Lung cancer

What to expect -

Lung cancer

The following information describes the optimal care that should be provided at each step of the cancer pathway.

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Lung cancer support

Call the lung foundation on 1800 654 301 for information about lung cancer and where to go for support and help or visit www.lungfoundation.com.au

Also, qualified cancer nurses at Cancer Council can answer your questions about the effects of cancer, explain what will happen during treatment and link you to support groups and other community resources. Call Cancer Council 13 11 20.

Translating and Interpreting Service LogoIf you need an interpreter, call TIS (the Translating and Interpreting Service) on 13 14 50. For support and advice for carers, call the Carers Association on 1800 242 636.

Click here to view additional resources.

beyondblue: The National Depression Initiative
Information on depression, anxiety and related disorders, available treatment and support services
• Telephone: 1300 22 4636
• Website: www.beyondblue.org.au

Cancer Australia
Information on cancer prevention, screening, diagnosis, treatment and supportive care for Australians affected by cancer, and their families and carers
• Telephone: 1800 624 973
• Website: www.canceraustralia.gov.au

Cancer Council (operated by Cancer Council Victoria)
A confidential telephone support services for people affected by cancer.
• Telephone: 13 11 20 (Monday to Friday, 8.30am – 5.30pm)
• Website: www.cancervic.org.au

Care Search: Palliative Care Knowledge network
Information for patients and carers on living with illness, practical advice on how to care, and finding services
• Telephone: (08) 7221 8233
• Website: www.caresearch.com.au

Lung Foundation Australia
Information about lung cancer and patient support
• Website: www.lungfoundation.com.au

National Health Services Directory
A directory providing information on local hospital and community services
• Website: www.nhsd.com.au

Clinical versions of the optimal care pathways have been developed for clinicians and general practitioners www.cancer.org.au/OCP

Phone

1. Initial investigations and referral

DoctorSymptoms of lung cancer may include coughing up blood and/or an unexplained and persistent (lasting more than three weeks) cough/chest infection, chest/shoulder pain, breathlessness and hoarseness.

Your general practitioner (GP) will assess your symptoms, conduct a physical examination and order a chest x-ray. Your GP should also discuss your needs (including physical, psychological, social and information needs) and recommend sources of reliable information and support.

Investigations

If lung cancer is suspected, you will be referred to a specialist for further testing. Your GP will provide the specialist with information about your medical history, whether there is a history of cancer in your family, and your test results.

It can be helpful to bring a family member or friend with you to your appointments.

2. Diagnosis and staging

The specialist should discuss your test results and options for further testing. This is to find out whether cancer is present, and if it is, its stage of development and if it has spread.

You may have one or more of these tests:

  • Computed tomography (CT) scan
  • Bronchoscopy
  • Biopsy
  • Endobronchial ultrasound (EBUS)
  • Positron emission tomography (PET) scan

CT Scan

Computer technology and x-rays are used to create detailed images of the lungs.

Bronchoscopy

A test done under anaesthetic where a flexible tube is used to examine the airways and take tissue samples

Biopsy

There are several ways to take a small tissue sample (a biopsy) from the lungs to examine under a microscope.

PET Scan

This produces a three-dimensional colour image that may show where cancers are located. A small amount of radioactive material is injected and the whole body is scanned.

EBUS Scan

Endobronchial ultrasound (EBUS) is a type of bronchoscopy that uses high-frequency sound waves to create an image.

Some people have further tests such as a bone scan.

It can also be helpful to contact lung cancer peer support groups and support groups for carers.

For a list of questions to ask your doctor visit http://www.cancer.org.au/about-cancer/after-a-diagnosis/questions-to-ask-your-doctor.html

3. Treatment

To ensure you receive the best care, your specialist will arrange for a team of health professionals to review your test results and plan your treatment based on your preferences and needs.

The team will be made up of health professionals who have experience managing and supporting a person with lung cancer. Your specialist will tell you when the team will be discussing your case.

