A two page guide for general practitioners to the evidence based guidleines for the assessment and management of lung cancer.

Lung cancer causes a major burden to the health of Australians in terms of morbidity and mortality. The guidelines for the prevention, diagnosis and management of lung cancer provide an evidence-based document produced by a multi-disciplinary working party to facilitate sound decision-making.

They can be utislised for the prevention and screening, initial and pretreatment assessment and supportive care of patients with:

• non-small cell lung cancer (locoregional)
• non-small cell lung cancer (metastatic/ recurrent)
• small cell lung cancer

Available as single PDF file (large file) or each chapter can be downloaded separately. Hard copies can be ordered.

This case study recounts the experience of Harold, a 75-year-old male diagnosed with lung cancer. This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in preventing and managing disease and treatment related care for a person at risk of or diagnosed with lung cancer across the cancer journey.

• Reduce risk; Find the condition early
• Have the best treatment and support during active treatment
• Have the best treatment and support between and after active treatment
• Have the best care at the end of life.

The aim of Education Program in Cancer Care (EPICC) lung module is to improve the quality of lung cancer care and control particularly in rural and regional Australia by providing greater opportunities for interested medical practitioners to increase their expertise in lung cancer management,  chemotherapy administration and management of common complications of cancer treatments.

This primary care respiratory module includes resources and information specific to lung tumour treatment and side effect management, clincial tools, an opioid conversion calculator and safe handling of cytotoxics.

Free registration is required to access the site.

The ASCO Lung Cancers MOC Module consists of 25 multiple-choice questions which include patient case information, educational links and answer rationales. This activity is a tool for self-assessment of medical knowledge as it relates to lung cancers.

Upon completion of this educational activity, participants will be able to:

• Identify knowledge and practice gaps relating to lung cancers
• Apply knowledge learned toward an enhanced ability to identify lung cancer risks and recommend effective interventions for individual patients
• Demonstrate participation in life-long learning and enhancement of competence.

A broad range of links to evaluated clinical practice guidelines that have been developed by a number of organisations and professional bodies in relation to the prevention, screening, diagnosis, treatment and management of malignant neoplasms of the lung.

Medscape from WebMD Lung Cancer Resource Centre offers specialists, primary care physicians, and other health professionals the Web's most robust and integrated medical information and educational tools about lung cancer. After a simple, 1-time, free registration, Medscape from WebMD automatically delivers to you a personalized specialty site that best fits your registration profile.

Some of the key features of Medscape from WebMD are:

• Original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, and more;
• Lung Cancer emedicine articles
• Lung cancer CME
• Conference Coverage: Thought leaders summarize key data and presentations from major medical meetings;
• The Internet's first primary-source medical journal, The Medscape from WebMD Journal of Medicine;
• Selected daily professional medical news in your specialty from Reuters, Medscape Medical News, and medical news journal publishers;
• Physician Optimized MEDLINE;
• Free subscription to Medscape's MedPulse, a weekly email newsletter that highlights what's new in your specialty on Medscape from WebMD;
• More than 125 medical journals and textbooks;
• Business, financial, managed care, and medical practice information

MesotheliomaSymptoms.com is an accurate, dedicated and unique source for information regarding the disease mesothelioma.

The site contains information on asbestos and methods of preventing exposure; as well as the causes, symptoms, diagnosis, staging, treatment and prognosis of mesothelioma.

Comprehensive guidelines developed for the management of patients with lung cancer, covering areas including:

• Presentation and referral
• Smoking cessation
• Diagnostic investigations
• Staging
• Surgery
• Radiotherapy
• Chemotherapy
• Combined modalities
• Endobronchial and vascular therapies
• Complementary therapies
• Multidisciplinary teams, follow up and communication
• Supportive and palliative care
• Implementation and further research
• Information for discussion with patients and carers

The guidelines include a key to levels of evidence statements and grades of recommendation.

UK and international clinical guidelines for the assessment, screening, diagnosis, treatment, disease managment and therapies for lung cancers.

The NICE lung cancer clinical guideline covers the full range of care that should be available from the NHS to adults who have lung cancer, or whose doctors think they may have lung cancer. They include how the diagnosis should be made and the treatments that should be offered at different times.

The full guideline, a quick reference summary and a patient guide are also available.

These clinical practice guidelines serve as a guide for doctors and outline appropriate methods of treatment and care.

Guidelines are avaialble for:

• American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small Cell Lung Cancer (2009)
• 
  Cancer Care Ontario and the American Society of Clinical Oncology Guideline for Adjuvant Chemotherapy and Adjuvant Radiation Therapy for Stages I-IIIA Resectable Non-Small Cell Lung Cancer (2007)

The NCCN Clinical Practice Guidelines in Oncology - the recognized standard for clinical policy in oncology - are the most comprehensive and most frequently updated clinical practice guidelines available in any area of Medicine.

The NCCN Guidelines for Non Small Cell Lung Cancer and Small Cell Lung Cancer include information regarding:

• Treatment
• Detection, Prevention, & Risk Reduction
• Supportive Care

The guidelines are also available for download as apps for iPhone and Android are free to download through the iTunes Store and Android Market. For further information, visit: http://www.nccn.org/mobile/ 

Guidelines are posted with their latest update date and version number.

A full range of guidelines and resources relating to non small cell and small cell lung cancers. including:

• information about prevention, genetics and causes
• screening and testing unformation about methods of cancer detection including new imaging technologies, tumor markers, and biopsy procedures
• Information about treatment, including surgery, chemotherapy, radiation therapy, immunotherapy, and vaccine therapy
  
• statistics related to cancer incidence, mortality, and survival
• research
• information and current news about clinical trials and trial-related data

The ANZ-LCNF has been established to provide a forum for specialist nurses working with people affected by lung cancer/mesothelioma to promote a standardised, evidence-based approach to care delivery for all people.

