Non-Small-Cell Lung Cancer (cont.)
Koyamangalath Krishnan, MD, FRCP
Following surgery for any operable lung cancer, the patient has a risk of developing a second primary lung cancer. Following any treatment, the original tumor may come back.
Palliative and terminal care
- Many lung cancers come back within the first 2 years after treatment.
- The patient should undergo regular testing so that any recurrence can be identified as early as possible.
- The patient should be checked every 3-4 months for the first 2 years and every 6-12 months afterward.
Palliative care or hospice
care refers to medical or nursing care whose goal is 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 of suffering becomes the primary goal for many.
- The patient, her family, and her doctor generally recognize when the patient has reached this point.
- Whenever possible, the patient should plan the transition to palliative care in advance.
- Planning should begin with a conversation between the patient (or someone representing the patient if she is too ill to participate) and her health care provider.
- During these meetings, the patient can discuss likely outcomes, medical issues, and any fears or uncertainties she may have.
Palliative care may be given at home, in a hospital if the patient cannot be cared for at home, or in a special hospice. Palliative care consists mainly of treatments to relieve shortness of breath and pain.
- Breathlessness is treated with oxygen and medications such as opioids (narcotic drugs such as opium, morphine, codeine, methadone, and heroin).
- Pain treatment includes anti-inflammatory medications and opioids. The patient is encouraged to participate in determining doses of the pain medication because the amount needed to block pain varies 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.
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