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The purpose of this INFOMED is to give information on lung cancer. While there are over a dozen types of lung cancer, over 90% are what doctors call small cell lung cancer and non-small cell lung cancer (these terms are based on the appearance of the lung cancer under the microscope). These types, along with the most of the other types of lung cancer, have a poor prognosis in the long run. This is because lung cancer spreads (metastasizes) to other organs before it can be completely removed surgically. Nonetheless, progress is being made. In fact, the 5-year survival of lung cancer patients has doubled in the past 20 years, from 7% to 14%.

Sometimes, surgical removal appears to be complete but then the cancer reappears at a later date. These patients also have a poor prognosis. The key point to remember is: If lung cancer is spread at the time of diagnosis, or comes back at a later time after surgical removal, it is almost always a terminal disease. On the other hand, if the cancer does not come back in five years, the overwhelming likelihood is that the patient has been cured. Radiation therapy and chemotherapy can give additional months of life and alleviate pain, but in the vast majority of terminal (recurrent or metastatic) lung cancer cases, the patient must decide when enough is enough.

The philosophy of this INFOMED, is that once patients have a terminal condition, they should accept treatment that keeps them comfortable and pain-free. This is best done in a home or hospice setting. Home care allows patients to pass away peacefully in the presence of family and friends. Hospices are specialized hospitals that do not give aggressive treatments, but concentrate on pain management and patient comfort. In this setting, terminally-ill patients usually slip into a coma and have a peaceful, pain-free death. Many patients - and doctors - do not agree with this philosophy and prefer a more aggressive approach. The choice, in the final analysis, is up to the patient.