The initial objectives of the ANZ-LCNF special interest group are to:

• Develop educational resources for patients, their families and carers
• Develop lung cancer/Mesothelioma educational resources for nurses
• Establish a communication forum for nurses working in lung cancer/mesothelioma care
• Encourage the use of research based approaches in the delivery of patient care
• Provide members with opportunities for networking, support and education
• Contribute to a national voice on strategic and clinically relevant issues in the care of people affected by lung cancer and mesothelioma

This site provides information regarding the medical issues and statistics related to lung cancer as well as the physical and emotional stresses for patients and carers.

The Lung Group offers its members access to information regarding current and emerging therapeutic strategies for the treatment of lung cancer and malignant pleural mesothelioma, as well as new diagnostics and basic science research.

For more details regarding this group or to become a member please contact us at: cosa@cancer.org.au

The International Association for the Study of Lung Cancer (IASLC) promotes the study of the etiology, epidemiology, prevention, diagnosis, treatment and all other aspects of lung cancer; disseminates information about lung cancer to the members of the Association, to the medical community at large, and to the public; and
uses all available means to eliminate lung cancer as a health threat for the individual patient and throughout the world.

The website contains information, resources, podcasts and vodcasts, guidelines and information about upcoming events, including the annual world conference.

Membership in the International Association of Lung Cancer is open to any physician or member of the health professions or scientist interested in lung cancer.

The International Lung Cancer Consortium (ILCCO) is an international group of lung cancer researchers, established in 2004 with the aim of sharing comparable data from ongoing lung cancer case-control and cohort studies.

Questionnaire data from a total of 26000 case-control pairs, and the biological samples from the majority of the subjects would be available. These studies are from different geographical areas and ethnicities.

The overall objectives are to achieve greater power, especially for subgroup analyses, reduce duplication of research effort, replicate novel findings, and afford substantial cost savings through large collaborative efforts.

The Kylie Johnston Lung Cancer Network aims to provide support, hope and understanding to Australians living with Lung cancer. It is committed to giving people touched by lung cancer a voice and raising public awareness of the urgent need for more lung cancer information and support services.

The website provides information for patients, their families and carers and health care professionals about resources, events, medical information, links and online forum about lung cancer.

The National Lung Cancer Partnership is a group of leading doctors, researchers, patient advocates, and lung cancer survivors who are working together to improve treatments for lung cancer patients, dedicated to raising public awareness of the disease and generating funding for lung cancer research.

The website contains information and support materials for patients, an online survivor blog and an Ask an Expert forum.  Resources and events are also available for lung health care professionals.

NSWOG Lung was established in December 2005 and has multidisciplinary representation from across the health spectrum, including consumer representatives. It aims to:

The group undertakes projects including developing, promulgating and assessing treatment algorithms for the management of lung cancer in NSW and the identification of succinct dataset extensions for lung cancer as statewide standards to complement the core dataset with additional measures and indicators specific to tumour streams.

A fact sheet developed by the group regarding lung cancer in NSW is available.

The Global Lung Cancer Coalition promotes global understanding of the burden of lung cancer and the right of patients to effective early detection, better treatment and supportive care and are committed to improving disease outcomes for all.

The website contains information, resources and a calendar of events.

Our organization was formed to help those who have been affected by Mesothelioma, a cancer caused from being exposed to Asbestos.

Our mission is to improve the life expectancy, and survival rate of patients affected by this aggressive cancer.

The National Lung Cancer Forum For Nurses website has been developed to provide information to patients, carers and for health professionals whose work involves those with lung cancer. The site contains information for patients and carers about Common Signs And Symptoms, Lung Cancer Tests, Coping With A Diagnosis, Treatments For Lung Cancer, Patient Support Groups, Living With Cancer and Useful Links.

A section provides Health Professional information including Guidelines and Publications and Conferences and Events.

Members can contribute to the online forum and join the regional support group.

The Roy Castle Lung Cancer Foundation works in a variety of ways to reach the goal of defeating lung cancer, including carrying out unique research into the early detection of lung cancer to lead to early diagnosis.

The Foundation also provides practical and emotional support for those affected by lung cancer, research funding, prevention and
awareness campaigns about how to detect the early signs of lung cancer and educational resources for health professionals, patients and their carers.

GuidelineStat™ is the only Website of its kind – a wholly CME guideline resource dedicated to the needs of busy, practice-based physicians, spanning multiple therapeutic areas and linked to guideline-oriented patient cases.

The Non-small cell lung cancer tool includes:

• A Slide Presentation, suitable for self-directed learning
• A Disease State Animation focused on the disease entity and its treatment
• Practical Case Studies exemplifying key teaching points and best-practice guideline recommendations
• Treatment and Diagnostic Algorithms
• An Executive Summary that addresses the practical, need-to-know information from the guideline
• Self-Evaluations
• Patient Education Resources for in-office communications with patients
• A Discussion Forum to promote information exchange between learners and guideline experts
• Breaking News with links to recent publications

Comprehensive information regarding lung cancer including prevalence, classification, pathophysiology, screening, staging, treatments and outcomes.

Rapid changes in cancer care make it imperative to have current information about the prevention, detection, diagnosis and treatment of lung cancer.

