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Tailored treatment turns up the heat on melanomas

When Christopher Gordon first felt the pea-sized lump under his armpit, he decided to ignore it. It was 2006, he was just 35 and, as far as he was concerned, in rude good health.

But as he would discover over the following years, a life can be hijacked, halted even, by something as apparently innocuous as a tiny swelling.

Diagnosed with melanoma, one of the deadliest of skin cancers, he underwent surgery to remove the tumour, followed by three months of radiation in his native New Zealand. That was only the beginning of a long and arduous journey that would take him far from home in an effort to save his life.

Six months after those first treatments, a CT scan revealed more lumps in his abdomen and in his back. Those tumours were growing quickly.

Chris Gordon’s life changed when he found a small lump under his armpit nearly 10 years ago. Picture: Ross Land

‘It was like a bombshell when they told me that the cancer had metastasised,’ he recalls. The bad news continued. The flight attendant spent six months travelling back and forth to Los Angeles to participate in a promising drug trial but his tumours did not respond.

Then he was told of another drug trial in Melbourne and, in late 2008, he met University of Melbourne Professor Grant McArthur and Lorenzo Galli Chair in Melanoma and Skin Cancers at the Department of Oncology at Peter MacCallum Cancer Centre. This time fortune would favour the brave New Zealander.

Professor McArthur belongs to a band of medical pioneers which is revolutionising the way treatment is being delivered to patients. Dubbed ‘precision medicine’ or ‘individualised medicine’, it works on the premise that every person is as unique on the inside as they are on the outside.

Treatments are tailored to each patient, taking into account their individual variability in genes, environment and lifestyle. This approach harnesses the expertise of leaders in the fields of medicine, genetics, mathematics, pathology and technology. It represents teamwork at its best and it would take some time for Christopher to fully understand he was standing with innovators on the frontier of medicine.

The story of the drug that would save his life began years ago at Plexxikon, a small biotech company in San Francisco. Its work centred on a gene called a BRAF, which helps regulate cell growth. After discovering that a mutated form of the gene was present in nearly half of all advanced melanoma cancers, researchers developed a drug that could turn off the mutant program caused by that mutated gene.

Professor McArthur’s laboratory in Melbourne was among the first centres in the world to conduct clinical trials of the anti-BRAF drug. Patients’ responses to the drug were dramatic and the treatment is now a standard throughout the world.

The possibilities in the field have fired Professor McArthur and the multi-disciplinary experts who support his clinical work.

Professor Grant McArthur, here in his laboratory, is one of the pioneers of precision medicine. Picture: Chris Hopkins

‘You have to establish the technology in healthcare systems to enable clinicians to look at gene mutations,’ Professor McArthur says. ‘It’s a clear example of the paradigm of personalised medicine where you profile an individual’s cancer, looking at all the unique features in the DNA, and then link that to a therapy.’

The treatment has significantly improved the prognosis for patients with advanced melanoma. Where the average survival rate was once nine months, it has now been extended to more than two years.

An estimated 1400 Australians die from melanoma each year and about 40 per cent of them have the BRAF mutation. ‘This means that 500 to 600 people now benefit from this treatment,’ says Professor McArthur. ‘What is also important is that we are now rapidly identifying all the genes that are mutated or that change in cancers and are getting detailed catalogues of these.

A 3D structure of a melanoma cell. Picture: Sriram Subramaniam, National Cancer Institute, National Institutes of Health

‘There are major efforts happening in ovarian, lung, acute myeloid leukaemia as well as other cancers. These are world-leading efforts to develop personalised medicine approaches for patients with these type of cancers.’

This new approach marks quite a departure from the old. ‘The old approach was to develop cancer treatments in an empirical way, to look for drugs that could kill cancer cells, to test those drugs across all cancers and observe whether they work or not,’ says Professor McArthur.

‘Now cancer treatments can turn off precise individual proteins in the cancer cell and you can screen patients for changes in their DNA sequence that tell whether or not these drugs will work.’

The team is not resting on its laurels. ‘In many ways, the BRAF story was like picking low-hanging fruit,’ he explains. ‘The real challenge is to be able to personalise treatment based on rare events that are occurring in patient cancer genomes.

