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METHODOLOGY TEXT BOOK 2009 2010.doc
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Fast fact

If a person (to stop) _________ smoking the risk of lung cancer (to reduce) ____ greatly ____________, so that after about 15 years the chances of developing the disease (to be) _______ similar to that of a non-smoker.

Symptoms

If you (to have) __________ the following, or any other symptoms, you must (to have) ____________ them checked by your doctor. But remember, all (to occur) __________ in many conditions other than cancer.

  • a persistent cough or change in the nature of a longstanding cough

  • shortness of breath

  • coughing up blood-stained phlegm (sputum): blood is a warning sign that always needs urgent investigation

  • chest discomfort - a dull ache or sharp pain when you cough or take a deep breath

  • loss of appetite and weight

Diagnosis

At present there (to be) ______ no effective screening test for lung cancer. If you (to suspect) ___________ you (to have) _________ any of the symptoms mentioned, see a GP immediately. Initial tests (to include) _________ a chest x-ray. You may also (to ask) to bring samples of phlegm for examination.

There (to be) ______ several tests that can (to do) _________ to diagnose lung cancer and these include:

  • Bronchoscopy - a thin flexible tube (to pass) __________ gently through your nose or mouth and into the lung airways. Photographs and cell samples (to take) _____then _________.

  • Mediastinoscopy - a small cut (to make) ____________ through the skin at the base of the neck under general anaesthetic. A tube (to pass) ____then __________ into the chest, allowing the doctor to examine the area at the centre of the chest and local lymph nodes.

  • Lung biopsy - a needle (to pass) ____________ through the skin into the lung and a sample of cells (to take) ____________ for examination.

Lung cancer patients may (to refer) _______________ to special clinics.

Treatment

There (to be) ______ two main types of lung cancer: about a quarter (to spread) ______ rapidly ______________ small-cell lung cancers (SCLC); the remainder (to be) _____ relatively slow-growing non-small-cell lung cancers (NSCLC).

When the tumour (to be) _____ away from the centre of the chest and there (to be) ______ little or no spread (NSCLC), surgery (to use) _____ often _________. A small part of the lung may (to remove) ________________ (wedge resection), or a lobe of the lung (lobectomy) or an entire lung (pneumonectomy).

Chemotherapy and/or radiotherapy (to be) _____ usually more effective in treating SCLC because this type of cancer rarely (to occur) ___________ in one place.

Sometimes lung cancer (to cause) _________ breathlessness by obstructing the wind pipe or one of the main airways. In such cases laser therapy can (to provide) __________ some relief.

You can (to breathe) __________ normally with only one lung. However, if you (to have) ________ breathing difficulties before the operation you may (to be) ______ more breathless afterwards. Breathing tests (to carry out) _______________ out to help you and your doctor decide on the best course of action.

New ways of treating lung cancer (to study) _______________. In NSCLC cases, different ways of giving radiotherapy and chemotherapy (to investigate) _______________.

Sometimes new symptoms can (to develop) _______________ during your illness. These may (to cause) ________________ by the spread of the cancer to other parts of the body, but could also (to come) _______________ about because some lung cancer cells (to produce) ____________ hormones that upset the body's chemical balance.

If you (to have) ______________ any new symptoms, tell your GP straight away so you can (to give) _______________ treatment or reassured that there's nothing to worry about.