Editing Patient Pathways: Lung Cancer (section)

= Patient pathways =

Developing a comprehensive lung cancer treatment plan involves steps from initial presentation and diagnosis to treatment and follow-up. Below is a detailed plan:

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== 1. Diagnostics ==

The patient presents with symptoms such as cough, shortness of breath, chest pain, coughing up blood.

'''Consultation with a general practitioner (GP):''' The patient visits a general practitioner.

'''Medical history and physical examination:''' Detailed medical history of the patient.

'''Initial tests:''' High-resolution low-dose CT scan.

'''Referral to a specialist''' Referral to a radiologist and oncologist.

'''Diagnostic evaluation'''

* Chest X-ray
* Chest CT scan - the gold standard for suspected lung cancer.
* Brain CT/MRI - may be appropriate to locate potential brain metastases.
* PET-CT - provides information on whether tumor tissue is growing.
* FOB with sampling - can reveal the area of the tumor and a sample can be taken for biopsy.
* Transbronchial needle aspiration or biopsy (TBNA) - carries a small risk of air entering the lungs and developing pneumothorax.
* Thoracentesis - to detect cancer cells. Bone scintigraphy - used to determine if the cancer has metastasized to the bone.
* Endobronchial ultrasound - EBUS (inspection of mediastinal structures linearly with an ultrasound probe pressed against the wall of the trachea and large bronchi and needle punctures of enlarged lymph nodes) and rEBUS (diagnosis of peripheral lesions with a radial ultrasound probe)
* Surgery - if none of the previous methods lead to a diagnosis, the tumor tissue must be reached by surgical biopsy.
* Blood tests - to detect biochemical and metabolic abnormalities in the body that sometimes accompany cancer.

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== 2. Treatment ==

'''Multidisciplinary Team (MDT) meeting'''

'''MDT discussion:''' Review of diagnostic findings with specialists including endocrinologists, surgeons, oncologists, radiologists, and pathologists.

Development of a treatment plan: Based on the stage of lung cancer and the patient’s overall health.

'''Treatment options'''

* Surgical treatment
* Radiotherapy
* Chemotherapy
* Targeted therapy
* Angiogenesis inhibitors
* Immunotherapy
* Combined treatment

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== 3. After Treatment: Follow-up, Rehabilitation and Survivorship ==

'''Monitoring'''

Intensive care unit, regular check-ups with physical examinations

Periodic imaging (ultrasound, CT or MRI) to monitor for recurrence.

'''Rehabilitation'''

Physical therapy to recover from surgery.

'''Psychosocial support:''' counseling and support groups for emotional well-being.

'''Long-term care for survivors:''' monitoring for late effects of treatment. Health promotion and lifestyle changes to improve overall well-being.

'''Secondary prevention:''' screening for other malignancies and maintaining a healthy lifestyle.

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== 4. Palliative care (if applicable) ==

'''Palliative treatments:''' To relieve symptoms and improve quality of life in advanced cancer.

'''Pain management:''' Medications, nerve blocks.

'''Symptom control:''' Managing shortness of breath, pain, etc.

'''Hospice care:''' For end-of-life care if curative treatment is no longer an option.

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