Your team should discuss the different treatment options with you including the likely outcomes, expected timeframes, possible side effects, and the risks and benefits. Your doctor may also suggest you consider taking part in a clinical trial. You might want to ask for more time before deciding on your treatment, or ask for a second opinion.

Let your team know about any complementary therapies you are using or thinking about trying. Some therapies may not be appropriate, depending on your medical treatment.

In some cases, more than one type of treatment will be used to get the best outcome.

Treatment options:

Surgery

Surgery

Surgery is the most common treatment for patients with early lung cancer. It is important that this surgery is performed by a surgeon who is very experienced in performing lung surgery and performs several operations every year.

Radiation therapy

Radiation therapy

Radiation therapy (also called radiotherapy) may benefit patients if surgery is not suitable, or may be combined with chemotherapy.

Chemotherapy or drug therapy

Chemotherapy or drug therapy

Chemotherapy or drug therapy may be given before or after surgery, or if surgery is not suitable, with or without radiation.

Palliative treatment

Palliative treatment

Palliative treatment will be used at different stages to relieve various symptoms and help to improve your quality of life.

The treatment options depend on whether the cancer has spread to both sides of your chest or beyond your lungs.

Lung cancer is often not found until it is advanced because it can grow rapidly and symptoms can be vague.

For more information about treatment and treatment side effects ask your doctor or visit www.cancer.org.au/about-cancer/treatment

Your doctor should discuss your needs with you during and after treatment (including physical, psychological, social and information needs) and may refer you to another service or health professional for different aspects of your care.

4. After treatment

After Treatment

After treatment is completed, your doctor should provide you with a treatment summary which details the care you received, including:

  • diagnostic tests performed and their results
  • types of treatment used and when they were performed
  • treatment plans from other health professionals
  • supportive care services provided to you


Your doctor will decide whether your ongoing care will be managed by your GP or a palliative care physician. You should both receive a follow-up care plan that tells you about:

  • the type of follow-up that is best for you
  • care plans for managing any side effects of treatment, should they occur
  • how to get specialist medical help quickly if you think the cancer has returned or got worse

Your doctor should:

Discuss

discuss your needs with you and refer you to appropriate health professionals and/or community organisations, if support is required

Thermometer


provide information on the signs and symptoms to look out for that might mean a return of the cancer

Healthy eating


provide information on prevention and healthy living

5. If cancer returns

CalendarSometimes lung cancer can come back after treatment. This is why it is important that you have regular check-ups. Usually this will be detected at your routine follow-up appointments or if you notice symptoms are coming back.



6. Living with cancer

Sife Effects
Side effects: Some people experience side effects (for example tiredness) that continue beyond the end of treatment. Side effects sometimes might not begin until months after treatment has finished.
For more information about side effects ask your doctor or visit http://cancervic.org.au/about-cancer/survivors/long-term-side-effects

Advanced care
Advance care plan: Your doctor may discuss with you the option of developing an advance care plan. An advance care plan is a formal way of setting out your wishes for future medical care.
For more information about advance care planning ask your doctor or visit www.advancecareplanning.org.au

Palliative care
Palliative care: This type of treatment will be used at different stages to help you with pain relief, to reduce symptoms or to help improve your quality of life.
For more information about palliative care ask your doctor or visit www.palliativecare.org.au

7. Questions of cost

There can be cost implications at each stage of the cancer care pathway, including costs of treatment, accommodation and travel. There can
be substantial out-of-pocket costs if you are having treatment in a private health service, even if you have private health insurance. You can discuss these costs with your doctor and/or private health insurer for each type of treatment you may have. If you are experiencing financial difficulties due to your cancer treatment you can contact the social worker at your local hospital.

CostFor more information about cost of treatment ask your doctor or visit http://canceraustralia.gov.au/affected-cancer/living-cancer/dealing-practical-aspects-cancer/costs-treatment

TravelFor more about accommodation and travel costs ask your doctor or visit http://www.cancercouncil.com.au/get-support/practical-support-services/