[Cat purring]

My name’s Paula Wells and I’m a clinical oncologist,

which means I give radiotherapy and chemotherapy treatments for lung cancer.

Lung cancer is a disease where cells become transformed into what we call malignant or cancerous tissue.

The symptoms are quite hidden, in that they are a cough, which may be a chronic cough

in many of these patients for many years.

What we should notice is that there is a change in their cough pattern. That’s very important.

Other symptoms which would require urgent investigation

are coughing up blood, and that should require immediate referral to a specialist within a hospital setting.

If patients develop persistent or gradual increasing chest pain which is unexplained by other means

or have repeated chest infections requiring multiple courses of antibiotics

or unresolving chest infections, they should also be investigated.

It’s well known that smoking is the major cause of lung cancer,

and this data has been available to us from screening studies performed in the 1950s.

The treatment depends on the type of lung cancer and there are two main groups.

There is small cell lung cancer and non-small cell lung cancer.

If I describe the non-small cell cancer group first,

treatments are related to what we call the stage of the disease, and that defines how advanced the disease is -

whether it’s spread beyond the chest or whether it’s gone into the lymph glands, into the chest, or elsewhere in the body.

If the disease is localised to the chest and it’s technically possible to do an operation

for that patient, then they will be offered a surgical option.

This is the main curative treatment for lung cancer

and is offered in probably up to 20% of cases of lung cancer in the UK.

The second main curative option is radiotherapy, which is giving x-ray treatment, from outside the body,

directed to the lung cancer.

And then the next group of treatments are really what we call palliative or symptom control type treatments

and these include x-ray treatment, or radiotherapy with small numbers of treatments

to help with symptoms such as pain or breathlessness, cough, or bleeding.

and then of course chemotherapy.

The other group of patients is the small cell lung cancer patients.

These behave in a different way. They’re more aggressive.

They’re more likely to spread around in the blood stream at an earlier stage,

so therefore chemotherapy, in the first instance, is the main treatment that we offer

And for those patients that have disease which is localised just to the chest, and have a good response to chemotherapy,

we offer radiotherapy x-ray treatment.

The lung cancer rates are related to smoking exposure,

so historically men have had the highest prevalence of lung cancer and this is still the case,

although, in women this is increasing, unfortunately,

because women are taking up smoking at a higher rate and men are giving up at a higher rate.

And also, women are starting at an earlier age.

It’s clear that the main thing that one can do to reduce your risk of lung cancer is

either give up smoking if you are a smoker and try to avoid taking up smoking if you are a non-smoker.

A good diet full of fresh fruit and vegetables

and a good exercise regime and a general healthy lifestyle

can help improve your outcomes from cancers

because we know that those people who have poor general health do less well with any treatment.

It’s certainly true to say that with the changes in practices that have occurred

over the last five or ten years with regard to the improvement in the diagnostic pathway for patients

and the availability of all treatment options,

that the outcomes for lung cancer are improving.

And there is no doubt that if patients present earlier that the results for lung cancer patients will be improved.

For information, help, or if you just want to chat, call the Macmillan Support Line on 0808 808 00 00, or visit Macmillan.org.uk