‘The challenge is how we deal with gene mutations that are unique to 1 per cent of the population … We need to identify these needles in the haystack. We then need to learn how these certain mutations might benefit from certain treatment approaches.’

Associate Professor Clara Gaff says our genomic information is the equivalent of 1000 copies of the novel War and Peace. Picture: Chris Hopkins

A critical element in this new world of precision medicine is genomics. This is where the work of University of Melbourne Associate Professor Clara Gaff, Executive Director of Melbourne Genomics Health Alliance at the Walter and Eliza Hall Institute, comes in to play.

While genetics is the study of one particular gene, genomics is the study of the complete genome, the full set of DNA, which gives doctors a better chance of finding gene changes associated with a disease or condition.

‘Knowing the genetic make-up of a person or a cancer can assist the clinician to make decisions about the patient’s management based on that knowledge,’ she explains. ‘Doctors used to rely on information about the structure of the body, tissues and cells.

Genetic and genomic tests offer more precise information about the cause of a condition or a cancer. The more precise the knowledge a clinician has, the more precise the diagnosis or treatment can be.

Unlocking the mysteries of genomics is a formidable challenge. ‘There are about 3 billion base pairs in the human genome,’ says Associate Professor Gaff. ‘A common analogy used is that our genomic information is the equivalent of 1000 copies of War and Peace.’

Not all the information can be interpreted. ‘For now we understand some facets of the genome,’ she adds. ‘Big data sets are being used to better understand the significance of changes across the genome.’

It is estimated that 60 gigabits of storage is required to hold the data of one patient. Melbourne Genomics estimates that over the next three years an allocation in excess of 100 terabits could be required.

Dr Doug Boyle is the brains behind key infrastructure being developed to access patient data. Picture: Steve McKenzie

Providing this technological framework is another piece of the precision medicine puzzle. Dr Doug Boyle, Director of the Research Information Technology Unit at the University of Melbourne, is the brains behind key infrastructure that has been developed to access patient data across Australia so it can then be used by researchers to push back medical boundaries.

He calls the technology GRHANITE, the GeneRic Health Network Information Technology for the Enterprise. One of its greatest innovations is its ability to record-link without any identity exposure.

There are an estimated 7300 general practice surgeries around Australia and until the advent of GRHANITE, little or no GP patient data has been able to be captured for record-linked research purposes.

So far, 650 of those practices have been linked with GRHANITE for the first time. This, says Dr Boyle, allows researchers to look at the whole care journey that patients have undertaken.

‘Anecdotally 95 per cent of all healthcare happens in the community and yet, because of the difficulty of accessing such data, very little research is conducted using it. Our ability to open up the vast amount of information that is primary care is hugely exciting.’

It has been estimated that with proper integrated data analytics, healthcare costs could be reduced by as much as 30 per cent. A 10 per cent reduction would result in a cost saving of $1.5 billion in Victoria alone.

As medical research advances, it will be increasingly common for the diagnosis, planning, pre-operative preparation, operation and post-operative care to be tailored to the individual. ‘Working as a multi-disciplinary team optimises a patient’s care,’ says David Story, Chair of Anaesthesia at the University of Melbourne.

Professor David Story says working in a multi-disciplinary team optimises a patient’s care. Picture: Chris Hopkins

‘It allows a team to look at a patient’s care from different perspectives. The aim of precision medicine in anaesthesia is to identify an individual’s risk factors and to optimise care, taking those risks into consideration.’

Professor Story says diabetes is an obvious example of a risk factor. One in four patients admitted to many hospitals has diabetes and half are undiagnosed before admission.

Precision medicine is an excellent strategy and philosophy. It’s an excellent way forward.

‘We need to look at individual patients every time we take care of them.’

Christopher Gordon’s medical journey has not been easy but it has been successful. Once he was taking eight BRAF inhibitor pills twice a day, and almost three times as many to counter side effects.

When chronic inflammation of the eyes forced him off the trial, he was gutted. ‘I had always told myself that one day this might happen.’

However, an alternative treatment without the same side effects, and which he continues to take, was found for him. ‘The medical team has been incredible and saying goodbye to them has been bittersweet. I will miss them.’

