Lung Cancer

Alison Leary is Senior Lecturer in Oncology at University College London NHS Foundation Trust. She is also Visiting Fellow at Kings College London.

Contributors ix Acknowledgements xi

1 Introduction to Lung Cancer and Mesothelioma 1
Alison Leary

Introduction 1

Epidemiology and causes of lung cancer 2

Overview of the types of lung cancer 6

Delivering cancer services and the multidisciplinary team 8

Meeting information needs 11

Summary 13

References 13

2 The Presentation and Diagnosis of Lung Cancer and Mesothelioma 15
Neal Navani and Stephen G. Spiro

Introduction 15

Clinical features of lung cancer 17

Paraneoplastic syndromes 22

Risk factors for lung cancer 26

Performance status 27

Investigation of lung cancer 28

Staging of lung cancer 38

An algorithm for the diagnosis and staging of non-small-cell lung cancer 41

Mesothelioma 42

Summary 46

References 46

Further reading 47

3 Chemotherapy and Biological Agents 49
Fharat A. Raja and Siow Ming Lee

Introduction 49

Chemotherapy 50

Chemotherapy for advanced NSCLC 53

Addition of targeted therapies to chemotherapy in NSCLC 55

Chemotherapy for small-cell lung cancer 57

Mesothelioma 59

Summary 61

References 61

4 Lung Radiotherapy 65
Nita Patel and Dawn Carnell

Introduction 65

Principles of radiotherapy 65

The use of radiotherapy in non-small-cell lung cancer 73

The use of radiotherapy in small-cell lung cancer 76

Palliative radiotherapy 78

Management of patients during radiotherapy 80

New techniques under evaluation 83

Summary 84

References 84

5 Surgery for Lung Cancer 87
Neil Cartwright and Aman S. Coonar

Introduction 87

The role of the surgeon 89

Reaching decisions about surgery 90

Surgery for cancers of the lung 100

The role of adjuvant treatment in NSCLC 108

Palliative surgical procedures 110

Carcinoid tumours and neuroendocrine cancer 111

Surgery for small-cell lung cancer 112

Bronchoalveolar cell cancer 112

Postoperative complications, rehabilitation follow-up 112

The multidisciplinary team in postsurgical care 115

Summary 116

References 116

6 The Nursing Care of Patients with Lung Cancer 121
Sally Moore

Introduction 121

What are the important issues in relation to lung cancer nursing? 122

Context of lung cancer services 123

The challenges of lung cancer 124

The role of the specialist nurse 138

Summary 139

References 139

7 Supportive Care in Lung Cancer 145
Kay Eaton

Introduction 145

Supportive care 146

Communicating the 'diagnosis' 147

Attitudes towards cancer 148

Uncertainty 149

Psychological distress 150

A family-centred approach to care 152

Improving the patient experience: care across the pathway 153

Summary 156

References 156

8 End of Life Care 159
Michael Coughlan

Introduction 159

Palliative and end of life care 159

Dying in the twenty-first century 160

Diagnosing dying 162

Managing complex ethical dilemmas 163

Planning care for the patient dying from lung cancer 164

Summary 181

References 182

9 Quality of Life in Lung Cancer 189
Alison Leary

Introduction 189

Cancer: the journey, the individual and society 190

Doing the work of cancer and quality of life 192

Towards an understanding of the meaning of quality of life in lung cancer 192

Quality of life in advanced lung cancer: instruments used to measure health-related quality of life 197

Summary 199

References 199

Index 203