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Lung Cancer (cont.)

Lung Cancer Follow-up

Following surgery for any operable lung cancer, there is an increased risk of developing a second primary lung cancer 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 the point that palliative care is necessary.
  • 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.
  • Nicotine gum, nicotine sprays, nicotine inhalers, and some prescription medications have been successfully used to help people trying to quit smoking.
  • Eliminating or 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, medical therapy, 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 potential in detecting early-stage lung cancer and therefore more surgical cures. 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 cancers in smokers and former smokers. However, it has not yet been proven conclusively whether the use of this technique actually saves lives or lowers the risk of death from lung cancer. Trials are under way to further determine the utility of spiral CT scans in screening for lung cancer.
  • The U.S. Preventive Services Task Force (USPSTF) has determined that current evidence is insufficient to recommend for, or against, screening for lung cancer. This means that further research is needed to clarify whether screening tests for lung cancer are beneficial.

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