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Foundations of Respiratory Medicine pp 87–118Cite as

Lung Cancer

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Abstract

The accurate diagnosis, staging and management of lung cancer occupies a large part of modern adult respiratory practice. Although smoking is less prevalent, the incidence and mortality of this condition remain high, and earlier detection through screening programmes is currently being evaluated. Widely available techniques, including endoscopic ultrasound and positron emission tomography scanning, have changed diagnostic strategies and now have an established role in the staging pathway where they have largely replaced surgical staging of the mediastinum. Minimally invasive techniques and lung-sparing resections have allowed potentially curative operations in patients whose comorbidities would have prevented traditional surgical approaches. Although the role of chemotherapy in small cell lung cancer (SCLC) has been well established, recent data have identified benefits of chemotherapy in non-small cell lung cancer (NSCLC) in both primary and adjuvant settings or when combined with radiotherapy. A particularly exciting development has been the recognition of subsets of NSCLC tumours exhibiting driver mutations or expressing programmed cell death receptors which predict response to a rapidly emerging therapeutic armamentarium and which appear more effective and better tolerated than conventional combination chemotherapy. Increasingly sophisticated techniques of irradiation have expanded the hitherto largely palliative role of radiotherapy (RT). Patients with T1–2 tumours who are unfit for surgery can be treated with radical intent using stereotactic ablative body radiotherapy (SABR) or in some centres hyperfractionation. The roles of thoracic and cranial RT in SCLC and NSCLC can now be approached with a firmer evidence base and are discussed in this chapter.

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Author information

Authors and Affiliations

  1. Thoracic Medicine, University Hospital Aintree, Liverpool, UK

    Seamus Grundy

  2. Queen’s Centre for Oncology and Haematology, Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Cottingham, UK

    Rachael Barton

  3. Cellular Pathology, Hull and East Yorkshire Hospitals NHS Trust, Hull Royal Infirmary, Hull, UK

    Anne Campbell

  4. Cardiothoracic Surgery Department, Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Cottingham, UK

    Michael Cowen

  5. Queen’s Centre for Oncology and Haematology, Hull York Medical School, Castle Hill Hospital, Cottingham, UK

    Michael Lind

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  1. Seamus Grundy
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  2. Rachael Barton
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  3. Anne Campbell
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  4. Michael Cowen
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  5. Michael Lind
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Correspondence to Seamus Grundy .

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Editors and Affiliations

  1. Respiratory Research Group, Hull York Medical School, Castle Hill Hospital, Cottingham, East Yorkshire, UK

    Simon Hart

  2. Department of Respiratory Medicine, Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Cottingham, East Yorkshire, UK

    Mike Greenstone

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Grundy, S., Barton, R., Campbell, A., Cowen, M., Lind, M. (2018). Lung Cancer. In: Hart, S., Greenstone, M. (eds) Foundations of Respiratory Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-94127-1_6

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  • DOI: https://doi.org/10.1007/978-3-319-94127-1_6

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