Lung cancer : prevention and care

SN : In spite of prevention campaigns on tobacco, there is an increase in lung cancer, mainly in women.

TN : Except for tobacco, are there any other causes ?

SN : Yes. We point out to some environmental and professional factors, genetics and family history, and the prolonged use of recreative drugs, mainly cannabis. And, by the way, do you happen to know anything about the histology of this kind of cancer ?

TN : I guess there are two types, the non-small-cell and small-cell neuroendocrine lung cancers. But I know nothing about their symptomatology.

SN : Well, we find many, non-specific and late signs, with more than one out of two patients diagnosed at the metastatic stage, and also paraneoplatic symptoms, usually associated to the small-cell cancer.

TN : Which is why screening is recommended when certain symptoms appear ! But can you tell me how lung cancer can be detected for sure ?

SN : Oh, as usual, either by thoracic radiography, scanner with injection of a contrast product, and, depending on the localization, a Pet-scan, cerebral scan, body scan and liver sonography, and biopsies.

TN : But after the exam, what would be the action to take ? I don’t know for sure. I mean surgery and chemo ?

SN : Well, if cancer is detected, we implement an operability assessment for localized cancers and a general check-up for the metastatic ones with the help of a performance score, that is on the scale from zero to 5, if the patient is able to carry out usual activities with no constraint or not, if he is bed-ridden…

TN : And apart from surgery, chemo and radio therapies, are there any new therapeutic approaches ?

SN : Yes. We have now what we call targeted therapy and immunotherapy which have doubled the patients’ life expectancy and improved their quality of life, and allowed limited use of chemo, since chemo has major repercussions and needs close surveillance.

TN : Are there any other measures that might be taken ?

SN : We also have adjuvant treatments, like the antibiotherapy, oxygen therapy, aerosolotherapy and of course painkillers.

TN : What if there are complications all the same ?

SN : There would be some usual complications like dyspnea, hemoptysis and pulmonary infections. In this case, a nursing care plan is implemented, which revolves around comprehensive supportive care and patient education in order to minimize complications and favor speedy recovery from surgery, radio or chemo therapy. We’d then target the gas exchange, airway clearance, acute pain, fear and anxiety, knowledge about cancer, and other nursing diagnosis, like self-care deficit, usually concerning decreased strength or endurance, presence of pain, depression, presence of therapeutic devices like the IV lines and how to deal with all that.