Adenocarcinoma is a type of non-small cell lung cancer (NSCLC). It is a little more common in women and is also the most common type of lung cancer amongst people under 45.

More frequently seen in the outer parts of the lung, adenocarcinoma develops from a particular type of cell that produces mucus (phlegm) and can lead to a chronic cough. It accounts for approximately 50% of all cases of NSCLC.

This type of lung cancer tends to grow quite quickly and often arises in the larger air passages. It has a tendency to spread outside the lung at an earlier stage.

This is the most common type of primary lung cancer in the UK and often forms in the larger, more central airways.

EGFR (epidermal growth factor receptor) is a protein found on the surface of cancer cells as well as normal cells. Mutations in the EGFR gene cause cancer cells to have too much of the EGFR protein, which leads them to grow faster.

EGFR-positive NSCLC is considered to be a genetically distinct form of lung cancer. It is detected in about 10-15% of cases of NSCLC. It is most common in people with adenocarcinoma, non-smokers, people of Asian origin and women.

In the UK, patients diagnosed with NSCLC are now routinely tested for gene mutations such as EGFR.

As with cases of NSCLC, if the disease is diagnosed at an early enough stage, before it has spread to other parts of the body, there is a better chance that it may be treated with curative intent. In such cases, surgery to remove the tumour would be the preferred option, although radiotherapy and chemotherapy are sometimes used.

When lung cancer has spread beyond the chest, it may no longer be possible to treat with curative intent. EGFR tumours usually respond well to treatment with targeted therapies as well as conventional cancer therapies.

These treatments are given in tablet form and often have much less in the way of side effects when compared with conventional cancer treatments. In recent years there have been major developments in targeted therapies for EGFR lung cancer.

I was eligible for a new targeted therapy called osimertinib. For me, it has been a dream come true. The drug is keeping my cancer in check and, just as importantly, it has given me my life back. I have a few minor side effects and loads of energy. I had to give up work but, with a packed social calendar, I don’t know how I’d fit it in now anyway!

Kathy, living with EGFR+ lung cancer

ALK positive lung cancer (often written as ALK+) is a rare form of the disease that occurs in around 3-5% of patients diagnosed with NSCLC.

ALK belongs to a family of proteins called receptor tyrosine kinases (RTKs), which are involved in the growth of cells. In patients found to be ALK positive, the ALK protein is abnormally active and can drive the growth of cancer cells.

The ALK gene rearrangement is a genetic alteration within lung tissue cells that causes them to grow abnormally and, ultimately, behave as cancer cells.
Younger patients — usually 55 and under — who have never smoked are most likely to be diagnosed as being ALK positive.

GPs haven’t really heard of my type of lung cancer. I’ve got an ALK rearrangement which is a type of mutation. I am a GP in the army and none of my colleagues have heard of that kind of lung cancer.

Amanda, living with ALK+ lung cancer

In the UK, patients diagnosed with NSCLC now have their tumours routinely tested for the ALK gene rearrangement.

As with most cases of NSCLC, if the disease is diagnosed at an early enough stage, before it has spread to other parts of the body, there is a better chance that it may be treated with curative intent. In such cases, surgery to remove the tumour would be the preferred option, although radiotherapy and chemotherapy are sometimes used.

When lung cancer has spread beyond the chest, it may no longer be possible to treat with curative intent. Tumours that are ALK positive usually respond well to treatment with targeted therapies as well as conventional cancer therapies.

These treatments are given in tablet form and often have much less in the way of side effects when compared with conventional cancer treatments. In recent years there have been major developments in targeted therapies for ALK positive lung cancer.

ROS1 positive (sometimes written as ROS1+) is a rare form of the disease which occurs in around 1–2% of NSCLC patients.

In this type of the disease, the lung cancer cells contain changes affecting the gene responsible for a protein called ROS1.

ROS1 belongs to a family of proteins called receptor tyrosine kinases (RTKs), which are involved in the growth of cells. In patients found to be ‘ROS1-positive’, the ROS1 protein is abnormally active and can drive the growth of cancer cells.

The ROS1 gene rearrangement is a genetic alteration within lung tissue cells that causes them to grow abnormally and, ultimately, behave as cancer cells.
In the UK, patients diagnosed with NSCLC now have their tumours routinely tested for gene mutations and rearrangements such as ROS1.

As with most cases of NSCLC, if the disease is diagnosed at an early enough stage, before it has spread to other parts of the body, there is a better chance that it may be treated with curative intent. In such cases, surgery to remove the tumour would be the preferred option, although radiotherapy and chemotherapy are sometimes used.

When lung cancer has spread beyond the chest, it may no longer be possible to treat with curative intent. Tumours that are ROS1-positive usually respond well to treatment with targeted therapies as well as conventional cancer therapies.

These treatments are given in tablet form and often have much less in the way of side effects when compared with conventional cancer treatments. In recent years there have been major developments in targeted therapies for ROS1-positive lung cancer.

It is closely associated with a history of asbestos exposure either through work or contact with a person in the asbestos industry. It generally affects older males and may take 35-40 years from the date of first exposure for the cancer to develop. The cancer cells usually positioned in the lining of the lung and often produce fluid. This may require draining from time to time, but may improve breathing.

Mesothelioma can be difficult to treat as it is often found when it is at an advanced stage. Patients should therefore discuss treatment options with their cancer doctor or lung cancer nurse specialist. Treatment may include chemotherapy, radiotherapy or surgery. Please note that financial compensation from the government may be available if lung damage from exposure to asbestos is proven.

This rare tumour grows at the top of the lung. Treatment is usually the same as the NSCLC and will depend on where the tumour is, the size of it and whether it has spread to other parts of the body.

This is a rare tumour disease of the lung which is generally less aggressive than other types. The tumour develops from a special type of cells in the lung called neuroendocrine cells.

Many carcinoid tumours can be cured by surgery but some are more aggressive and can spread to other parts of the body. In this case treatment with chemotherapy may be required.

Pleural effusion is an excessive build-up of fluid between your lungs and chest cavity. There are many causes of a pleural effusion, but unfortunately cancer is one of the most common. This is called malignant pleural effusion and occurs when there is a build up of fluid and cancer cells that collects between the chest wall and the lung.