Lung cancer survivorship in older adults

Overview

Survivorship means life after, during, and beyond a cancer diagnosis. For older adults who have had lung cancer, survivorship is about managing the after-effects of treatment, watching for any signs of cancer returning, and maintaining the best possible quality of life. It is a phase of care, not just a label.

Yes. It is becoming more common for older adults to survive lung cancer, thanks to earlier diagnosis and better treatments.

People aged 65 and older who have been diagnosed with lung cancer, including those who have completed treatment, are on maintenance therapy, or are living with cancer as a long-term condition.

Symptoms

Common symptoms

• A cough that doesn't go away
• Shortness of breath
• Chest pain that worsens with deep breathing or coughing
• Coughing up blood or rust-colored sputum
• Unexplained weight loss
• Fatigue

Symptoms in children

• Lung cancer is extremely rare in children. This article focuses on older adults.

Symptoms in older adults

• Older adults may dismiss early symptoms like a lingering cough or mild breathlessness as part of aging, which can delay care. Report any persistent change in breathing or cough to your doctor.

Causes

Main causes

• Lung cancer is caused by changes (mutations) in lung cells. Smoking is the leading cause, but it can also affect people who have never smoked.
• Exposure to radon gas at home, secondhand smoke, asbestos, or other workplace hazards.

Risk factors

• Smoking or being exposed to secondhand smoke
• Age 65 or older
• Family history of lung cancer
• Past radiation therapy to the chest
• Exposure to air pollution or toxic chemicals

When to see a doctor

See a doctor urgently if:

• Call your doctor or local health service the same day if you notice new or worsening symptoms like coughing up blood, more shortness of breath, or fever.

Book a routine appointment if:

• Attend all scheduled follow-up appointments as part of your survivorship care plan.

Diagnosis

Lung cancer is usually found with imaging scans and a biopsy (taking a small tissue sample). If you are already in survivorship, surveillance scans and check-ups help make sure your cancer has not come back or spread.

Tests that may be done

• Low-dose CT scan of the chest
• PET or MRI scans
• Bronchoscopy (a thin tube with a camera into the lungs)
• Biopsy and lab tests on the sample
• Spirometry or other lung function tests

What to expect at your appointment

Your doctor will review your results and discuss the next steps with you. Ask for a copy of your care plan and for time to ask questions.

Treatment

Treatment for lung cancer depends on the type, stage, and your overall health. The goal may be to remove the cancer, control it, or relieve symptoms. Your age alone should not stop you from getting effective treatment.

Self-care at home

• Follow a survivorship care plan and keep your follow-up appointments
• Stay as physically active as you are able
• Get vaccinated against flu and pneumonia (ask your healthcare team)
• Eat a nutritious diet and stay hydrated
• Rest when you need to, but avoid long periods of inactivity

Medical treatments

Treatment approaches may include surgery to remove part of the lung, radiation therapy to kill cancer cells, and systemic therapies given by mouth or intravenously to attack cancer throughout the body. Your cancer team will explain your options and what each involves. They will also manage side effects such as pain, fatigue, and breathing problems without using brand-specific advice here.

When is surgery considered?

Surgery might be considered if the cancer is in an early stage and your heart and lungs are strong enough. The decision is based on your overall health, not just your age.

Living with this condition

Focus on doing what brings you joy and a sense of purpose. Good sleep, gentle movement, and staying socially connected can help you feel better. Keep a list of your medicines and appointments, and tell your doctors about any changes in how you feel.

Lifestyle tips

• If you smoke, ask your healthcare team for help to quit
• Limit alcohol, as it can weaken your appetite and sleep
• Try breathing exercises or relaxation techniques
• Stay in touch with friends, family, or a support group

Diet and exercise

Eat plenty of vegetables, fruits, whole grains, and lean protein. You do not need a special 'cancer diet'. Aim for light activity, like walking or tai chi, as much as is comfortable. A physiotherapist or occupational therapist can suggest safe exercises for you.

Mental health and emotional wellbeing

Survivorship brings many emotions, including relief, worry, sadness, or guilt. These feelings are normal. If they last or get in the way of your daily life, speak to your healthcare team. They can recommend counselling or other support. If you are in crisis, reach out for help right away.

Prevention

You cannot prevent cancer from coming back entirely, but a healthy lifestyle can lower the risk of other serious illnesses and help you stay strong. Avoid smoking, stay active, and keep up with all medical check-ups.

Vaccines

Vaccines against flu, pneumonia, and other infections are important for older adults with a lung cancer history. Ask your healthcare provider about recommended vaccines.

Screening programmes

If you are at high risk, low-dose CT scans can help detect lung cancer early. After treatment, regular surveillance scans are part of your follow-up, but they are done by your cancer team, not as general screening. Ask your doctor what follow-up plan is right for you.

Complications

If left untreated

• Persistent pain and breathing problems can affect daily life
• The cancer could spread beyond the lungs and affect other organs
• Infections like pneumonia may be more serious
• Without follow-up, recurrence or new problems may be missed

Long-term outlook

The outlook for lung cancer has improved greatly, even for older adults. Many people live for years after treatment. Your overall health, the type of cancer, and how you respond to treatment all play a role. Focus on what you can control: staying active, eating well, and keeping up with your care plan. There is always hope.

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