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Contributors ix Acknowledgements xi 1 Introduction to Lung Cancer and Mesothelioma 1 Alison Leary Introduction 1 Epidemiology and causes of lung cancer 2 Overview of the types of lung cancer 6 Delivering cancer services and the multidisciplinary team 8 Meeting information needs 11 Summary 13 References 13 2 The Presentation and Diagnosis of Lung Cancer and Mesothelioma 15 Neal Navani and Stephen G. Spiro Introduction 15 Clinical features of lung cancer 17 Paraneoplastic syndromes 22 Risk factors for lung cancer 26 Performance status 27 Investigation of lung cancer 28 Staging of lung cancer 38 An algorithm for the diagnosis and staging of non–small–cell lung cancer 41 Mesothelioma 42 Summary 46 References 46 Further reading 47 3 Chemotherapy and Biological Agents 49 Fharat A. Raja and Siow Ming Lee Introduction 49 Chemotherapy 50 Chemotherapy for advanced NSCLC 53 Addition of targeted therapies to chemotherapy in NSCLC 55 Chemotherapy for small–cell lung cancer 57 Mesothelioma 59 Summary 61 References 61 4 Lung Radiotherapy 65 Nita Patel and Dawn Carnell Introduction 65 Principles of radiotherapy 65 The use of radiotherapy in non–small–cell lung cancer 73 The use of radiotherapy in small–cell lung cancer 76 Palliative radiotherapy 78 Management of patients during radiotherapy 80 New techniques under evaluation 83 Summary 84 References 84 5 Surgery for Lung Cancer 87 Neil Cartwright and Aman S. Coonar Introduction 87 The role of the surgeon 89 Reaching decisions about surgery 90 Surgery for cancers of the lung 100 The role of adjuvant treatment in NSCLC 108 Palliative surgical procedures 110 Carcinoid tumours and neuroendocrine cancer 111 Surgery for small–cell lung cancer 112 Bronchoalveolar cell cancer 112 Postoperative complications, rehabilitation follow–up 112 The multidisciplinary team in postsurgical care 115 Summary 116 References 116 6 The Nursing Care of Patients with Lung Cancer 121 Sally Moore Introduction 121 What are the important issues in relation to lung cancer nursing? 122 Context of lung cancer services 123 The challenges of lung cancer 124 The role of the specialist nurse 138 Summary 139 References 139 7 Supportive Care in Lung Cancer 145 Kay Eaton Introduction 145 Supportive care 146 Communicating the 'diagnosis' 147 Attitudes towards cancer 148 Uncertainty 149 Psychological distress 150 A family–centred approach to care 152 Improving the patient experience: care across the pathway 153 Summary 156 References 156 8 End of Life Care 159 Michael Coughlan Introduction 159 Palliative and end of life care 159 Dying in the twenty–first century 160 Diagnosing dying 162 Managing complex ethical dilemmas 163 Planning care for the patient dying from lung cancer 164 Summary 181 References 182 9 Quality of Life in Lung Cancer 189 Alison Leary Introduction 189 Cancer: the journey, the individual and society 190 Doing the work of cancer and quality of life 192 Towards an understanding of the meaning of quality of life in lung cancer 192 Quality of life in advanced lung cancer: instruments used to measure health–related quality of life 197 Summary 199 References 199 Index 203