Emphysema is a form of chronic obstructive pulmonary disease (COPD). It shares certain characteristics with lung cancer, but the two conditions are not the same. Some people end up with these two conditions simultaneously or are misdiagnosed with one or the other.

Emphysema and lung cancer make breathing more difficult and put your life at risk. Both smoking and genetics contribute to these conditions, which often have many of the same symptoms. However, because they affect your body differently, there are tests to distinguish between emphysema and lung cancer.

3 Differences Between Emphysema and Lung Cancer

Some members of MyLungCancerTeam have emphysema and lung cancer. One member shared, “Dealing with flare-up of COPD. Hopefully, I can recoup enough for chemo next week.” Below are some ways that emphysema and lung cancer differ.

1. The Underlying Disease and Treatment Is Different

The biggest difference between these two conditions is what they do to the lungs. With emphysema, the lung tissue becomes damaged and stiff. As a result, it cannot transport oxygen from the outside air and into the body.

Diseased tissue from emphysema is permanently damaged. Sometimes, surgery can remove it, and your doctor may prescribe medication to help your lungs function better.

Lung cancer also affects lung function but in a different way. During lung cancer, abnormal cells develop into tumors in the lungs. These tumors cause airflow obstruction or other problems that prevent the lungs from working well. Lung cancer tumors can also be removed with surgery, but this is different from removing the actual lung tissue (as with emphysema).

Unlike emphysema, lung cancer is treated with radiation therapy and chemotherapy. In addition, several new targeted drugs and immunotherapy options are available to help address specific forms of lung cancer. If breathing is compromised from late-stage lung cancer or severe emphysema, you may need extra oxygen to help keep your blood levels up.

2. You’ll Need Different Tests for Diagnosis

Some of the initial imaging tests for emphysema and lung cancer are the same. However, the specific testing to diagnose each condition is different.

Diagnosing emphysema involves a range of tests, including pulmonary function tests, arterial blood gas (a blood test measuring oxygen and carbon dioxide in the bloodstream), genetic testing, and electrocardiograms (ECGs) to check if heart problems are responsible for shortness of breath. Your health care provider will also listen to your chest with a stethoscope to check for sounds of hollow breathing.

Lung cancer diagnosis starts with a low-dose CT scan but requires a biopsy of the lung tissue to check for cancer cells. Examining the affected lung cells under a microscope helps doctors determine what type of lung cancer you have and how it should be treated.

3. Unlike Emphysema, Lung Cancer Can Spread

Emphysema only affects the lung tissue. Although it can have major consequences, including a high risk of other health problems (including lung cancer), emphysema doesn’t metastasize (spread) in the same way that lung cancer can.

Like other types of cancer, lung cancer has the potential to move into different organs, like the liver. When this happens, the stage or the severity of the disease gets worse. Metastatic lung cancer is harder to treat and is more life-threatening than lung cancer nodules that stay in the lungs. Emphysema is a disease that affects only the alveoli, a specific type of lung cell. Therefore, there’s no way for it to appear in new places in the body.

3 Similarities Between Emphysema and Lung Cancer

Emphysema and lung cancer share many of the same symptoms, such as shortness of breath and coughing. One member commented, “I have breathing trouble. I have COPD, too.”

1. Smoking Is the Leading Risk Factor for Both

You don’t have to smoke to develop lung cancer or emphysema, but most people do. Cigarette smoking is by far the leading cause of both conditions. Fortunately, quitting smoking can help protect your lungs from further damage, even if you’re already diagnosed with emphysema or lung cancer.

There are also genetic and environmental risk factors for lung cancer and emphysema, many of which overlap. These conditions usually affect people after years of exposure to lung-damaging compounds. Cleveland Clinic notes that most people are diagnosed after age 40 and into their 60s.

Chronic inflammation is a common denominator in both conditions. Having emphysema leads to an increased risk of lung cancer, even in people who've never smoked. Researchers suspect that high inflammation levels play a strong role in this connection.

2. X-Rays and CT Scans Are the First Steps in Diagnosis

An official diagnosis of emphysema or lung cancer requires different tests. However, many people with lung symptoms or a history of smoking are advised to have a chest X-ray first. Chest X-rays provide a general view of the lungs, and low-dose CT scans create a three-dimensional picture of the lungs. Depending on the results of these imaging tests, your doctor will recommend following up with more specific testing for emphysema or lung cancer.

It’s possible to have emphysema and lung cancer at the same time. Sometimes, testing for one condition helps uncover another, allowing for early-stage treatment. One MyLungCancerTeam member shared, “I have COPD and was recently diagnosed with squamous cell lung cancer stage 1. It was found via X-ray for an unrelated problem. … I call it a gift because it was found early!”

If you’re at risk for lung cancer or have symptoms of a lung condition, getting screened is essential to learn more about what’s going on in your body. Finding problems sooner rather than later can help prevent more damage to the lungs or the spread of tumors.

3. Neither Lung Disease Is Contagious

People with emphysema and lung cancer may have shortness of breath and coughing. But that doesn’t mean they have an infectious disease. If you’re coughing or wheezing, other people may assume you have a cold or the flu. However, you can’t spread emphysema or lung cancer to other people.

People with emphysema or lung cancer may have a higher susceptibility to respiratory infections. Getting sick makes your symptoms worse and potentially lands you in the hospital. Wash your hands regularly, avoid other people who are sick, and stay healthy by getting enough rest and eating well to protect yourself. If you start to feel unwell, follow up with your doctor quickly to see if you need antibiotics.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Did your lung cancer screening lead to additional tests for related conditions like emphysema or chronic bronchitis? How does lung disease affect your quality of life? Share your experience in the comments below, or start a conversation by posting on your Activities page.