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Lung Cancer

Lung Cancer

See a health-care provider as soon as possible if any of the following develop:

  • any symptom of lung cancer,
  • new cough or change in an existing cough,
  • hemoptysis (flecks of blood in the sputum when coughing),
  • unexplained weight loss,
  • unexplained persistent fatigue, or
  • unexplained deep aches or pains.

Go immediately to the nearest hospital emergency department if any of the following occur:

Follow-up

Following surgery for any operable lung cancer, there is an increased risk of developing a second primary lung cancer is present as well as risk that the original tumor will come back.

  • Many lung cancers come back within the first two years after treatment.
  • Regular testing should be performed so that any recurrence can be identified as early as possible.
  • A person who has undergone surgery should receive follow-up care and examinations according to recommendations from the treatment team.

Palliative and terminal care

Palliative care or hospice care refers to medical or nursing care to reduce symptoms and suffering without attempting to cure the underlying disease. Because only a small number of people with lung cancer are cured, relief from suffering becomes the primary goal for many.

  • The patient, his or her family, and the doctor will probably recognize when the patient has reached this point
  • Whenever possible, the transition to palliative care should be planned in advance.
  • Planning should begin with a three-way conversation between the patient, someone representing the patient (if he or she is too ill to participate), and the health-care provider.
  • During these meetings, likely outcomes, medical issues, and any fears or uncertainties can be discussed.

Palliative care may be given at home, in a hospital if home care is not possible, or in a hospice facility. Palliative care consists mainly of treatments to relieve shortness of breath and pain.

  • Breathlessness will be treated with oxygen and medications such as opioids, which are narcotic drugs such as opium, morphine, codeine, methadone, and heroin.
  • Pain management includes anti-inflammatory medications and opioids. The patient is encouraged to participate in determining doses of the pain medication, because how much is needed to block pain will vary from day to day.
  • Other symptoms, such as anxiety, lack of sleep, and depression, are treated with appropriate medications and, in some cases, complementary therapies.

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Prevention

Lung cancer remains a highly preventable disease because 90% of lung cancers occur in smokers or former smokers. The best way to prevent lung cancer is to not smoke.

  • Cigarette smoking is highly addictive, and quitting often proves to be difficult. However, smoking rates have recently decreased in North America and in other parts of the world.
  • Health-care workers play an important role in identifying smokers and helping them quit.
  • Many products such as nicotine gum, nicotine sprays, nicotine inhalers, and other types of medications have been successfully used to help people trying to quit smoking.
  • Minimizing exposure to passive smoking is also an effective preventive measure.
  • Using a home radon test kit can identify and allow correction of increased radon levels in the home, which can also cause lung cancers.
  • Smokers who use a combination of supplemental nicotine, group therapy, and behavioral training show a significant drop in smoking rates.

Screening for lung cancer consists of the following:

  • Currently, the American Cancer Society does not recommend routine chest x-ray screening for lung cancer. What this means is that many health-insurance plans do not cover screening chest x-rays or CT scans.
  • Periodic chest x-rays may be appropriate for current or former smokers. Discuss the pros and cons of this approach with a health-care provider.
  • Low-dose CT scans have shown great potential in detecting early stage lung cancer and therefore surgical cure. This procedure requires a special type of CT scanner (spiral CT) and has been shown to be an effective tool for the identification of small lung cancersin smokers and former smokers. However, it has not yet been proven whether the use of this technique actually saves lives or lowers the risk of death from lung cancer. Trials are underway to further determine the utility of spiral CT scans in screening for lung cancer.

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Outlook

Overall (including all types and stages of lung cancer), 16% of people with lung cancer survive for at least five years. Survival rates tend to be low when compared to the 65% five-year survival rate for colon cancer, 89% for breast cancer, and over 99% for prostate cancer.

  • People who have stage I NSCLC and undergo lung surgery have a 60%-70% chance of surviving five years.
  • People with stage II NSCLC have a 30%-40% chance of cure, and those with stage IIIa have a 20%-30% chance of cure.
  • People with extensive nonoperable lung cancer have an average survival duration of nine months or less.
  • Those with limited SCLC who receive chemotherapy have a two-year survival rate of 20%-30% and a five-year survival rate of 10%-15%.
  • Less than 5% of people with extensive-stage SCLC (small cell cancers) are alive after two years, with a median survival range of eight to 13 months.

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