Banner image: A summer’s day at Manly Beach, Sydney, Australia. Picture: Sacha Fernandez/ Flickr

Lung Cancer 101

Managing Treatment Side Effects

The body’s reaction to chemotherapy, radiation, or targeted treatments depends on a number of factors such as length of treatment, dosage prescribed, and a person’s health history. Most side effects are short term, but some can last throughout your treatment and even for some time afterward. Although side effects can be uncomfortable or painful, doctors now have many ways to reduce and even prevent side effects from treatment.

The following are possible side effects you may experience and resources to help you manage:

Blood clots

People with cancer are at risk for developing blood clots for various reasons, but steps can be taken to prevent and treat blood clots.

Learn more and view resources ‘

Bone issues

Cancer that starts in or spreads to the bones can lead to bone pain and an increase in risk for complications, including weakening of the bone, fractures, and high calcium levels in the blood. Cancer treatments may also affect your bones.

Learn more and view resources ‘


Problems with memory and concentration, along with a general feeling of not functioning as well mentally as usual, are informally referred to by patients as chemobrain.

Learn more and view resources ‘

Dental issues

Side effects from cancer treatment may include tooth decay and other mouth issues, including dry mouth and mouth sores. It’s important to address any dental concerns you have, especially before beginning treatment, but also during and after with both your treating physician and dentist.

Learn more and view resources ‘


Defined as two or more loose bowel movements per day, diarrhea may be caused by some types of chemotherapy and radiation to certain areas of the body. There are many things you can do to help control diarrhea.

Learn more and view resources ‘


Fatigue is the most commonly reported side effect of cancer and its treatment. Make sure to report fatigue to your health care team so that everything can be done to manage it.

Learn more and view resources ‘

Hair loss

Hair loss from chemotherapy treatment occurs because hair follicles are weakened by chemotherapy, which causes your hair to fall out much more quickly than it would normally.

Learn more and view resources ‘


People with cancer who have undergone lymph node removal and/or radiation as part of their treatment are at risk for developing lymphedema, a painful swelling that happens when your body’s lymphatic fluid is unable to circulate properly and builds up in your soft tissues instead.

Learn more and view resources ‘

Mouth sores

‘Oral mucositis’ refers to mouth sores caused by irritation of the mucosa-the soft tissues that cover the tongue and inside of the mouth, and can be a serious side effect of chemotherapy treatment.

Learn more and view resources ‘

Nausea and vomiting

While many people who are treated for cancer experience nausea and vomiting, medicines exist that can help control these side effects.

Learn more and view resources ‘


Some people who receive chemotherapy experience numbness or tingling in their hands and feet, what doctors call peripheral neuropathy.

Learn more and view resources ‘


If you are experiencing pain as a result of your cancer or its treatment, you should know that managing this pain is an important part of your overall care and should be brought to the attention of your physician. They may find it helpful to provide a referral to a pain management specialist.

Learn more and view resources ‘


A type of targeted treatment that blocks epidermal growth factor receptors (EGFRs) often causes rashes and other bothersome skin conditions.

Learn more and view resources ‘

Weight loss or gain

Cancer treatments can usually lead to weight loss, but people with cancer can also experience weight gain from chemotherapy treatment, steroid medications, and hormone therapy.

Learn more and view resources ‘

What’s the Survival Rate for Each Stage of L...

Updated October 13, 2015.

Lung cancer survival rates are a measure of how many people remain alive with lung cancer after a certain amount of time. For example, a 5-year survival rate of 40% for a condition, would mean that 40% of people, or 40 out of 100 people, would be alive after 5 years. When talking about lung cancer, physicians often use the term median survival as well. Median survival is the amount of time at which 50% of people with a condition will have died, and 50% are still alive.

Lung cancer survival rates are statistics and don’t necessarily give an accurate estimate of how long an individual will survive with a certain disease. There are many factors that affect lung cancer survival rates, including general health, sex, race, and treatments used. Smoking cessation is demonstrated to improve survival in patients with early stage non-small cell lung cancer and in some patients with small cell lung cancer.

The majority of patients with lung cancer have metastatic non-small cell cancers at the time of diagnosis, and there is no data showing that smoking cessation improves survival in this population. Here are some things that affect lung cancer survival.

Not everyone living with lung cancer is interested in hearing statistics about survival rates. Some people want to know what they can expect (statistically that is) with their particular type of lung cancer, whereas others find numbers about survival rates to be discouraging. It is important for loved ones to be sensitive to this, and honor the wishes of their loved one with cancer. That said, even if you aren’t interested in statistics there are things you can do to raise your odds.

