Worldwide, lung cancer is the top cause of cancer deaths and the second most diagnosed cancer.⁴ In Australia, there were around 14,800 new cases in 2023.¹ In 2023, the disease caused around 8,700 deaths that year, making it the most common cause of cancer-related death in Australia.¹ Since 2000, the number of new annual lung diagnoses in Australia have remained fairly consistent, with 58 cases per 100,000 people in 2000 and an estimated 56 cases per 100,000 people in 2023.¹ However, there is a noticeable difference between genders. In Australian men, there has been a decrease from 85 cases per 100,000 in 2000 to an estimated 62 cases in 2023.¹ On the other hand, there has been an increase in Australian women from 36 cases per 100,000 in 2000 to an estimated 51 cases in 2023.¹

What Causes Lung Cancer?

Smoking cigarettes is the leading cause of lung cancer, but the disease can occur in people who have never smoked.⁵

The exact causes of lung cancer aren't known, but many factors can increase your risk. The clearest connection is between smoking and lung cancer, with about 80% of lung cancer deaths attributable to smoking and others often attributed to secondhand smoke. Although lung cancer can occur in people who never smoked, it is uncommon.⁵

Cancer can spread beyond the original tumour when the tumour sheds cancer cells. These cells enter the bloodstream or lymph nodes, where they can then spread to other parts of the body.¹⁰

Cancer is named by the original location of the tumour.¹⁰ If Lung Cancer spreads to another area of the body, it is called metastatic lung cancer or advanced lung cancer.¹¹ If cancer that starts in another part of the body, say breast, metastasise (spread) to the lungs, it is called “metastatic Breast Cancer to the lungs”.¹⁰
Lung cancer most often spreads to:¹¹

• Nearby lymph nodes or other parts of the lung and chest
• Brain
• Bones
• Liver
• Adrenal glands

Other types of cancer can also spread to the lungs. Those cancers are still named after the original site of the tumour. For example, breast cancer that spreads to the lungs is called metastatic breast cancer.¹⁰ Cancers that most commonly spread to the lungs include:¹²

• Breast
• Colorectal
• Head and neck
• Kidney
• Testicular
• Uterine
• Lymphoma

Cancer can spread beyond the original tumour when the tumour sheds cancer cells. These cells enter the bloodstream or lymph nodes, where they can then spread to other parts of the body.¹⁰

Cancer is named by the original location of the tumour.¹⁰ If Lung Cancer spreads to another area of the body, it is called metastatic lung cancer or advanced lung cancer.¹¹ If cancer that starts in another part of the body, say breast, metastasise (spread) to the lungs, it is called “metastatic Breast Cancer to the lungs”.¹⁰
Lung cancer most often spreads to:¹¹

• Nearby lymph nodes or other parts of the lung and chest
• Brain
• Bones
• Liver
• Adrenal glands

Other types of cancer can also spread to the lungs. Those cancers are still named after the original site of the tumour. For example, breast cancer that spreads to the lungs is called metastatic breast cancer.¹⁰ Cancers that most commonly spread to the lungs include:¹²

• Breast
• Colorectal
• Head and neck
• Kidney
• Testicular
• Uterine
• Lymphoma

• Non-Small Cell Lung Cancer (NSCLC)
• Small Cell Lung Cancer (SCLC) 

Non-Small Cell Lung Cancer (NSCLC)

• Adenocarcinoma. The most common subtype, adenocarcinoma forms in the cells that line the outer layers of the lungs, which are responsible for making mucus.13 It is more likely to be caught early before it has spread.³
• Squamous cell carcinoma. Another common subtype,13 squamous cell carcinoma starts in the flat cells that line the inside airways of the lungs, called squamous cells. This kind of lung cancer is more likely to be associated with smoking.³

Small Cell Lung Cancer (SCLC)

Signs of Lung Cancer

• Shortness of breath
• Coughing up blood
• Persistent cough
• Fatigue
• Chest pain that may get worse with coughing, laughing, or deep breathing
• Unexplained weight loss
• Loss of appetite
• Upper respiratory infections that don't get better
• Hoarseness
• Shoulder or back pain

Lung Cancer Complications

• Bone pain
• Dizziness, headache, weakness, numbness of the limbs, seizures
• Jaundice (yellowing of the skin or eyes)
• Swelling in the lymph nodes

In Australia, there is no national screening program as none of the currently available tests can accurately screen for early signs of prostate cancer.⁶ However, early detection is crucial for ensuring the best possible optimal treatment outcomes.⁶

If you have symptoms or you are at higher risk of prostate cancer, your doctor may carry out one or more tests. These can include blood tests, a digital rectal examination and biopsy.

Prostate-specific antigen (PSA) testing is a simple blood test that measures the level of the PSA protein. PSA is a substance made by both healthy and cancerous prostate cells and levels can vary over time. Higher than normal levels of PSA may indicate that there is an issue with the prostate.⁶ However, not all men with higher levels of PSA have cancer and some men can have prostate cancer and normal PSA levels.⁵ Because of this, the PSA test will typically be used in combination with other tests to confirm diagnosis.⁶

A digital rectal examination (DRE) is a physical examination carried out by a doctor, to check the size and feel of the prostate. A DRE alone does not diagnose prostate cancer and is no longer routinely performed in patients without symptoms of prostate cancer. It may still be used to check the prostate before a biopsy, or to help determine the next step in diagnosis.^6,11,12

If PSA testing suggests that cancer might be present, a urologist may perform a prostate biopsy. During a biopsy, the urologist will remove a small piece of tissue from the prostate. A pathologist will examine it under a microscope for the presence of cancer cells to help make a prostate cancer diagnosis.⁶  A biopsy not only helps to determine whether cancer is present, it can also be used to identify the type and grade of the cancer.⁶

