Lung and chest cancer – ask a clinical nurse specialist

Hi, I’m Michael, and I’m a clinical nurse specialist in thoracic cancer – primary or secondary cancer of the lung or chest. I’d like to help answer some of your questions about thoracic cancer.

Latest Entries
  • November 14th --- at long last.

    HI,

     my apologies first of all for not having been around for a few weeks and not letting you know.

    There was one outstanding question from the last time I posted.

    By JULIE2009

    Hi Michael

    My father-in-law discovered his cancer which started in his bowel has now spread to his lungs and stomach.

    Apparently the tumour in his lung is large and he started a course of chemo tablets this morning and has to take these for the next two weeks.  He was told by the specialist that there is no cure.  Can you tell me why he was prescribed these tablets and do you think they will do him any good

    Thanks

     Without knowing what the tablets are it'd be difficult to say what they are for. Your fathers team can let you know what they expect them to do for his condition, whether it's treating the cancer or the effects of cancer.

    The team is usally best accessed by contacting  the Clinical Nurse Specialist that's attached to your fathers medical team. They should be able to give you all the information you need.

    I hope that helps.

     

    I won't be blogging for a few weeks, so will post again when I am going to take more questions.

     

    in the menatime a live webchat has been set up for next week with Kate  one of the Specialist Nurses from the Macmillan Support line.

    Details below.

    Join us in the chatroom from 12-1pm on Wed 21st.

    More info here:  http://community.macmillan.org.uk/blogs/b/community_news/archive/2012/11/15/lung-cancer-webchat-wednesday-21-november.aspx

    Look forward to next time.

    Michael

     

     

  • October 25th

    HI All,

     

    It’s good to be back.

     

    Three questions this week all answered below.

     

    I hope that the  answers are useful.

     

     

     

    By olive1974

    hi my ex partner has pleural effusion cancer contained in fluid not mets hes 45 never smoked drank will be having op to drain fluid then chemo and rad prog 2 month to 2 year can you  tell me if he has longer he has kids 6 and 4 please help thanks x

    Hi Olive1974,

    It’s incredibly difficult to predict a prognosis accurately. Any ideas of prognosis are based on statistics which cover a large amount of people and it’s difficult to apply these statistics on an individual basis. The best I can suggest is ensuring that your ex-partner and his team are speaking regularly about his progress and what’s expected to happen in terms of treatment and symptom management.

     

    By SStone

    Hi, my mum is 68 and was diagnosed with NSCLC (pleural effusion)and affected nodes in chest in Feb.  She underwent 4 rounds of chemo, finished it in June, where doctors felt the cancer was stable and has been doing brilliantly well since then particularly as she had no previous health problems to deal with, and it may seem an odd thing to say but despite having advanced cancer she has been feeling pretty good and is not far off her old self.   However, over the last few weeks I have started to hear a slight raspiness when she breathes particularly on the phone where she has the mouthpiece close, although she isn't breathless nor does she have a cough. She also suffers a "cold" that she just hasnt been able to shake properly over the past couple of weeks, despite a course of antibiotics given to her by her doctor, to be on the safe side.  My question is, are these signs that her cancer could be on the move again?  I was told to watch for changes in health, but I dont know what exactly I need to look out for and dont wish to panic unnecessarily.  Can you please give me an indication, in your experience, of the sorts of symptoms that are likely to start to develop and at what point should I report them to the hospital?   thanks

    Hi SStone,

     

    It’s difficult to be precise about exactly how significant symptoms are without knowing your mum, but if she has had a course of antibiotics and it has made no difference. it would be worth getting her oncology team to review her. Either for reassurance or to make sure any disease progression is managed early on. The best way to get seen by the team is usually by contacting the Clinical Nurse Specialist.

     

    By rocket

    Hi, my husband was diagnosed 12 months ago with NSCC  right lung. Now has tumor  invading esophagus, had stent ,now blocked cant eat or drink having to cough continuously to clear saliva and blood stained mucus.Dr ordered suction for me  to help clear.  I get instructions how this week.He is so tired and weak. Has RIG for feed and medicine. I am worried about the chances of haemmorage  as I heard bleeding can lead to this. any advice appreciated

    Hi Rocket,

     

     Speaking to your husbands team about your concerns so that they can tell you of any likely risk of haemorrhage is the best place to  start. They can explain where the tumour is and if it is near any major vessels or structures that could lead to an increased haemorrhage risk. They should also be able to offer you advice on managing this situation if it arises.

     

     

     

     

    I’ll be back again next week so if you start sending me your questions I’ll post another Blog next Thursday 1st November

     

     

    Kind Regards

    Michael

  • Ask a Thoracic CNS

    HI everyone,

    Sorry it's been a while since I last took your questions.

     

    I am happy to answer any questions you have about Thoracic Cancer and will post my replies on Thursday 25th October at 2pm ish.

     

    Hope that's helpful and look ofrward to your questions.

    Kind Regards

     

    Michael

  • 6th September

    Hi everyone,

     

    I've put some answers to the questions below.

     

    Please let me know if they are useful and if you have any other questions.

     

    By ollie1

    Hi

    I have lung mets speckled on both lungs from bowel cancer, I have just finished 12 sessions of chemo and the mets are the same so am having a 3 month break.

    I am interested to see if you know much about having the mets lasered, I know there is a dr in London who uses a fairly new machine to do this. Do you know many people who have had this done and was it a success, and does it get rid of the lung mets.

    Thanks. 