Check out this article to see things (other than surgery, chemotherapy, and radiation therapy) that have been found to increase survival in well-researched studies.

Overall Survival Rates by Lung Cancer Type

    Small Cell Lung Cancer – The overall 5-year survival rate for small cell lung cancer (limited and extensive) is only about 6%.
  • Non-Small Cell Lung Cancer – The overall 5-year survival rate for non-small cell lung cancer (all stages combined) is roughly 18%.
  • BAC (Bronchioloalveolar Carcinoma) – The survival rate with BAC is significantly better than with other forms of non-small cell lung cancer, especially when it is caught early and only one tumor is present. In one study, those who were diagnosed with BAC and had tumors less than 3 centimeters in diameter, had a 5-year survival rate of 100% with surgery. The 5-year survival rate for people with more advanced stages of the disease varies considerably.

Survival Rates by Lung Cancer Stage

As mentioned above, survival rates do not reflect differences in individuals. In addition, keep in mind that not everyone with a particular stage of lung cancer has the same prognosis. Staging lung cancer can help guide treatment, but there is a wide spectrum of cancers within each stage.

  • Stage 1 Non-Small Cell – The overall 5-year survival rate for stage 1A lung cancer is 49% and for 1B is 45%.
  • Stage 2 Non-Small Cell – The overall survival rate with stage 2A lung cancer is 30% and for stage 2B lung cancer, 31%.
  • Stage 3A Non-Small Cell – The overall survival rate for stage 3A lung cancer is 14%, but this varies widely among different cancers that are classified as stage 3A.
  • Stage 3B Non-Small Cell – The 5-year survival rate with stage 3B lung cancer is only 5%. The median survival time with treatment is 13 months.
  • Stage 4 (Metastatic) Non-Small Cell – The overall 5-year survival rate with stage 4 lung cancer is sadly only 1%. The median survival time is about 8 months.
  • Small Cell Lung Cancer – The overall 5-year survival rate for both stages of small cell lung cancer (limited stage plus extensive stage) is only about 6%. Without treatment, the average life expectancy for extensive disease is 2 to 4 months, and with treatment is 6 to 12 months.

American Cancer Society. Cancer Facts and Figures 2014. Atlanta: American Cancer Society; 2014. Cancer Society. Lung Cancer (Non-Small Cell.) Non-Small Cell Lung Cancer Survival Rates by Stage. 04/30/2014. http://www.moverfairfaxva.comAmerican Cancer Society. Lung Cancer (Small Cell.) Small Cell Lung Cancer Survival Rates by Stage. Updated 02/11/14. for Disease Control and Prevention. National Program of Cancer Registries. United States Cancer Statistics. 1995-2005 Cancer Incidence and Mortality Data. Accessed 02/16/10. http://www.moverfairfaxva.comEbright, M. et al. Clinical pattern and pathologic stage but not histologic features predict outcome for bronchioloalveolar carcinoma. The Annals of Thoracic Surgery. 2002. 74(15):1640-6.Henschke, C. et al. Survival of patients with stage 1 lung cancer detected on CT screening. The New England Journal of Medicine. 2006. 355(17):1763-71.Liu, Y. et al. Prognosis and Recurrent Patterns in Bronchioloalveolar Carcinoma. Chest. 2000. 118:940-947.National Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ). Stage 0 Non-Small Cell Lung Cancer. Updated 08/06/14. Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ). Stage 1 Non-Small Cell Lung Cancer. Updated 08/06/14. Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ). Stage II Non-Small Cell Lung Cancer. Updated 09/06/14. Cancer Institute. Non-Small Cell Lung Cancer (PDQ). Stage IIIA Non-Small Cell Lung Cancer. Updated 08/06/14. Cancer Institute. Non-Small Cell Lung Cancer (PDQ). Stage IIIB Non-Small Cell Lung Cancer. Updated 08/06/14. http://www.moverfairfaxva.comNational Cancer Institute. Non-Small Cell Lung Cancer (PDQ). Stage IV Non-Small Cell Lung Cancer. Updated 08/06/14. Cancer Institute. Small Cell Lung Cancer Treatment (PDQ). Updated 08/06/14., A. et al. Influence of smoking cessation after diagnosis of early-stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. British Medical Journal BMJ2010:340:b5569. Published online 21 January 2010.