For those with prostate cancer, doctors will use the results of the PSA test, biopsy, and additional imaging tests, such as an x-ray or magnetic resonance imaging (MRI), to determine what type of cancer it is and the stage of its growth.¹²

First, the cancer tissue will be assigned a grade using the Gleason system, which measures how much the cancer resembles normal prostate tissue and helps to indicate how aggressive the cancer is. A Gleason grade of 1 means it looks a lot like normal tissue, while a grade of 5 means it looks very abnormal. Because prostate tumours typically have areas with different grades, the pathologist will assign different grades to the two areas that make up most of the cancer, then add those numbers to produce a Gleason score. For example, if most of the tumour is grade 3 and the rest is grade 5, the total Gleason score is 8.¹²

The Gleason score tells the doctor whether the cancer is:¹²

• Low-grade: Gleason score of 6 or less
• Intermediate-grade: Gleason score of 7
• High-grade: Gleason scores of 8 to 10

Low grade cancers are usually slow growing, while high grade cancers grow more quickly and are more likely to spread to other parts of the body. This grade information is used to help stage the cancer.

After receiving a prostate cancer diagnosis, a healthcare team will need to determine the cancer's stage, or how far it has spread, to decide the best course of treatment. Prostate cancer stages are based on five key pieces of information:¹³

• The size of the tumour
• Whether it has spread to nearby lymph nodes
• Whether the diagnosis is metastatic prostate cancer, meaning it has spread to other parts of the body
• PSA level at the time of diagnosis
• Gleason score

There are four stages of prostate cancer:¹³

• Stage 1 prostate cancer. The cancer has not reached lymph nodes or other parts of the body. PSA level is less than 10 and Gleason score is 6 or less. 
• Stage 2 prostate cancer. Cancer has not spread to lymph nodes or other parts of the body. For subtypes of Stage 2A, Gleason scores are 6 or less. For Stage 2B and Stage 2C, Gleason scores can be 7 or 8. For all subtypes of Stage 2, PSA scores range between 10-20.
• Stage 3 prostate cancer.  In stages 3A, 3B, and 3C, cancer has not spread to lymph nodes or other parts of the body. For 3A and 3B, Gleason scores are 8 or less. For Stage 3C, Gleason scores can be 9 or 10. PSA levels are at least 20 for Stage 3A, while any PSA score may occur with Stage 3B or Stage 3C. 
• Stage 4 prostate cancer. Stage 4 prostate cancer consists of Stage 4A and Stage 4B. In Stage 4A, the cancer has reached lymph nodes but has not reached other parts of the body. It can have any Gleason score and any PSA level. In Stage 4B, the cancer may or may not have reached nearby lymph nodes, but it has reached other parts of the body. It can also have any Gleason score and any PSA level.

Cancer stages indicate how advanced the cancer is and help doctors decide on treatment options.¹³

If the cancer is low-grade and unlikely to grow quickly, the doctor might recommend postponing treatment for prostate cancer and instead waiting to see if the condition worsens. This might involve monitoring with regular PSA tests and biopsies (active surveillance), or simply waiting until symptoms develop (watchful waiting).^6,14

Prostate cancer surgery may involve a prostatectomy to remove the prostate or a radical prostatectomy to remove the prostate and some of the surrounding tissues. This may be an option for patients if the cancer has not yet spread outside the prostate.^6,14

Radiation therapy for prostate cancer uses high-energy rays to eliminate cancer cells, though healthy cells also may be affected by the radiation. There are two main types of radiation therapy:^6,14

• External radiation therapy (external beam radiation therapy, EBRT), which uses a machine to direct radiation at cancer cells

• Internal radiation therapy (brachytherapy), where seeds or pellets are surgically placed into or near the cancer to destroy the cells

Chemotherapy stops the growth of cancer cells either by causing cell death or halting cell division. Chemotherapy may also affect healthy cells. Depending on which drug is used, chemotherapy medications may be administered orally or via injection into muscle tissue or veins.^6,14

Hormone therapy removes or blocks hormones to stop the growth of cancer cells. It may also affect non-cancerous cells.¹⁵ One approach to hormone therapy is called androgen deprivation therapy (ADT). In ADT, doctors use other hormones, drugs, or surgery to reduce the amount of male sex hormones (androgens) or prevent them from functioning. Hormone therapy for prostate cancer may involve:^6,14

• Antiandrogen drugs, which can prevent androgen production (androgen biosynthesis inhibitors); drugs that can block the action of androgens (antiandrogens); drugs that inhibit the androgen receptor at multiple sites to help slow the growth of cancer cells (androgen receptor inhibitors)^14,16

• Orchiectomy surgery to remove one or both testicles and decrease testosterone production¹⁴

• Drugs to prevent testicles from making testosterone¹⁴

Targeted therapy for prostate cancer uses drugs or other molecules to preferentially single out and act on cancerous cells. Targeted therapy may also affect healthy cells but to a lesser extent than chemotherapy or radiation therapy.^14,17

Immunotherapy is a type of therapy that utilises the body’s natural defences—the immune system—to fight cancer.¹⁸

There is no proven way to prevent prostate cancer as the main prostate cancer risk factors cannot be controlled or changed.^7,8 Disease awareness and testing are key to prevention, especially in people experiencing symptoms or with risk factors.

There are many therapies for prostate cancer, including investigational therapies in clinical trials. Treatability depends on the patient's age and overall health and how advanced the cancer is when diagnosed.¹⁴

Anyone with a prostate can get prostate cancer.²

In Australia, prostate cancer is the most commonly diagnosed cancer in males.¹ In 2024, the Australian Institute of Health and Welfare (AIHW) estimated the lifetime risk of being diagnosed with prostate cancer was 1 in 5 for Australian males.³