses a computerised tomography (CT) scanner to guide a needle to the site of the tumour. The needle will be pressed into the tumour and radio waves 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 a 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 to 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 thats blocking the airways. Photodynamic therapy is carried out in 2 stages. Firstly, youll be given an injection of a medication that makes the cells in your body very sensitive to light. The next stage is carried out 24to 72 hours later. A thin tubewill be guided to the site of the tumour, and a laser will be beamed through it. The cancerous cells, which are now more sensitive to light, will be destroyed by the laser beam. Side effects of photodynamic therapy can include inflammation of the airwaysand 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. Living with lung cancer Breathlessness is common in people who have lung cancer, whether it is a symptom of the condition or a side effect of treatment. Inmany cases, breathlessness can beimproved with some simple measures such as: breathing in slowly through your nose and out through your mouth (after treatment for lung cancer, you may see a physiotherapist, who can teach you some simple breathing exercises) making daily activities easier  for example, using a trolley when you go shopping or keeping things you often need downstairs so you dont need to regularly walk up and down the stairs using a fan to direct cool air towards your face eating smaller and more frequent meals, and taking smaller mouthfuls Ifmeasures like these arent enough to control your breathlessness, you may need further treatment.There are a number of medications that can help improve breathlessness. Home oxygen treatmentmay be an option in more severe cases. If your breathlessness is caused by another condition, such as a chest infection ora fluid build-up around the lungs (a pleural effusion), treating thisunderlyingcausemayhelp your breathing. Read further information: Macmillan Cancer Support: Managing breathlessness Cancer Research UK: Coping with breathlessness The Roy Castle Lung Cancer Foundation: Managing lung cancer symptoms Pain Some people with lung cancer have pain, while others never have any. About 1 in 3 people who are treated forcancer experience some pain. Pain isnt related to the severity of the cancer  it varies from person to person. What causes cancer pain isnt thoroughly understood, but there are ways of treating it so the pain can be controlled. Peoplewith advanced lung cancer may need treatment for pain as their cancer progresses. This can be part of palliative care 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. Read further information: Macmillan Cancer Support: Controlling cancer pain Macmillan Cancer Support: Pain 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. Its 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 dont feel shy about telling people that you need some time to yourself, if thats what you need. Read further information: Macmillan: Cancer and your emotions 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 practice 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 peoplewho have been diagnosed with lung cancer and had treatment. If you have feelings of depression , talk to your GP  they can provide advice and support. Read further information: The Roy Castle Lung Cancer Foundation: Lung cancer support groups Macmillan Cancer Support: Depression 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 youre caring for someone with cancer, you may be entitled to financial support. If you have a job but cant work because of your illness, you are entitled to Statutory Sick Pay from your employer. If you dont have a job and cant work because of your illness, you may be entitled to Employment and Support Allowance . If youre caring for someone with cancer, you may be entitled to Carers Allowance . You may be eligible for other benefits if you have children living at home or you have a low household income. Its 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, whocangive you the information you need. Read further information: GOV.UK: Carers and disability benefits . Macmillan Cancer Support: Money, finance and insurance Palliative care If you have a lot of symptoms caused by 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 carers) wishes. This includes whether youd prefer to go to hospital, a hospice, or be looked after at home as you become progressively more ill. It will take account of what services are available to you locally, whats clinically advisable and your personal circumstances. More about palliative care Read further information: NICE: Supportive and palliative care for adults with cancer Macmillan Cancer Support: Looking after