Page 30 - Inspire Autumn/Winter Edition 2017

Simon Says

Simon Says...

Lung Cancer Nurse Specialist, Simon Bolton, answers
questions from our patients.

“I have small cell lung cancer, which has been traced from a lymph
node. I’m told it’s hard to see the primary tumour. Is this common?
And is it harder to find a small cell tumour early?”
from Arony via Health Unlocked

Around 15-20% of all lung cancers are small cell lung cancer (SCLC).
It’s considered to be the most aggressive form, often spreading to lymph nodes
and other organs before it’s detected.

Early stage small cell lung cancer is difficult to detect, but, if diagnosed before spreading, it can be treated using a
combination of chemo and radiotherapy. Most small cell lung cancer is found at an advanced stage and chemotherapy
alone is used as the primary treatment.

Some primary cancers are difficult to see on CT scans. They may be tiny or obstructed from view by other organs or
blood vessels. It’s not unusual to secure a diagnosis of SCLC by taking a sample or biopsy from somewhere other than
the lung, such as a lymph node.

“I have an EGFR+ tumour and stage IV NSCLC. “I would like to know more about pleural
I am now on a second-line treatment because effusion. What is it, and how can consultants
of exon 19 deletion. The treatment, osimertib, tell so much about it from a CT scan?”
is holding my tumour, but I’ve been admitted to from Ruth 65 via Health Unlocked
hospital frequently with sepsis or pneumonia. Pleural effusion is a collection of fluid within the space
Is this a side effect of the drug?” between the visceral pleura, a thin membrane covering
from dizzie-wh via Health Unlocked the surface of the lungs, and the parietal pleura, which
Osimertinib is used to treat EGFR mutation positive lines the chest wall.
tumours when first-line treatment has stopped working.
Tests could reveal a genetic mutation called T790M: It occurs when too much fluid accumulates because the
an indicator of why the first treatment stopped being pleura can no longer reabsorb fluid. It can be seen on
effective, but it also suggests other treatment options; in chest X-rays, and an ultrasound scan is a good way of
this case, osimertinib. identifying the position of the fluid build-up.

Common side effects may include: This can guide doctors when draining the effusion, which
can help reduce coughing, chest pain and breathlessness
Low blood counts, particularly white blood cells, which can by relieving pressure on the lung.
lead to infection - and hospital admissions. Early detection
of infection can speed recovery and prevent complications. A CT scan will also show a pleural effusion, and can also
give a very accurate indication of tumours elsewhere in
Shortness of breath. This could be mistaken for infection, but the body which might have caused it.
might be due to inflammation of lung tissue or a blood clot
in the lung (Pulmonary Embolism). Report changes to your If you have questions about lung cancer,
oncology team. Early diagnosis gives a far greater chance you can post them on our dedicated
of effective treatment with antibiotics, steroids or blood-
thinning drugs. lung cancer forum:
healthunlocked.com/lungcancer
Nail defects. Reporting changes will allow early treatment Or call our free Nurse-led helpline:
and might prevent long-term effects on shape, texture and 0800 358 7200
colour, or even loss of the nail.

30 Inspire 2017