The patient with lung cancer

Abstract

Cancer of the lung is responsible for the majority of deaths from malignant disease and accounts for at least twice as many fatalities as cancer of the breast and malignant disease of the stomach. About 40 000 people die annually from this disease and there is little evidence that the mortality rate is falling. Because it is so common and usually follows a rapid and often distressing course, the disease produces situations which result in highdependency patients who occupy much of the time of the caring professions. It is also interesting and surprising that one disease can produce such a plethora of symptoms and signs from patient to patient, even with identical primary tumours, and it is characterized by a variety of syndromes which may mimic other disease and lead to errors in diagnosis and treatment. Such a universally fatal disease will obviously present a problem for the attendant medical practitioner whether in the hospital or the community and it is a situation where, with the exception of that minority of patients who are amenable to radical treatment, the doctor is literally dealing with a dying patient from the moment of diagnosis. Progress in the treatment of cancer patients has unfortunately had little influence on the curability of lung cancer and there is little effective longterm treatment that can be offered, and often no treatment is the right treatment. In spite of this hopeless situation there is much to be done in the way of palliation, but it is fruitless to hope for more than the temporary relief of symptoms in all but a small percentage of patients. Such improvement is acceptable because the survival time is short.