Expertise domain: Cancérologie, Traitements

Published on

The Groupe d’étude en oncologie du Québec (GEOQ) and the Comité de l’évolution des pratiques en oncologie (CEPO) of the Institut national d’excellence en santé et en services sociaux (INESSS) teamed up to develop an interactive tool that will facilitate the management of lung cancer patients. The tool was developed with the support of the Direction québécoise de cancérologie (DQC) of the Ministère de la Santé et des Services sociaux (MSSS).

This innovative tool, written by Gino Boily, Jim Boulanger, Stéphanie Goulet and Marie-Christine Paquin, includes lung cancer investigation, treatment and follow-up algorithms that reflect both the best available evidence and clinical practice in Québec (expert consensus). Nearly 50 Québec oncology experts specializing in the investigation and treatment of lung cancer took part in a meeting for the purpose of answering more than 140 questions concerning specific topics. A review of the scientific literature was then carried out for each question. The algorithms were written by the CEPO’s methodologists using the answers to the questions and literature data. The document was validated and revised by the Consensus Day Organizing Committee, the group of experts who were present, and the CEPO.

The tool is divided into five parts:

  1. The decision algorithms;
  2. The main recommendations by topic;
  3. A summary of the main evidence and of the points of discussion;
  4. The main chemotherapy protocols used to treat lung cancer;
  5. The references supporting these recommendations.

There are clickable links throughout the document that serve as bridges between all the sections. Therefore, from a given topic in an algorithm, the user can quickly navigate to the recommendations and underlying evidence.

This document is intended as a tool for fostering clinical excellence and efficient resource utilization in the health and social services sector, and for facilitating clinical decision-making across the province.

Breathing new life

In many ways, lungs are a medical mystery. The first signs of breakdown and blood leakage are currently undetectable, so there’s no easy way for doctors to know when a patient’s lungs are beginning to fail. This is also why transplant specialists are unable to tell which lungs will survive, and which ones won’t. So not surprisingly, only 35% of donor lungs are able to be transplanted.

The solution: Uncovering the chemical key

Renowned thoracic transplant physician, Dr Dan Chambers, and Queensland’s chief lung transplant research scientist, Dr Stephanie Yerkovich are leading an exciting research project that hopes to uncover the elusive chemical process which occurs in the body when the lining of the cells starts to breakdown, causing blood leakage into the lungs.

‘If we can identify this biomarker, we can start developing a blood test that will aid in early detection,’ said Dr Yerkovich.

‘This will enable transplant teams to make more informed assessments, not just of donor lungs, but of all donor organs.’

‘And it will help researchers find new ways to treat failing organs.’

This research project could mean a brighter future for so many people. Not just those suffering lung disease, anyone who needs an organ transplant or anyone at risk of organ failure as well.

Lung cancer: what you need to know –

What is lung cancer?

Lung cancer is a growth of abnormal cells inside the lung. These cells reproduce at a much faster rate than normal cells. The abnormal cells stick together and form a cluster or growth, known as a tumour. If the abnormal cells began growing in the lung, this is known as a primary lung tumour.

What are the 2 main types of lung cancer?

Cancers that begin in the lungs are divided into 2 main types, non-small cell lung cancer and small cell lung cancer, depending on how the cells look under a microscope.

Non-small cell lung cancer, which is the most common type of lung cancer, accounting for about 80 per cent of all lung cancers, affects the cells that line the main bronchi (tubes into the lungs) and smaller airways. Non-small cell lung cancer generally spreads to distant organs at a slower rate than small cell lung cancer.

Small cell lung cancer, which tends to start in the middle of the lungs and is very strongly associated with cigarette smoking, accounts for about 20 per cent of all lung cancers.

What causes lung cancer?

Cigarette smoking is the major cause of lung cancer. Up to 90 per cent of cases of the disease are caused by smoking. However, it is not known why one smoker develops lung cancer while another does not. Although unusual under the age of 40, the risk of developing lung cancer increases significantly after the age of 50. The younger a person is when they first commence smoking, the higher the risk of developing lung cancer.