This course provides an overview of these key topics, including:

• Identify risk factors associated with lung cancer development.
• Discuss measures to prevent lung cancer.
• Describe the development and clinical manifestations of lung cancer.
• Describe components of the diagnostic evaluation for lung cancer.
• Discuss the current treatment options for non-small cell and small cell lung cancer.
• Describe management strategies to alleviate the common symptoms of lung cancer.
• Identify measures to provide psychosocial support to the patient and family.

Clear, physician developed general information regarding lung cancer anatomy, causes, risk factors, symptoms, types, diagnosis, staging, treatments and prognosis.

Comprehensive, authoritative, evidence-based information regarding lung cancer and its

• Causes
• Symptoms
• Diagnosis
• Prevention and Treatment
• Prognosis

Multimedia resources including anatomical drawings are available on the site. 

Information regarding the annual Australian lung cancer conference including program details and registration information.

Lung cancer is the biggest cause of cancer deaths in Australia and along with smoking-related conditions it remains a continued burden on the health system and economy.

Cancer Australia, through the new National Lung Cancer Program will:

• build an accessible evidence-base through research, clinical guidance material and improved cancer data.
• support health professionals to deliver consistent best practice care through targeted programs.
• fund research to identify where variations in lung cancer management are leading to variations in outcomes for people with or who may have lung cancer.
• develop targeted clinical guidance material to guide clinical decision making and treatment for lung cancer.

Clinical Lung Cancer is a tumor-specific, peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer.

Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer.

Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.

Articles are available for download as PDFs from the site or information is available for subscription to the journal.

Lung Cancer aims to provide individuals or organisations with the most recent information on lung cancer and other thoracic malignancies.

The Journal publishes original research and review articles on clinical and basic science aspects of topics represented by the fields of interest of Lung Cancer (prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities, outcomes).

Articles can be accessed as downloadable PDFs freely from the site. Information is available on the site to subscribe to the journal.

Users can customise the site to receive weekly emails regarding the latest literature and articles in selected journals regarding their topic of interest.

The lung cancer literature offers users 69 journals to select to receive information about the latest articles.

A site containing information about lung cancer and lung cancer treatment with ASCI* (Antigen-Specific Cancer Immunotherapeutics), a new approach to a type of lung cancer treatment called immunotherapy that combines a cancer-specific antigen (called MAGE-A3) and an immune reaction booster (called an Adjuvant System). 

The AMR collects information about cases of mesothelioma to:

• Better understand the exact relationship between asbestos exposure and mesothelioma.
• Better understand the nature and levels of asbestos exposure that can result in mesothelioma.
• Identify the groups of workers exposed to potentially dangerous levels of asbestos and to prevent that exposure.
• Assist the development of policies to best deal with the asbestos still present in our environment (mainly our built environment).
• Provide information to assist researchers in undertaking investigations with the aim of preventing mesothelioma in the future.
• Identify other potential exposures that may cause mesothelioma.

Information regarding the upcoming Perspectives in Lung Cancer conference, to be held 11-12 March 2011, in Torino, Italy.

Focusing on state-of-the art information on treatment and diagnosis, this Congress will provide attendees with valuable data for the management of patients with lung cancer.

Information is available on the site regarding registration and program details.

A wide range of evidence based articles and PowerPoint presentations relating to the diagnosis and treatment of lung cancer. Links to non-ERS resources and articles are also available on the website.

PDFs and PowerPoint presentations can be downloaded for free from the site. Webcasts and videos of the presentation are available to members or may be purchased in a pay-per-view format.

Hem/Onc Today strives to be the global, definitive information source for oncology and hematology professionals by delivering timely, accurate, authoritative and balanced reports on clinical issues, socioeconomic topics and industry developments, as well as presenting clinically relevant information on medical therapies for the benefit of the patient. All articles in Hem/Onc Today are reviewed by the Chief Medical Editor and Executive Editor.

The lung cancer page includes featured articles regarding the latest in lung cancer research and treatment.

Users can sign up for regular email updates.

The application can also be downloaded to iPhones here.

A personalised news service allowing subscribers to receive news feeds and information to receive the latest news, updates and research regarding their chosen topic.

Users can customise the lung cancer searches to receive information regarding specific areas of lung cancer or information from specific countries or journals.

Providing relevant, high quality and up-to-date information, MedConnect is a gateway to leading local and international medical news, research, events and resources to allow health care professionals to stay connected to the most important developments in medicine.

The lung cancer page features the latest news, research, drugs, podcasts, videos, articles, conferences and events.  

Users can sign up for free to receive daily news feeds and journal summaries about their specialist topic.

Information regarding the restrictions and treatment details regarding authority to supply gefitinib (Iressa®) for the treatment of locally advanced or metastatic non-small cell lung cancer through the Pharmaceutical Benefits Scheme.

An application form is available on the site.

A range of interactive CME modules regarding lung cancer categorised according to the stage of the disease and the patient journey:

• Epidemiology and Etiology 
• Prevention and Screening
• Diagnosis and Staging
• Treatment 
• Supportive Oncology

Courses may have expiry dates.

BMC Public Health is an open access journal publishing original peer-reviewed research articles in the epidemiology of disease and the understanding of all aspects of public health.

This article was written by Landi, Maria Teresa; Consonni, Dario; Rotunno, Melissa; Bergen, Andrew; Goldstein, Alisa; Lubin, Jay; Goldin, Lynn; Alavanja, Michael; Morgan, Glen; Subar, Amy; Linnoila, Ilona; Previdi, Fabrizio; Corno, Massimo; Rubagotti, Maurizia; Marinelli, Barbara; Albetti, Benedetta; Colombi, Antonio; Tucker, Margaret; Wacholder, Sholom; Pesatori, Angela; Caporaso, Neil and Bertazzi, Pier Alberto. (2008, 8:203) and the abstract is as follows:

Background
Lung cancer is the leading cause of cancer mortality worldwide. Tobacco smoking is its primary cause, and yet the precise molecular alterations induced by smoking in lung tissue that lead to lung cancer and impact survival have remained obscure. A new framework of research is needed to address the challenges offered by this complex disease.

