Understanding Lung Cancer: Key Symptoms and How It's Diagnosed

Most people have experienced symptoms of coronavirus over the past few years, so when Ilana Hastings had feelings of breathlessness after recovering from the virus in July 2024, she thought that she might have long Covid. As a seasoned runner, she was also surprised that, before this, she had been getting out of breath on a regular basis and didn’t seem as fit as she had been in the past. She put it down to being tired and stressed. But the symptoms persisted, and, in January 2025, she went to see her GP, who ordered blood tests, which came back normal. She was prescribed a Symbicort inhaler in the hope that this would help, but, while there was some improvement, she was still getting out of breath. So, in March, she went back to her doctor, who referred her for a chest X-ray and a lung function test – the results of which were very unexpected. “After my X-ray, I was told to go to A&E as some of the results were abnormal. After ruling out a chest infection and tuberculosis, they kept me in so I could see the respiratory consultant the next morning,” she says. “I had a sleepless night with a lot of scenarios running through my head, including cancer, which I hoped it wasn’t as no one had mentioned it. “When I saw the consultant, the working theory was sarcoidosis, and I was referred for a CT scan and a lung function test.” Sarcoidosis is a condition that causes tiny collections of immune system cells. These form swollen lumps called granulomas, which commonly occur in the lungs and the lymph nodes of the chest. “I had never heard of sarcoidosis before but was relieved that it wasn’t cancer, even though I knew it hadn’t been ruled out and the only way to do so was a biopsy.” The 44-year-old, who lives in Dublin with her husband and two sons, was discharged and, over the next few months, underwent a series of tests and a CT-guided biopsy to get the final result – which, to her shock, was incurable lung cancer. “I was told that my cancer was incurable and because it is in all lobes of the lungs, it isn’t operable,” she says. “My initial reaction was shock, and trying to think of sensible questions to ask the respiratory consultant. It was awful watching my mum, who came with me, get really upset, and then having to tell my husband. Only high-level information was available at this stage, as the histology was still being carried out, but I did know it was incurable. “The next couple of weeks were quite intense, waiting to get a Pet/CT scan to see if it had spread, waiting to see an oncologist, and then starting targeted treatment immediately and chemotherapy the following week. My husband took a few weeks off work so that we could try and process everything together and we spent most of those weeks walking many kilometres to tire ourselves out so we could sleep well at night. Support in many forms from friends and family also helped to keep me going. Physically, I didn’t feel too bad, but mentally it was really tough. I cried a lot. “It has only been a few months since the diagnosis so it’s still fairly new. I’ve been to counselling at ARC [Cancer Support Centre] twice, which has helped – but I have wobbles frequently enough. Practical things like getting enough sleep and exercise help, as does support from those around me. Every little message cheers you up a bit. We also got a puppy, which is a great distraction, although I’ll be happy when she stops chewing everything.” [ Lung cancer: ‘I was 47 at the time, and the only person in my family who has never smoked’Opens in new window ] As a nonsmoker with no relatives having ever had lung cancer, the mother of two, who is originally from Australia, was told that due to the fact the cancer was widespread, neither surgery nor radiation were an option. She started a course of treatment shortly after diagnosis, which she is still on and finding tough. “The cancer is EGFR (estimated glomerular filtration rate) positive so I can take targeted treatment in the form of a daily tablet,” she says. “I also have chemotherapy every three weeks. The first four rounds were with two drugs, which was a bit tough, and now I’m on a maintenance dose of one drug, which will continue indefinitely along with the targeted tablet as long as it is effective. I will have a scan every three months to monitor any changes. “The first two rounds of chemotherapy were fairly tolerable, but the third and fourth caught up with me as the side effects are cumulative – it wasn’t too bad, but I was quite tired and emotional. The targeted tablet and maintenance dose are pretty tolerable, and luckily I don’t have many side effects – so if it could remain effective forever I would be very happy. “I am starting to feel more like myself again now that the initial tougher chemotherapy had finished, and the treatment is working well so I am much less out of breath, both of which make it easier to feel positive, or at least not think about it all the time.” [ Athlete Ciara Mageean thankful for ‘kind words of support’ during cancer treatmentOpens in new window ] Ilana, who is an architect, says scans have shown that the treatment is working well, but it is difficult to know what the future will hold. “The problem is that at some point the cancer will develop resistance and at present there are limited further options,” she says. “This is why funding and research are so important, as at present I feel like a sitting duck. Notwithstanding some sort of cure being the goal, if there were more treatment options it would greatly improve the chances of being able to successfully hold the lung cancer under control for a longer period of time, almost like a chronic disease, which is already possible with some other types of cancer. “No one knows how long the current treatment might continue to work or when resistance might start to develop, and what form the new cancer cells may take, and apart from keeping myself otherwise fit and healthy, it is something I have no control over. Both these things are quite difficult to manage mentally.” While still trying to come to terms with her diagnosis, Ilana would encourage others to seek medical advice if they experience any concerns. “It’s worth getting any unusual symptoms checked, even if there appears to be a logical explanation,” she says. “Once referred, chest X-rays are often on a walk-in basis and only take a minute, so asking your GP about them would be worthwhile, even if you don’t have typical risk factors. My only initial symptom was getting out of breath – and even then only while I was running – although I did get a lot more colds and coughs than usual last winter. “Having said that, while my cancer may have been less extensive if I had gone to the doctor earlier, I wouldn’t necessarily have been in a different treatment category. It was explained to me that the lungs have a lot of spare capacity, which is why people can climb at high altitudes or have a whole lung removed and still be relatively okay, so at the point where you notice getting out of breath there is likely quite a lot of obstruction in the lungs. This is where funding and research is really important – if there are no early symptoms which mean the cancer is found relatively late, people are much more reliant on nonphysical treatment options. [ Long Covid: ‘I’m only in my 30s, but I’m not the person I was in December 2020′Opens in new window ] “Having a range of different options would increase the chances of the cancer being able to be held under control for longer, and if something could be done to address the resistance issue, this would be amazing, as the existing treatment I am on is working well with relatively few side effects. It would be great if it could work for much longer than it typically does. There are lots of different variations of lung cancer so obviously the more options for everyone the better. “There are plenty of people getting lung cancer even though they’ve never smoked and are otherwise fit and healthy – you would never dismiss any other type of cancer because you didn’t smoke, such as breast or bowel cancer, so why should you dismiss lung cancer?” About lung cancer