There is no widely accepted screening test for lung cancer. In up to 25% of cases, lung cancer is first discovered on a routine chest X-ray or CT scan as a small solitary mass.
Significant improvements in surgery and staging techniques over the last 15 years offer the possibility of curative surgery for those with early stage NSCLC. Some patients will also be treated with chemotherapy or radiotherapy after surgery.
If the cancer is advanced but still hasn’t spread, patients who are fit enough receive intense chemotherapy and radiotherapy, however, fewer than 15% will be alive at five years.
With advanced NSCLC, if the tumour contains a mutation in the EGFR gene, patients can be given a ‘targeted therapy’ which blocks this mutant gene’s activity. However, the tumours almost always develop drug resistance and eventually patients will need chemotherapy. For advanced NSCLC patients without the EGFR mutation, there is only chemotherapy and/or radiotherapy. Overall survival for either group is still less than 5% at five years.
When SCLC is localised to the chest, patients who are considered fit enough receive aggressive chemotherapy and radiotherapy. Once SCLC has spread beyond the chest, there is only chemotherapy to try to make the patient more comfortable, and less than 1% will be alive at five years.
Despite advances with targeted therapies in the last decade, the prognosis for lung cancer remains very poor and there isn’t a lot of hope for patients or their families. As the treatments are often toxic and have severe side effects, patients need to give up work and will often need a lot of supportive care, a major impact on families and an enormous cost to society.