Methods/Design
We designed a large population-based case-control study that combines a traditional molecular epidemiology design with a more integrative approach to investigate the dynamic process that begins with smoking initiation, proceeds through dependency/smoking persistence, continues with lung cancer development and ends with progression to disseminated disease or response to therapy and survival. The study allows the integration of data from multiple sources in the same subjects (risk factors, germline variation, genomic alterations in tumors, and clinical endpoints) to tackle the disease etiology from different angles. Before beginning the study, we conducted a phone survey and pilot investigations to identify the best approach to ensure an acceptable participation in the study from cases and controls. Between 2002 and 2005, we enrolled 2101 incident primary lung cancer cases and 2120 population controls, with 86.6% and 72.4% participation rate, respectively, from a catchment area including 216 municipalities in the Lombardy region of Italy. Lung cancer cases were enrolled in 13 hospitals and population controls were randomly sampled from the area to match the cases by age, gender and residence. Detailed epidemiological information and biospecimens were collected from each participant, and clinical data and tissue specimens from the cases. Collection of follow-up data on treatment and survival is ongoing.

Discussion
Environment And Genetics in Lung cancer Etiology (EAGLE) is a new population-based case-control study that explores the full spectrum of lung cancer etiology, from smoking addiction to lung cancer outcome, through examination of epidemiological, molecular, and clinical data. We have provided a detailed description of the study design, field activities, management, and opportunities for research following this integrative approach, which allows a sharper and more comprehensive vision of the complex nature of this disease. The study is poised to accelerate the emergence of new preventive and therapeutic strategies with potentially enormous impact on public health.

Published by Bowman RV, Yang IA, Semmler ABT, Fong KM (Respirology 2006:11) the abstract is as follows: Abstract:

Epigenetics is the study of heritable changes in gene expression that occur without changes in DNA sequence. It has a role in determining when and where a gene is expressed during development. Perhaps the most well known epigenetic mechanism is DNA methylation whereby cytosines at position 5 in CpG dinucleotides are methylated. Histone modification is another form of epigenetic control, which is quite complex and diverse. Histones and DNA make up the nucleosome which is the structural unit of chromatin which are involved in packaging DNA. Apart from the crucial role epigenetics plays in embryonic development, transcription, chromatin structure, X chromosome inactivation and genomic imprinting, its role in an increasing number of human diseases is more and more recognized. These diseases include cancer, and lung cancer in particular has been increasingly studied for the potential biological role of epigenetic changes with the promise of better and novel diagnostic and therapeutic tools.

This paper reviews the need for a gender-sensitive approach to lung cancer research. Lung cancer is a major cause of premature and avoidable mortality around the world, and although in more developed countries mortality rates are beginning to decrease, especially in men, the number of deaths from lung cancer in less developed countries is steadily increasing.

The paper reviews lung cancer and smoking from a gender perspective, identifying best practices in addressing gender in research and the gaps in gendered research, and making recommendations to address those gaps.

A comprehensive review of the major issues in smoking and health in Australia, compiled by Cancer Council Victoria.

Chapter Three contains information about the dangers of lung cancer and its links to tobacco smoking.

Information about the genetic risk of lung cancer and methods of preventing the development of the disease.

Should participants wish to be tested for a genetic predisposition to lung cancer, a deCODEme Complete Scan and the deCODEme Cancer Scan kit can be ordered to identify the two risk variants and provide an interpretation of the associated risk for developing lung cancer for individuals of European descent who smoke.

These guidelines were developed to provide a framework for care providers to assist patients in smoking cessation, including:

• Assess and document smoking status of every patient.
• Provide smoking cessation intervention to all smokers.
• Treat behavioral/ psychological aspects of cigarette addiction with advice and counseling.
• Treat biologic aspects of cigarette addiction with pharmacological therapies.

Information regarding the leading environmental risk factors associated with lung cancer including:

• Alcohol
• Asbestos
• Diet and Body Mass
• Environmental Tobacco Smoke
• Occupational Exposure
• Radiation

A broad range of information pages, summaries of studies, directories and guides to the prevention, risks and genetic predisposition to lung cancer.

This site provides links genetic information about lung cancer for educational purposes, including:

• Mutated Genes and Abnormal Protein Expression
• Recurrent Chromosome Abnormalities 
• Overview of the Molecular
• Biology of Lung Cancer  
• del(1p36)  in Lung Cancer 
• del(3p) in Lung Cancer 
• del(9p) in Lung Cancer 
• Telomerase Activity and Lung Cancer
•  Smoking, Genes, and Susceptibility to Lung Cancer
• Environmental Tobacco Smoke and lung Cancer
• Lung Cancer: Clinical and Epidemiological Resources

Practical information on smoking cessation and effective strategies that general practitioners and other practice staff can apply to identify smokers and assist them to stop smoking.

Information and educational resources that can be utilised by health professionals to make their patients aware of the dangers of cigarette smoking and its links to increased risk of lung cancer.

This prediction tool can assess a long-term smoker's risk of developing lung cancer in the next 10 years based on the person's age, sex, smoking history, and asbestos exposure.

Knowing about risk can help clinicians and patients make decisions about health care, such as whether to get screened for lung cancer.

