TREATMENT

A patient’s chance for recovery and amount of time left to live depends on the type of lung cancer, the localisation and size of the cancer, the presence of symptoms, the degree of spread and the patient’s overall health status.?

Small cell lung cancer (SCLC) has the most aggressive growth rate of all lung cancers, the average survival time being only 2-4 months post-diagnosis if untreated. However SCLC is the type of lung cancer most responsive to chemotherapy and radiation therapy.

On average less than 10% of people with primary lung cancer survive five years after diagnosis. On average patients with untreated lung cancer survive up to 8 months. However, if patients undergo surgical resection for cancer that has not spread beyond the lungs the 5 year survival rate may be as high as 35-40%. Unfortunately because small cell carcinoma has almost always spread beyond the lung at the time of diagnosis the prognosis for lung cancer is generally worse than for other types of cancer.

A small number of people with lung cancer can be offered an operation. If your Doctor thinks that this is the best option for you, you will be referred to a chest surgeon. Before a final decision is made, the surgeon will need to be sure that your general health is good, and you will also have another scan (called a "PET scan"). This is a further check on the status of the cancer.

Removing lung cancer is a major operation, and it will take you a number of weeks to recover fully.

Sometimes surgery is more successful if you have chemotherapy (see below) either before or after your operation. The team looking after you will discuss this with you once all your results are available.

This uses high-energy X-rays to destroy cancer cells. It is arranged by a specialist called a "clinical oncologist". You might be offered either:

A long course of treatment ("radical radiotherapy"). This aims to cure the cancer if the cancer is small, but an operation is not possible. It means daily trips to the hospital for treatment over several weeks. This therapy can cause temporary side-effects like tiredness, dry throat or problems with swallowing. Your specialist nurse will give you advice about this and the cancer team will see you regularly to check how you are coping with treatment.

A short course of treatment ("palliative radiotherapy"). This aims to improve symptoms such as cough, bleeding, pain or breathlessness. This only involves between one and five visits to the hospital and generally causes few side-effects.

Chemotherapy

This means using drugs to treat cancer. It has the advantage that the drugs go straight into your blood stream where they can attack the cancer cells wherever they are, including outside the lung. But since chemotherapy also affects normal cells, temporary side-effects are common. The specialist (called a "medical oncologist") will always seek to minimise these side-effects.

Treatment involves having a drip and receiving drugs by injection and tablets, usually as an out-patient. You would usually have two courses ("cycles"), and then have another CT scan to see how you are responding. If chemotherapy is working you may be given four to six cycles in total, every three weeks.

If your cancer is found at an advanced stage or is making you feel unwell, you might decide with your doctors that none of the treatments described above is right for you.

You might benefit from a palliative approach. This focuses on the symptoms you are getting such as cough, breathlessness, poor appetite or weakness, and using medicines or other treatment to control these. The purpose is to improve the quality of your life so that you feel as well as possible.

Your specialist might recommend referring you to a palliative care team who can visit you and your family at home. Some of these teams are linked to a local hospice, and can provide lots of additional help and support to you during your illness

A laser is a very strong, fine beam of light that is very hot. It is used to unblock airways blocked by tumours and to control the cancer, however laser treatment does not cure the cancer. It can burn away tumour tissue and patients receiving the treatment will have an anaesthetic first.

While the patient is asleep, the doctor will put a bronchoscopy tube down their throat, which the laser goes down. When it is in the right place, the surgeon can switch on the laser light and burn away some of the tumour that is causing the blockage. The treatment won't usually burn away the entire tumour but will shrink the tumour enough to improve the symptoms.