Follow-up

Following surgery for operable lung cancer, there is a risk of developing a second primary lung cancer. The original tumor may also return after treatment.

• Many lung cancers recur within the first 2 years after treatment.
• Patients should undergo regular testing to detect recurrence early, with check-ups every 3-4 months for the first 2 years and every 6-12 months afterward.
• Palliative and terminal care

Palliative care or hospice care aims to reduce symptoms and suffering without attempting to cure the underlying disease, primarily for individuals who cannot be cured of lung cancer.

• The decision to transition to palliative care should be planned in advance through discussions between the patient or their representative and the healthcare provider.
• Palliative care can be provided at home, in a hospital if home care is not possible, or in a hospice. It mainly focuses on relieving shortness of breath and pain.
• Shortness of breath is treated with oxygen and medications like opioids, while pain is managed with anti-inflammatory medications and opioids. Other symptoms like anxiety, sleep disturbances, and depression are treated with appropriate medications and complementary therapies in some cases.

Prevention

Lung cancer is highly preventable, with 85% of cases occurring in smokers or former smokers. The best way to prevent lung cancer is not to smoke.

• Cigarette smoking is highly addictive, but smoking rates have decreased in recent years due to the use of supplemental nicotine, group therapy, and behavioral training.
• Smokers using sustained-release bupropion (Wellbutrin, Zyban) have higher quitting and abstinence rates after 1 year.

Screening for lung cancer

The American Cancer Society does not recommend routine chest x-ray screening for lung cancer. However, individuals who smoke or have a smoking history may consider periodic chest x-ray films and should discuss this with their healthcare providers.

Outlook

Overall, 14% of people with non-small cell lung cancer (NSCLC) survive for at least 5 years.

• Patients with stage I NSCLC who undergo surgery have a 70% chance of surviving for 5 years.
• For individuals with extensive non-operable NSCLC, the average survival duration is 9 months.

The patient's functional status can significantly impact their survival duration. Those with small-cell lung cancer who maintain good functionality have an advantage over those who are unable to work or engage in regular activities.

Complications of NSCLC

• Spinal cord compression
• Bone pain
• Hormone or electrolyte imbalances
• Problems with mental functioning or concentration
• Visual problems
• Liver failure
• Pain on the right side due to an enlarged liver
• Weight loss
• Severe hemoptysis

Complications of chemotherapy

• Unexplained fever (due to neutropenia or infection)
• Bleeding (due to low platelet count)
• Electrolyte imbalances
• Kidney failure
• Peripheral neuropathy (tingling, numbness, pain in extremities)
• Hearing problems