Smoking remains the main cause of preventable disease and premature deaths in the UK. In March 2006 the National Institute for Health and Clinical Excellence (NICE) published guidelines on how to manage people who would benefit from stopping smoking.

After completing this module, participants should be better equipped to:

• Advise all smokers to quit
• Know what services are available for people who want to stop smoking
• Know when drug treatment may help people who want to stop smoking

An article written by Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar and published in eMedicine (Mar 2009), this article discusses issues related to lung cancer staging.

"The most important prognostic indicator in lung cancer is the extent of disease. The Union Internationale Contre le Cancer (UICC) and the American Joint Committee for Cancer Staging (AJCC) developed the tumor, node, and metastases (TNM) staging system. This system takes into account the degree of spread of the primary tumor, represented by T; the extent of regional lymph node involvement, represented by N; and the presence or absence of distant metastases, represented by M. The TNM system is used for all lung carcinomas except small cell lung cancers (SCLCs), which are staged separately."

An electronically accessible manual regarding the Staging, Imaging, and Lymph Node Classification of Lung Cancer.

Chapters include:

• Staging System for Lung Cancer
• TMN Definitions
• Illustrations and Imaging
• Regional Lymph Node Classification
• Applications of the System
• Implications for Survival Rates

Written by The International Early Lung Cancer Action Program investigators (names listed in the appendix) and published in The New England Journal of Medicine (2006;355:1763-71), the abstract is as follows:

Background:
The outcome among patients with clinical stage I cancer that is detected on annual screening using spiral computed tomography (CT) is unknown.

Methods:
In a large collaborative study, we screened 31,567 asymptomatic persons at risk for lung cancer using low-dose CT from 1993 through 2005, and from 1994 through
2005, 27,456 repeated screenings were performed 7 to 18 months after the previous screening. We estimated the 10-year lung-cancer–specific survival rate among
participants with clinical stage I lung cancer that was detected on CT screening and diagnosed by biopsy, regardless of the type of treatment received, and among those
who underwent surgical resection of clinical stage I cancer within 1 month. A pathology panel reviewed the surgical specimens obtained from participants who underwent
resection.

Results:
Screening resulted in a diagnosis of lung cancer in 484 participants. Of these participants, 412 (85%) had clinical stage I lung cancer, and the estimated 10-year survival rate was 88% in this subgroup (95% confidence interval [CI], 84 to 91). Among the 302 participants with clinical stage I cancer who underwent surgical resection within 1 month after diagnosis, the survival rate was 92% (95% CI, 88 to 95). The
8 participants with clinical stage I cancer who did not receive treatment died within 5 years after diagnosis.

Conclusions:
Annual spiral CT screening can detect lung cancer that is curable.

The Early Interventions Resource Center provides information on lung cancer risk, early detection, surgical treatments and upcoming research. The Center's website is a comprehensive guide providing a better understanding of lung cancer in its earliest, most treatable stages by addressing lung cancer risk, early detection, surgical treatments and upcoming research.

NCCN Clinical Practice Guidelines in Oncology for Lung Cancer Screening, a new addition to the Complete Library of NCCN Guidelines®. Lung cancer remains the leading cause of cancer-related deaths in the United States and the world; guidance on using effective screening tools for early detection can assist in the effort to decrease mortality rates.

A comprehensive guide providing a better understanding of lung cancer in its earliest, most treatable stages by addressing lung cancer risk, early detection, surgical treatments and upcoming research.

Information from the National Cancer Institute regarding lung cancer screening and clinical trials to screen for lung cancer, including:

• Prevention, Genetics, and Causes of Lung Cancer
• Screening and Testing for Lung Cancer
• Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial
• National Lung Screening Trial
• Lung Screening Study
• Lung and Upper Aerodigestive Cancers Research Group in the Division of Cancer Prevention

In June 2005 the National Institute for Health and Clinical Excellence (NICE) published guidelines on when and how to refer patients with suspected cancer to specialist services.² These guidelines are important because failing to appropriately refer patients with suspected lung cancer is distressing to both patients and doctors. Over-referral can be a problem too. The purpose of this module is to help you learn about the guidelines and put them into practice.

Clinical Evidence is the international source of the best available evidence on the effects of common clinical interventions, including Lung Cancer.

The Clinical Evidence systematic Lung Cancer review summarise the current state of knowledge and uncertainty about the treatment of lung cancers, based on thorough searches and appraisal of the literature.

Information can be downloaded as PDFs.

Information regarding the assessment of health-related quality of life (HRQoL) in lung cancer patients and provides information and links to the most commonly used symptom assessment questionnaires:

• EORTC QLQ-LC13
• FACIT 
• LCSS

Haymarket Medical Education develops CME programs that help clinicians provide the best possible care for their patients by partnering with leading academic centers and top clinicians to show how the latest scientific advances can be put to use in day-to-day practice.

This article, (Girgis, Afaf & Li, Jiong 2006, 15: 509–516) was published in Psycho-Oncology journal.

While the unmet supportive care needs are well documented for some groups of cancer patients, relatively little is known about the levels and types of needs of lung cancer patients. The study aims to compare the levels of lung cancer patients’ psychosocial needs with those of other cancer patients. A total of 1492 consecutive patients in nine major public cancer treatment centres in New South Wales, Australia, were invited to participate in the Supportive Care Needs Study; 888 completed surveys were received. The mean number of unmet needs (out of a maximum of 59) reported by lung cancer patients was 15.6 (95% CI 12.1–19.1), compared to 10.9 (95% CI 10.0–11.8) in other cancer patients. The differences were mainly due to the fact that lung cancer patients reported a higher mean number of unmet psychological needs (7.6 versus 5.0) and physical and daily living unmet needs (2.8 versus 1.4), compared to the other cancer patients. Having a lung cancer diagnosis was an independent predictor of having a high level of psychological need (RR 2.00, 95%CI 1.13–3.56) and daily living need (RR 2.81, 95%CI 1.60–4.95), together with not being in remission, and receiving the cancer diagnosis more than two years previously. The results suggest that priority needs to be given to addressing the specific needs of this sub-group of cancer survivors.

