21. Management of patients with lung cancer

In this series featuring information for patients and professionals taken from SIGN’s evidence-based guidelines we reproduce the section on ‘Information for discussion with patients and carers’ from SIGN guideline number 80, on management of patients with lung cancer.

Frequently asked questions

Patients and their families need information to help them understand and cope with the diagnosis of lung cancer, the treatment options and possible outcomes.

The following points are based on the types of question most commonly asked by lung cancer patients. These notes may be of use to health professionals when discussing lung cancer with patients and carers. They may also be useful in guiding the production of local patient information materials. The advice is divided into sections to highlight the issues that patients and carers might wish to discuss at each stage of care.

Understanding lung cancer

  • What is lung cancer?
  • Is there a cure for lung cancer?
  • How do I find out more?
  • What causes lung cancer?
  • Are their different types of lung cancer?
  • What is small cell lung cancer?
  • What are the different types of non-small cell lung cancer?
  • Can other cancers occur in the lungs?
  • Is it an advantage to know what type of lung cancer I have?
  • Does lung cancer spread?
  • How long have I had lung cancer?

Tests for lung cancer

  • What are the different tests for lung cancer?
  • How accurate are the test results?
  • Are the tests painful?

Diagnosis

  • I have just been told that I have lung cancer – how will I cope?
  • How long will it take me to come to terms with my diagnosis?
  • What if I feel that I cannot cope with my diagnosis?
  • How do I tell the children?
  • How will family members and friends cope with the diagnosis?
  • Will treatment be painful?
  • How long do I have left?
  • Am I going to die?

Treatments for lung cancer

  • What kinds of treatment are available to me?
  • How do doctors decide what type of treatment will be best for me?
  • How can doctors tell if my cancer is curable or not?
  • I am a smoker. Is it worthwhile trying to quit before I start treatment?
  • If I decide to stop is help available?
  • How will I cope with treatment?

Surgery

  • How will it be decided if I am suitable for surgery?
  • Are there different types of surgery?
  • How long will I have to wait to have my surgery?
  • What happens after surgery?
  • Will I be in pain after surgery?
  • What will happen on the first and second days after my operation?
  • When will I know how successful my operation was?
  • When will I be able to go home?
  • What happens after I am discharged from hospital?
  • What should I do when I get home?

Chemotherapy

  • My doctor has told me that I need chemotherapy. What does this mean?
  • I have read that chemotherapy for lung cancer is not very effective – is this true?
  • I am frightened of needles and feel sick at the thought of treatment. What should I do?
  • What actually happens when I get my chemotherapy?
  • What are the main side-effects of chemotherapy?
  • What can be done to alleviate these side-effects?
  • Do the side-effects ease with time?
  • Should I change my diet while I’m having chemotherapy?
  • How do the doctors know if the chemotherapy is working?

Radiotherapy

  • I have been told that I need radiotherapy. What does this mean?
  • Why is radiotherapy used to treat lung cancer?
  • How will the doctors know how many treatments I need?
  • Is radiotherapy painful?
  • Are there any side-effects of radiotherapy?
  • Should I change my diet during radiotherapy?
  • How do the doctors know if the radiotherapy is working?
  • How will I feel after the treatment ends?

Palliative care

  • I’ve been told that my cancer can’t be treated. How will I cope?
  • My doctor has referred me to the palliative care team. What does this mean?
  • Will the palliative care nurse come to visit me at home?
  • Is there any help available if I need nursing during the night?
  • Will I become very short of breath?
  • Am I going to have a lot of pain?
  • Will I have to take morphine?
  • Should I plan for the future?
  • How do I find out how much time I have left?
  • Can I choose where I die?

General issues

  • I have been asked by my doctor to take part in a clinical trial. What does this mean?
  • Are clinical trials safe?
  • Where do clinical trials take place?
  • I’m not happy with my care, how do I complain?
  • Who might be involved in my treatment and care?
  • How can I make sure that I’m seeing the doctor who will give me the best treatment?
  • Will tiredness affect my ability to carry out everyday activities?
  • What kinds of changes might I need to make?
  • Will I still be able to get out and about?
  • Will my sexual feelings be affected?
  • What will life be like after treatment?
Box 1: Sources of further information for patients and carers
ASH London
102 Clifton Street, London EC2A 4HW
Tel: 020 7739 5902
Fax: 020 7613 0531
Email: enquiries@ash.org.uk Website: www.ash.org.uk
Ash is the leading voluntary organisation campaigning for effective tobacco control legislation and providing an expert information service.
CancerBACUP
3 Bath Place, Rivington Street, London EC2A 3JR
Tel: 020 7696 9003
Fax: 020 7696 9002
Website: www.cancerbacup.org.uk
Aims to help people live with cancer. Experienced and qualified cancer nurses staff the information service.

DIPex (Database of individual experiences)
Webite: www.dipex.org/main.asp
DIPex is a website that reports on a wide variety of personal experiences of health and illness. People can watch, listen to or read interviews, find reliable information on treatment choices and where to find support. The site includes lung cancer.

Macmillan Cancer Relief
89 Albert Embankment, London SE1 7UQ
Tel: 020 7840 7840
Fax: 020 7840 7841
Website: www.macmillan.org.uk
Supports people with cancer and their families with specialist information, treatment and care.
Maggie’s Centres Scotland
The Stables,Western General Hospital, Edinburgh EH4 2XU
Tel: 0131 537 3131 Fax: 0131 537 3130
Maggie’s centres aim to help people with all kinds of cancer, their families and friends, to address all aspects of living with cancer, to share their experiences and to become more informed about their disease.
Marie Curie Cancer Care
89 Albert Embankment, London SE1 7TP
Tel: 020 7599 7777
Website: www.mariecurie.org.uk
This charity is dedicated to the care of people affected by cancer and to the enhancement of their quality of life through its caring services, research and education.

Roy Castle Lung Cancer Foundation
200 London Road, Liverpool L3 9TA
Tel: 0871 220 5426
Freephone Helpline: 0800 358 7200
Website: www.roycastle.org
Provides a comprehensive support, information and advocacy service for people affected by lung cancer.

Smokeline and Tobacco unwrapped
Tel: 0800 848484
Website: www.herbs.com/tobacco/
For advice and support on giving up smoking.
Tak Tent Cancer Support Scotland
Flat 5, 30 Shelley Court, Gartnavel Complex, Glasgow G12 0YN
Tel: 0141 211 0122
Fax: 0141 211 3988
Email: tak.tent@care4free.net Website: www.taktent.org.uk
Promotes the care of cancer patients, their families and friends. It provides practical and emotional support, information and counselling as required.
Adapted from SIGN 80. Management of patients with lung cancer. Edinburgh: Scottish Intercollegiate Guidelines Network, 2005.

Guidelines in Practice, May 2005, Volume 8(5)
© 2005 MGP Ltd
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