Screening to diagnose cancer, in a group of people at increased risk of having that cancer, with the objective of identifying the disease before having symptoms and decreasing mortality, is called screening. Screening for breast, cervical and colon cancer is already underway. A study recently demonstrated that screening for lung cancer makes possible, when diagnosis is made earlier, a decrease in mortality. Efforts are being made to implement screening in the countries of the European Union.

It is difficult to know exactly when the cancer appeared. Initially precancerous lesions appear in most patients caused by irritation of the bronchi by tobacco smoke, which will later turn into cancer. This process can take years to show symptoms or to be visible on radiological exams.

The degree or stage of the disease describes its size and tells whether the tumor has already spread to other organs.

There are 4 stages:

Stage I: the cancer is small and located in a part of the lung

Stage II the cancer is small, it is located only in the chest and in the adjacent lymph nodes

Stage III: the cancer is located only in the chest, but it is larger and may have invaded the surrounding tissues and lymph nodes

Stage IV: the cancer has spread to other sites outside the chest (metastases)

Of course! All patients have the right to ask other doctors for a second opinion about their illness. They must be confident that they are being evaluated and treated in the best way. To do this, they must ask the attending physician for a report on the state of the disease and the therapeutic plan. Ideally, a second opinion should be requested at a larger centre with more experience than the centre where you were initially evaluated.

Each patient reacts differently to this treatment. Radiotherapy is a locoregional therapy, so the location of the treated area and the dose administered are determining factors for the appearance of side effects. In the thoracic region the most common effects are fatigue, difficulty in swallowing, non-productive cough and episodes of shortness of breath. If any of these symptoms appear during the course of treatment, you should consult your Radioncologist.

The most common side effects of chemotherapy are changes in the blood (decrease in red blood cells - anemia; decrease in white blood cells - decreased defenses against infections; decrease in platelets - can bleed more easily) and tiredness. Other possible effects are nausea and vomiting, constipation, hair loss and neurological injuries. Different treatments produce different symptoms, and there are several drugs used to mitigate these effects. You should report any new symptoms to your doctor.

It depends on the job you do, your desire to work, and how you will feel during treatment. You should discuss this decision with your doctor.

The main adverse effects of targeted therapies are on the skin. It is therefore very important that, from the beginning of the treatment, you hydrate your skin and protect yourself from sunlight, as recommended by your doctor. Changes in nails, eyes and diarrhea may also appear. You should report any new symptoms to your doctor.

The side effects of immunotherapy are usually different, less severe and less frequent than the effects of chemotherapy. The most common effects are tiredness, lack of appetite and diarrhea. Before starting immunotherapy treatments your doctor will give you a list of possible symptoms, and it is very important that you contact him if you have any symptoms, because if they are detected early they are easily treatable.

During treatment you will have tests, such as a CT scan, which will allow assessment of how your tumour is reacting to treatment.

Of course. Age is not a factor impeding treatment.

The use of alternative treatments can interfere with the treatments you are doing for your disease, or cause side effects that can sometimes be confused with the side effects of your treatments

So, if you plan to use any alternative therapy, you should talk to your doctor first.

It is very important that you tell your doctor all the medications you are taking, even over-the-counter medications like laxatives and vitamins. It is also important that you tell your doctor whenever any new medication is prescribed by another doctor.

There are drugs that interfere with your treatments, and your doctor will be able to advise on their use.

It is important that you have a thermometer at home, a list of the medicines you are taking, and the contact details of your doctor and / or nurse.

Whenever you go to the clinic, you should take the list of medications and a list of questions or doubts you want to ask your doctor.

In the course of your illness you may need oxygen if your lungs are affected to a great extent, if you have complications from your illness, or if you also initially have other illnesses such as heart failure or COPD. It is important that on each visit you explain to your doctor how you feel, if you have new symptoms, if it is more difficult for you to do your usual tasks.

Except in very particular cases, there is no reason to stop having normal sexual activity. If there is any problem, be sure to discuss it with your doctor, who can help you.

Regarding the ability to have children during or after lung cancer treatment, we know that women may have hormonal changes that stop menstruation, temporarily or permanently, while in men there is no apparent decrease in fertility.

As we do not know what would be the effect of treatments on the fetus , it is convenient that, during treatments, men and women should avoid pregnancy, using non-hormonal contraceptive methods.

It is important that you maintain some activity. You should try to maintain your daily routines, and do some exercise, as long as you don't get too tired in the end. In a few very specific situations you should avoid exercise, and in that case, your doctor will tell you.

Although the recommended degree of exercise varies greatly from patient to patient (age, degree of previous physical activity, symptoms of the disease), walking is an excellent physical exercise, which you can do daily outside or even at home.

Sometimes treatments cause a lack of appetite, nausea, changes in taste, a feeling of fullness after eating little. In these cases you should eat small amounts of food more often, eat slowly and chew your food well. You should not eat fried or fat food, too hot or too cold, acid fruits or fizzy drinks.

Eat a varied diet, which may include foods rich in calories, such as cookies, biscuits, toasts, olives, nuts, sweets and desserts, all in moderate quantities. As fat use olive oil, and season the food with parsley, coriander, oregano, nutmeg, cinnamon, bay leaf, garlic, onion, lemon and pepper.

Drink 1.5l to 2l of water a day, for wich you can drink fruit juices and teas.