ASCO provides CME designed for clinical- and translational-focused oncology professionals that focuses on the professional scope of the oncology practitioner and/or researcher.

ASCO offers a educational activities for lung cancer across a wide range of learning styles through their formats, including, but not limited to, live meetings and workshops, educational products utilising various media and interactive techniques, and other innovative self-assessment exercises.

Note: Activities have expiration dates.

Case Studies in Lung Cancer: A Johns Hopkins Oncology Series are a case-based newsletter series focusing on key treatment concepts in NSCLC.

Presentations of patient cases and discussion of relevant treatment dilemmas and options by a distinguished faculty of oncologists are designed to update you on the latest clinical trial results and their implications for clinical practice.

Learning objectives are included for each module in the 3 issue volume.

Courses may contain an expiry date.

A range of educational podcasts are available for free download in MP3 in a number of topic areas including:

• Lung Cancer Specific
• Medical Concerns
• Emotional Concerns
• Practical Concerns

Links to a wide range of resources regarding the coordination of care for lung cancer patients.

In a challenging and continually evolving treatment setting, careful selection of an appropriate treatment plan by considering lung cancer patient characteristics and available data from clinical trials can significantly impact survival, such as recent advancements including the development of novel targeted and chemotherapeutic agents, identification of tumor characteristics that are associated with benefit from distinct treatment regimens, and an emerging role for maintenance therapy in prolonging survival.

After completing this activity, participants will be able to:

• Review emerging clinical trial data that evaluates the role of biomarker analyses in treatment decision making
• Assess histological considerations for maximizing the safety and benefit associated with chemotherapy and targeted agents
• Discuss the role of maintenance therapy in the treatment of patients with non–small cell lung cancer (NSCLC).
• Assess and apply histologic considerations for maximizing the safety and benefit associated with chemotherapy and targeted agents in the treatment of patients with NSCLC.
• Evaluate recent studies investigating the utility of molecular markers as predictors of treatment response or resistance to specific agents and employ proven markers to develop individual treatment plans for patients with NSCLC.
• Discuss the role of maintenance therapy in the treatment of patients with NSCLC.

This educational activity is designed for lung cancer specialists, medical oncologists, pulmonologists, surgical oncologists, radiation oncologists, oncology pharmacists and allied healthcare providers worldwide whose scope of practice includes diagnosis, treatment and management of patients with cancer.

Upon completion of this educational activity, participants should be better able to:

• Summarize data from historical and ongoing studies examining adjuvant therapy for non-small cell lung cancer
• Review the prognostic and predictive factors for chemotherapy treatment for patients with NSCLC
• Identify the role of immunotherapies in the adjuvant setting for patients with resected stage IB-lllA NSCLC

Note: activity may have an expiry date

The Imedex E-Learning Center is designed to meet the needs of the busy healthcare professional with a complete suite of innovative E-learning products. Dozens of clinically-relevant, accredited activities are available to practitioners every day at no charge, focusing on impacting the clinical management of patients around the world.

• Lung cancer activities include webcasts, interactive case studies and podcasts on topics including:  Emerging Therapies for Lung Cancer
• Personalizing Care for the Evolving Spectrum of NSCLC: Identifying Novel Biologic, Genetic, and Molecular Targets
• Challenges in the Treatment of Advanced Non-Small Cell Lung Cancer

Free lung cancer CME courses consisting of a web cast and post test for health professionals interested in new developments for treatment of lung cancer.

Two courses consisting of a series of modules are available:

• International Congress for Lung Cancer, and Head & Neck Cancer: Modules 1-8
• Recent Advances in the Treatment of Lung Cancer and Head & Neck Cancer: Modules 1-5

A template that can be adapted by mutlidisciplinary teams for use in lung cancer stream meetings for the discussion and tracking of lung cancer patients and their multidisciplinary care needs.

This two-part activity addresses knowledge gaps related to the significance of histologic and molecular targets in the development of individualized treatment strategies in patients with NSCLC. It explores the evolving understanding of NSCLC and report on emerging evidence for targeted, individualized treatment strategies.

Participants complete a post test to download a certificate of participation.

At the end of this CE activity, participants should be able to:

• Recognize the significance of histology and molecular traits in treatment selection for patients with lung cancer.
• List epidemiologic and clinical characteristics that differentiate lung cancer in smokers vs. never-smokers.
• Compare and contrast current and emerging therapies in the management of patients with lung cancer and translate that knowledge in to individualized care of patients.

MedscapeCME offers specialists, primary care physicians, and other health professionals a variety of professional educational content that provides them with the most timely, comprehensive and relevant clinical information to improve patient care.

The Lung Cancer section features a selection of professional educational content focusing on specific conditions or topics of interest.

Due to the incremental improvements made regularly in the ways in which all treatment modalities (ie, surgery, radiation, and medical therapies) are applied to patients with lung cancer, practitioners face a continuing challenge in staying on top of new data and recommendations based on recent advances in therapy.

This wide variety of regularly updated CME courses provides physicians with the educational tools needed to stay current in their practice and knowledge of lung cancer therapies.

Free, online CME activities regarding the treatment and care of patients with Non-Small Cell Lung Cancer.