Other causes of lung cancer include environmental (passive) smoking, although the risk is less than active smoking, and occupational exposure to asbestos. The greater the exposure to asbestos at work, the greater the risk of lung cancer. This risk is even greater among smokers. Additional occupational exposures possibly associated with lung cancer include contact with the processing of steel, nickel, chrome, exposure to arsenic and coal gas, and exposure to radiation.

How common is lung cancer in Australia?

  • Lung cancer is the leading cause of death due to cancer in Australia.
  • Lung cancer is the fifth most common cancer in Australia.
  • More than 8,000 Australians are diagnosed with lung cancer each year.
  • More than 7,000 Australians die from lung cancer each year.


  • Lung cancer is the fourth most common cancer affecting men (excluding non-melanocytic skin cancer).
  • In 2005, there were 5,738 new cases diagnosed, and 4,711 deaths.


  • Lung cancer is the fourth most common cancer affecting women (excluding non-melanocytic skin cancer).
  • In 2005, there were 3,444 new cases and 2,716 deaths.

National trends

The incidence and death rates of lung cancer among men is falling along with a declining incidence of smoking among men. Lung cancer incidence and death rates among women have risen, reflecting a growing incidence in the number of women smoking cigarettes in the past few decades.

What are the symptoms of lung cancer?

Lung cancer is very difficult to detect at an early stage, although all tumours are present for some time before they are discovered. Sometimes lung cancer is discovered by chance, such as when a chest X-ray is done before surgery for another condition.

Common symptoms of lung cancer include:

  • a new or changing cough, along with hoarseness or shortness of breath or increased breathlessness during exertion; and
  • recurring episodes of lung infection, fatigue, weight loss and swelling of the face or arms.

If the lung cancer has already spread to other parts of the body, it may cause symptoms such as bone pain and headaches.

How is lung cancer diagnosed?

If lung cancer is suspected, several tests can be performed to determine whether or not the disease is present. The doctor will ask about past and current health, and smoking and work history, and will conduct a physical examination. The doctor may then recommend a series of initial tests for lung cancer, including a chest X-ray, CT scan, and sputum test. Your doctor may also refer you to a specialist for a bronchoscopy (a special test that allows your doctor to look inside your lungs and take tissue samples, or biopsies) and further scans. Some of these tests can show whether the cancer has spread to other parts of the body.

What are the treatment options for lung cancer?

The type of lung cancer treatment provided depends on many factors, including:

  • the type of cancer;
  • where the cancer first began growing in the body;
  • what the cancer cells look like under a microscope;
  • what stage the cancer is at – whether the cancer cells have spread beyond the primary tumour, and if so how far; and
  • the general health of the person affected.

There are various treatment options for lung cancer, each with different aims.

  • Surgery. This is used to remove all of the cancer in hope of a cure. Depending on the type and stage of the cancer, surgery may be used to remove the tumour and some of the lung tissue around it. If a lobe (section) of the lung is removed, the surgery is called a lobectomy. Removing only part of the lobe is called a wedge resection. If the entire lung is removed, the surgery is called a pneumonectomy. Surgery is rarely useful for small cell lung cancer.
  • Chemotherapy. This is a course of anti-cancer drugs given to destroy cancer cells. They work by disrupting the growth of cancer cells.
  • Radiotherapy. This is a course of high energy rays, such as X-rays, given to kill or shrink the cancer. The radiation may come from outside the body (external radiation) or from radioactive materials placed directly in the tumour (internal or implant radiation). External radiation is most commonly used to treat lung cancer.
  • Laser treatment. This is used to control the cancer cells and unblock airways obstructed by a tumour. While it does not cure the cancer, it provides symptom relief.

What questions should be asked about any proposed treatment?

When treatment is recommended, it is important to know whether the intention of this treatment is to cure or just to relieve symptoms. This decision is based on the cell type, where the cancer cells are located, and whether there has been any spread beyond the lung tissue itself. It is also important to ask about risks or side effects of any proposed treatment so that the correct decisions regarding appropriate treatment can be made.

What is the outcome of a diagnosis of lung cancer?

The outcome depends on the cell type, how far it has spread, and the person’s level of health and suitability for surgery. If small deposits of non-small cell lung cancer are surgically removed prior to spreading, there is a 5-year survival rate of about 80 per cent.

