LUNG CANCER

It is all too easy to jump to hasty conclusions on being told that you have got lung cancer. It can be difficult to take in all the available information regarding the condition and the possible treatments. The information that follows is intended to fill in some of the gaps and to help in the understanding of the nature of lung cancer.

Introduction

The body is made up of millions of cells. These multiply and divide to replace old dead cells and carry out repairs. The process is under strict control, but sometimes this control breaks down. A cell may then go on dividing in an uncontrolled way, producing a group of abnormal "cancerous"cells, to form a lump or tumour.

The underlying causes of many forms of cancer are unclear, but it is known that the risk of developing lung cancer is far greater for smokers than for people who never smoke. The term "lung cancer" covers a range of similar conditions, all of which behave in slightly different ways, so treatment must be tailored to individual needs. This decision takes account of not just the position and type of tumour and the patient's general fitness, but also their own views on the matter. No single treatment should be regarded as being better than another.

Treatment

To be sure about the right sort of treatment, a number of simple investigations are usually carried out. These may include examination of the sputum, and a bronchoscopy - during which a narrow flexible telescope is passed through the nose and down the windpipe into the lungs to see the tumour, and to take a sample of it.

When this is examined in the laboratory, the precise sort of lung cancer present can be determined. This influences the treatment that is offered. Some people may have a sample of the tumour taken through the skin after it has been anaesthetised with local anaesthetic. A CT scan may be suggested, or a bone scan or ultrasound scan, as well as blood tests. These are all simple, safe, and painless tests which help map out the extent of the tumour.

Types of Treatment

One option is to remove all or part of a lung by an operation. Some breathing capacity may be lost, but an operation will only be suggested if the doctor is sure that the remaining lung capacity will enable the patient to cope with everyday life without becoming too breathless.

Some tumours are very sensitive to drugs or to special doses of x-rays, which are given with the aim of shrinking the tumour. As with surgery, there can be no guarantee of a cure but, in the great majority of individuals with lung cancer, such treatment has a beneficial effect upon troublesome symptoms.

High-dose x-ray treatment (radiotherapy) involves sitting or lying in front of a large machine for a few minutes on a number of occasions, usually spread over two or three weeks. The treatment is completely painless, but may cause some soreness of the skin (rather like sunburn) and also cause some tiredness. However, some people notice no ill effects at all. Radiotherapy takes a little time to work, and continues to shrink the tumour after the course of treatment is over.

Treatment with drugs is known as chemotherapy. This treatment may be given either in the form of tablets or by injection. These drugs then travel in the blood stream, helping to stop cancer cells wherever they are in the body. Some people feel sick after the treatment, but in the overwhelming majority this sickness can be relieved with modern medication. Some drugs used in chemotherapy can cause hair loss, but this is temporary, with the hair growing back after treatment has finished. During chemotherapy, the ability to fight off infections may also be reduced. A careful watch will be kept on this, so that any infections can be dealt with promptly.

A number of other medical treatments may be suggested, such as treatment with a laser beam. In some cases no treatment at all may be necessary, particularly when the cancer is slow-growing and causing no immediate problems.