Each course contains webcasts, links to additional resources, post tests and downloadable certificates.

Note: Courses have expiry dates. 

Comprehensive information from the National Cancer Institute in the US about lung cancer treatments, including surgery, chemotherapy, radiation therapy, immunotherapy and vaccine therapy for both small cell lung cancer and non-small cell lung cancer.

Non-small cell lung cancer is the most common type of lung cancer, comprising 80% of all cases. Treatment of the three major subtypes (adenocarcinoma, squamous cell carcinoma and large cell carcinoma) are covered in this tool. Other types of lung cancer are not included in this Profiler Tool.

The Non-small Cell Lung Cancer Profiler treatment decision support tool helps you understand how your diagnosis, test results, and medical history affect your treatment options. Your free Treatment Options Report will include descriptions of treatments, side effects, and questions to ask your doctor…customized for your unique diagnosis.

Consumer information is also provided specifically for the non-small cell type of lung cancer, available as:

• Detailed Guide
• Overview
• Other materials

A glossary of terms is also available on the site.

Results of important recent clinical studies of first-line EGFR TKI therapies, antibodies combined with chemotherapy, consolidation and up-front supportive care are creating the potential to change the paradigm for what constitutes appropriate first-line care for non–small cell lung cancer (NSCLC) patients.

Medical professionals who work with lung cancer patients need to understand the results of these new studies assess their implications for the management of NSCLC and integrate this information into their practice of assessing, counseling and treating individual patients.

This free online activity based on reviews on recent advances in first-line therapy for non-small cell lung cancer contains comprehensive information as well as a downloadable post test exam.

A companion CME activity, Lung Cancer: Case Studies Assessing Novel Agents in First-Line Therapy, based on videotaped discussion of cases is also available.

Note: The course has an expiry date of January 2011.

The primary aim of this thirteen week program is to provide Division 1 Registered Nurses with the knowledge and skills required for this specialist area of practice.

Key topics covered in the program are:

• lung cancer the disease
• current trends in the treatment and management of lung cancer
• targeted assessment and management of symptoms, particularly fatigue and dyspnoea
• provision of skilled nursing care and support for patient and family throughout the disease trajectory
• impact of lung cancer on the quality of life of the patient and family
• the nurse‘s role in health education and health promotion.

• Using Histology and/or Molecular Variables to Individualize Chemotherapy Selection for First-Line Treatment of Advanced NSCLC   
• Maintenance Therapy for Nonprogressing Patients After First-Line Therapy for Advanced NSCLC   
• The Role of EGFR Biomarkers in Treatment Selection for Patients With NSCLC   
• Advances in Frontline Therapy for Patients With Advanced NSCLC   
• Second-Line Therapy for Patients With Disease Progression Following First-Line Therapy for Advanced NSCLC   
• Choices of Therapy for Treatment-Naïve Patients With Advanced NSCLC   

Please note: activities have an expiry date.

This patient management framework is a guide to the optimal care management of patients with Non Small Cell Lung Cancer. It is intended to improve patient outcomes by facilitating consistent care based on evidence and best practice and sets out the key requirements for the provision of optimal care which need to be considered at each step of the care pathway.

In contrast to clinical practice guidelines that guide appropriate practice and decision making, the patient management frameworks provide a guide to the patient journey to ensure patients with cancer and their families receive optimal care and support.

A complimentary, certified, 3-stage performance improvement (PI) CME series that allows physicians and nurse practitioners to evaluate their clinical processes according to national standards (US) of care and recent trial data regarding the management of NSCLC, as well as apply practical, evidence-based strategies to improve knowledge, competency, and performance.

NSCLC PI allows participants in undertake educational activities about current and emerging evidence in NSCLC to improve practice performance and optimize patient outcomes.

Another educational activity available in the series is Improving the Care of Patients With Non-Small Cell Lung Cancer: A Practical Guide for Performance Improvement, an implementation guide that offers a comprehensive series of activities designed to cover a broad range of topics on non-small cell lung cancer, with the ultimate goal of helping oncologists improve the care of patients with this condition.

The Peter Mac Lung Cancer Service provides comprehensive consultative and treatment services for patients with lung and mediastinal tumours, operating a multidisciplinary clinic twice a week. The Lung Service maintains its strong focus on identifying the psycho-social unmet needs of patients and providing holistic supportive care beyond the patient’s medical requirements. Evidence–based and investigational treatment of thoracic malignancies includes:

• Multi-modality approaches such as concomitant 3D conformal radiation therapy with chemotherapy and biological agents.
• Radiotherapy treatment planning based on hybrid FDG_PET/CT imaging.
• Phase I and II studies of new drugs.
• Participation in multinational phase III clinical trials addressing combined modality questions.
• Advanced radiotherapy technology is available to perform image guided treatment.

The site also contains information on different types of lung cancer including treatments, (surgery, radiation therapy and medical oncology), patient information, useful links and a profile of the supportive team. 

The condition this Profiler Tool covers is small cell lung cancer. Small cell lung cancer (SCLC) accounts for only about 20% of all lung cancers.

The Small Cell Lung Cancer Profiler treatment decision support tool helps you understand how your diagnosis, test results, and medical history affect your treatment options. Your free Treatment Options Report will include descriptions of treatments, side effects, and questions to ask your doctor…customized for your unique diagnosis.

Consumer information specifically for the small cell type of lung cancer, available as:

• Detailed Guide
• Overview
• Other materials

A glossary of terms is also available on the site.

A free year-long CME/CE program, which provides clinicians with up-to-date information about the management of lung cancer.