For more advanced non-small cell lung cancer limited to the chest, the 5-year survival rate, even with a combination of surgery, radiotherapy and chemotherapy, drops to less than 50 per cent.

The survival rate with widespread non-small cell lung cancer that has spread outside the chest is far less satisfactory. Small cell lung cancer also tends to have a poor outcome. Of people with limited disease, about a quarter can be cured with a combination of chemotherapy and radiotherapy. Unfortunately, because most small cell lung cancers have spread by the time they are diagnosed, cure rates are very low.

As many cancers have already spread at the time of diagnosis, only about 15 per cent of all lung cancers are cured. The aim of treatment in incurable lung cancer is to reduce symptoms and maintain quality of life, allowing terminal lung cancer patients to maintain their dignity and be cared for at home or in a hospice.

Essentially, the results of treatment are best when the cancer is detected and treated early. People who have surgery in the early stages of lung cancer have the best chance of cure.


    1. Australian Government – Australian Institute of Health and Welfare (AIHW). Australian cancer statistics update, December 2008 [accessed 2009, Jul 6]. Available at:

    2. Cancer Council Australia. Lung cancer – small cell [updated 2009, Mar 16; accessed 2009, Jul 6]. Available at:

    3. Cancer Council Australia. Lung cancer – non small cell [updated 2009, Mar 16; accessed 2009, Jul 6]. Available at:

    4. Cancer Council NSW. Fact sheet – lung cancer [updated 2005, accessed 2009, Jul 6]. Available from:

lung cancer treatment and survival rate

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Lung Cancer Causes, Symptoms, Treatment – Lu...

Lung Cancer (cont.)

Up to one-fourth of all people with lung cancer may have no symptoms when the cancer is diagnosed. These cancers usually are identified incidentally when a chest X-ray is performed for another reason. The majority of people, however, develop symptoms. The symptoms are due to direct effects of the primary tumor, to effects of metastatic tumors in other parts of the body, or to disturbances of hormones, blood, or other systems caused by the cancer.

Symptoms of primary lung cancers include cough, coughing up blood, chest pain, and shortness of breath.

  • A new cough in a smoker or a former smoker should raise concern for lung cancer.
  • A cough that does not go away or gets worse over time should be evaluated by a health-care provider.
  • Coughing up blood (hemoptysis) occurs in a significant number of people who have lung cancer. Any amount of coughed-up blood is cause for concern.
  • Chest pain is a symptom in about one-fourth of people with lung cancer. The pain is dull, aching, and persistent.
  • Shortness of breath usually results from a blockage to the flow of air in part of the lung, collection of fluid around the lung (pleural effusion), or the spread of tumor throughout the lungs.
  • Wheezing or hoarseness may signal blockage or inflammation in the lungs that may go along with cancer.
  • Repeated respiratory infections, such as bronchitis or pneumonia, can be a sign of lung cancer.

Symptoms of metastatic lung tumors depend on the location and size. About 30%-40% of people with lung cancer have some symptoms or signs of metastatic disease.

  • Lung cancer most often spreads to the liver, the adrenal glands, the bones, and the brain.
  • Metastatic lung cancer in the liver may cause a loss of appetite, feeling full early on while eating, and otherwise unexplained weight loss.
  • Metastatic lung cancer in the adrenal glands also typically causes no symptoms.
  • Metastasis to the bones is most common with small cell cancers but also occurs with other lung cancer types. Lung cancer that has metastasized to the bone causes bone pain, usually in the backbone (vertebrae), the large bones of the thigh (the femurs), the pelvic bones, and the ribs.
  • Lung cancer that spreads to the brain can cause difficulties with vision, weakness on one side of the body, and/or seizures.

Paraneoplastic syndromes are the remote, indirect effects of cancer not related to direct invasion of an organ by tumor cells. Often they are caused by chemicals released from the cancers. Symptoms include the following:

  • Clubbing of fingers — the depositing of extra tissue under the fingernails
  • New bone formation — along the lower legs or arms
  • Increased risk of blood clots in the arms, legs, or lungs
  • Low sodium levels
  • High calcium levels
  • Low potassium levels
  • Degenerative conditions of the nervous system otherwise unexplained.

Medically Reviewed by a Doctor on 4/10/2015

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