     

    Hi Ollie,

    I have seen patients in similar situations to what you describe. The surgeon and your oncologist would need to discuss your case and intended treatment plan e.g. how much chemotherapy or radiotherapy your oncologist is planning for you.

    To be suitable for removing your lung metastases, you would need to be able to undergo standard thoracic surgery. This is usually done by an incision called a thoracotomy which is on the side and or back of your chest. Each case is individual and a surgeon would need to assess your case, looking at the location of the metastases and calculating how much lung would need to be removed. Not everybody is suitable as if a large amount of lung is removed it may leave you permanently breathless. Some people may also have other diseases that may make them unsuitable for surgery.

    The aim would be to get rid of the lung metastases, but as in all disease that has spread, there is never a complete guarantee that disease will not return in the future.

    The best person to discuss this with would be your oncologist and ask if he can refer you to a thoracic surgeon if you both decide it may be a feasible option.

     

    By Andrea82

    Hello I am new here, my dad was told he has lung cancer and it may of spread to a gland near his throat, I feel shocked and upset he has this. But I was wanting to know if there is treatment if the cancer has spread? I know he is worried about dieing, I keep telling him He won't for a long time? It's hard. Thank you

     

    Hi Andrea82,

     

    I’m sorry to hear about your dad.

    There are usually options for treating lung cancer that has spread, but  each person needs to be assessed individually by their oncology team. Any treatment that may be available would be dependent on where your dad’s cancer has spread too, what type of cancer it is and your dad’s state of health. Your dad’s oncologist should discuss any options that are available with him and help your dad decide what treatment plan he would prefer.

     

    I've put a link below to a guide on what questions to ask your oncology team that may be helpful:

     http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Gettingtreatment/yourcancerservices.aspx

     

    By goldpast

    Hi Michael Female 64 Nsclc lung &lymphs.going for chemo to reduce lymphs before surgery to 2.5 cm tumour left upper.How long would it be before chemo starts and how long will chemo last in all. Everything seems to go so slowly and I am stuck in reverse.Is it because I am 64 nobody cares?

    All started in April, various Pets ebus etc.,I have NSCLC upper left lobe, also lymphs  infected on same side only. 2.5cm tumor. Was originally to have surgery, but because of lymphs maybe now chemo 1st or rad/chemo.This was diagnosed  finally in early August after tests/waiting. What I wish to ask is how fast do things spread once in lymphs as I have not had any treatment yet. I feel emotionally like a ticking time bomb and am so worried that it is speading, Please help

     

     

    Hi Goldpast,

     

    I’m sorry to hear about your situation.

     

    Once the decision has been made by you and your team on a treatment plan, the first treatment should usually start within about one month, according to NICE guidelines. There may be reasons why you can’t have treatment immediately e.g. if you have other health problems that need managing first, because the cancer treatment would be unsafe to give in that stuation. Your oncology team should explain any delays and the reason for them to you.

     I’m sorry you feel nobody cares, but it should have nothing to do with your age. All treatments should be based on a persons physical state. I have dealt with patients treated in their 90’s and also seen people in their 40’s and below who are unsuitable for treatment due to their physical state.

     It’s impossible to predict how a cancer spreads, but your oncologist should be able to give you a treatment plan and explain how they will follow up the diseases progress. It’s obviously a very worrying time and your keyworker should be able to help you in explaining the plan to you and helping you deal with the emotional effects.  You should have regular appointments already planned with your team, if you need to speak to someone before this contact your keyworker and ask if they can either talk to you on the phone or see you at the hospital.

    There's a link below to the current guidelines for managing Lung Cancer, that's  written for patients: 

    http://guidance.nice.org.uk/CG121/PublicInfo/doc/English

    I hope that helps.

     

     

    By Laura.d85

    Hello I am new to this site, my mother has breast cancer 2 years ago and had fully mastectomy and lymph node removal, she then had dual chemotherapy and radiotherapy. She was fit and well and returned to work after, until earlier this year she developed a cough and shortness of breath, she had 2 drains to drain the fluid and then had the talc effusion, she then started chemo capecitibine, we went to see the oncologist yesterday to find out the chemo had not responded and the cancer has grown in the pleural mesiolioma, the onc has offered her a drug called halaven, but we have to wait for funding, I wondered if you was familiar with the drug and the success rates? am desperate to know more. Thanks Laura

     

     

    Hi Laura,

     

    I’m sorry to hear about your mothers situation. Breast cancer isn’t one of my specialist areas, and I don’t have any experience of halaven I’m afraid.

     

    The best places I can advise to get information are via your mothers oncology team and trying the following organisations who have specialist advisers available :

     

    Breast Cancer Care

    http://www.breastcancercare.org.uk/

     Breakthrough Breast Cancer

    http://www.breakthrough.org.uk/

     Macmillan

    http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Breast/Breastcancer.aspx

     

     

    Thanks again for your questions.

     

    I hope the answers have been useful.

     

    I’ll be back in about two weeks and look forward to any questions you may have then.

     

    Michael

  • Any Questions

    Hello all,

    Just to let you know I will post another Blog Next Thursday - 6th September at 2pm (ish).

     

    If you have any questions about Thoracic Cancer I will try my best to answer them as before.

    Unfortunately I can't be specific about individual cases, but can hopefully provide some advice to point you in the right direction in getting the information you need.

     

    There are a few questions that have been posted since my last blog on 16th August, and they will be included.

     

    Look forward to any questions you may have.

     

    See you next week.

    Michael

     

     

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