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The lungs

When you breathe in, air passes from your nose or mouth through the windpipe (trachea), which divides into two tubes (airways), one going to each lung. These are known as the right and left bronchus and they divide to form smaller tubes called bronchioles, which carry air through the lungs. At the end of the bronchioles are millions of tiny air sacs called alveoli. In the alveoli, oxygen is absorbed from the air we breathe in and passes into the bloodstream to be circulated around the body.

Carbon dioxide is a waste gas that must be removed from the body. It passes from the bloodstream into the alveoli and is then breathed out by the lungs.

The right lung has three main areas (known as lobes) and the left lung has two.

Many lung cancers start in the cells lining the bronchi and are called carcinomas of the bronchus.
Primary lung cancer

Each year over 38,000 people in the UK are diagnosed with lung cancer.
There are two main types of primary lung cancer, which behave and respond to treatment quite differently. They are:
  • non-small cell lung cancer (NSCLC)
  • small cell lung cancer (SCLC).
About 1 in 5 lung cancers are small cell; the rest are non-small cell.

Non-small cell lung cancer

There are three main types of non-small cell lung cancer. Sometimes it’s not possible to tell which type someone has. This is because when the cells are looked at under a microscope they are not developed enough. The three types are:
  • Squamous cell carcinoma: This is the most common type of lung cancer. It develops in the cells which line the airways. This type of lung cancer is often caused by smoking.
  • Adenocarcinoma: This develops from the cells which produce mucus (phlegm) in the lining of the airways. This type of cancer is becoming more common.
  • Large cell carcinoma: This gets its name from the large, rounded cells that are seen when they are examined under the microscope. It is sometimes known as undifferentiated carcinoma.

A less common type of cancer that can affect the covering of the lungs is called mesothelioma. It is a cancer of the membrane which covers the surface of the lungs and lines the inside of the chest. It often occurs in people who have been exposed to asbestos.
Stages of non-small cell lung cancer
  • Stage I : cancer at this stage has invaded the underlying lung tissue but hasn't spread to the lymph nodes.
  • Stage II : This stage cancer has spread to neighboring lymph nodes or invaded the chest wall.
  • Stage IIIA : At this stage, cancer has spread from the lung to lymph nodes in the center of the chest.
  • Stage IIIB : The cancer has spread locally to areas such as the heart, blood vessels, trachea and esophagus — all within the chest — or to lymph nodes in the area of the collarbone or to the tissue that surrounds the lungs within the rib cage (pleura).
  • Stage IV : The cancer has spread to other parts of the body, such as the liver, bones or brain.
Stages of small cell lung cancer
  • Limited. cancer is confined to one lung and to its neighboring lymph nodes.
  • Extensive.cancer has spread beyond one lung and nearby lymph nodes, and may have invaded both lungs, more remote lymph nodes or other organs.
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