Lung Cancer

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 andMesothelioma 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-celllung 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 cancernursing? 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 pathway153
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 inlung cancer 192
Quality of life in advanced lung cancer: instruments used tomeasure health-related quality of life 197
Summary 199
References 199
Index 203