This outstanding program features an expert faculty co-chaired by Roy S. Herbst, MD, PhD, and Corey J. Langer, MD, FACP, and a comprehensive curriculum of web-based courses across three (3) currciulums. Get timely and practical information that you can immediately use in caring for your patients with lung cancer.

Each module contains learning objectives and treatment strategies targeted to specific audiences.

Please note that courses have an expiry date.

The CBCE™ (The Center for Biomedical Continuing Education) is a full-service provider of accredited CME/CE with a circular scope of capabilities.  They are dedicated to creating rigorous educational programs at the forefront of science that encourage healthcare professionals to commit to change and to define distinct outcomes in their practices that will improve patient care and quality of life.

There are two available educational lung cancer webcasts:

• Optimizing Treatments for Patients With Non–Small Cell Lung Cancer:
  Relevance of Histology in the Frontline Setting and Beyond - this module also has a test and evaluation component
• Discussions on Emerging Concepts and Controversies in the Treatment of Patients With Advanced Non–Small Cell Lung Cancer

Non-Small Cell Lung Cancer (NSCLC) is the most common type of lung cancer, comprising about 87% of all cases. Unfortunately, many patients with NSCLC are not diagnosed at an early stage when the disease is localized and potentially curable by surgery and radiation therapy. Despite incremental advancements over the past several decades, survival for patients with advanced or metastatic disease remains at approximately 1 year, with a 5-year survival rate of only 3%^{1, 2}

This activity discusses current and future research, novel technologies and therapy strategies that can improve the treatment and management of Non-Small Cell Lung Cancer (NSCLC).

At the conclusion of this activity, the participant should be able to:

1. State the standard first-line treatment for advanced non–small cell lung cancer (NSCLC) and the limitations of cytotoxic chemotherapy
2. Identify the patient subgroups and genetic alterations associated with enhanced response to EGFR inhibitors, and potential surrogate predictive markers
3. Summarize results from pivotal trials of angiogenic inhibitors for treatment of metastatic NSCLC, including impact on survival and common toxicities associated with use of these agents
4. Relate the new molecular targets under evaluation for treatment of lung cancer and the rationale for inhibiting these pathways
5. Assess recent data on the use of maintenance therapy in advanced NSCLC for patients who respond to induction chemotherapy

Prior to this activity, participants must complete a pre-test. After viewing the activity, participants must complete a post-test and evaluation. Upon receiving a score of 70% on the post test, participants may print out their CME Certificate.

• Module 1 - Early stage lung cancer: Advances in adjuvant therapy
• Module 2 - Unresectable locally advanced NSCLC
• Module 3 - Tools and guidance in therapy selection: Clinical and molecular biomarkers
• Module 4 - Individualizing therapy in metastatic NSCLC: Choosing the best option
• Module 5 - Advanced NSCLC: A patient with Bone metastases
• Module 6 - Evaluating the next generation of targeted therapies

Upon completion of this educational activity, participants should be able to:

• Identify contemporary approaches in the adjuvant therapy for resected NSCLC
• Appraise the potential utility of targeted agents in the management of unresectable locally advanced NSCLC
• Propose appropriate first-line and second-line management options for metastatic NSCLC, including the incorporation of approved and investigational therapeutic agents
• Appraise the potential utility of currently available and emerging targeted agents in the management of advanced NSCLC
• Identify currently available therapies and their impact on patients with bone metastases
• Integrate clinical and molecular markers in treatment decisions for individual patients
• Apply the practice-changing recent clinical trial data to daily clinical practice

Published in the Journal of Clinical Oncology (Uchitomi Y, Mikami I, Nagai K, Nishiwaki Y, Akechi T, Okamura H 2003 Jan 1;21(1):69-77).

Abstract:

Purpose: There have been few psychosocial studies of patients after curative resection of non–small-cell lung cancer (NSCLC). The purpose of this study was to clarify the clinical course of depression and psychological distress of such patients during the year after surgery and to identify predictors of their long-term outcome.

Patients and Methods: A total of 212 patients completed assessments during a 12-month follow-up period after curative resection of NSCLC. Psychological measurements at 1, 3, and 12 months after surgery were conducted using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (ed 3), Revised, and the Profiles of Mood States (POMS) scale. Univariate and multivariate analyses were used to identify predictors of psychological outcome according to these two methods of assessment.

Results: The prevalence of depression did not change during the year after curative resection (range, 4.7% to 8.0%). The total POMS score was also unaltered during the year after surgery: the anger-hostility (P < .001) and tension-anxiety subscale scores (P < .026) had increased at 12 months, but the vigor-activity subscale score had also increased (P < .001). All predictors of psychological outcome at 12 months included a depression episode after the diagnosis of lung cancer or at 1 month after surgery. Less-educated status was also a significant predictor of depression at 12 months.

Conclusion: These results suggest the need for psychosocial support even after curative resection of NSCLC and indicate that an approach that includes repetitive perioperative assessment of depression and careful attention to less-educated patients might be of benefit to patients in ameliorating depression and psychological distress during the year after curative resection.

The Managing Side Effects Booklets have been developed by CancerCare Connect and contain frequently asked questions, a glossary, photos and illustrations about common side effects of lung cancer treatments and are reviewed by cancer experts from around the USA.

Booklets include:

• Your Guide to the Latest Research and Treatments (Highlights from ASCO 2009) 
• Taking Pills for Cancer Treatment: Tips for Staying on Your Plan 
• Coping With Nausea and Vomiting From Chemotherapy 
• Tips for Managing Treatment-Related Rash and Dry Skin 
• Controlling Cancer Pain 
• Controlling Cancer Pain: What You Need to Know to Get Relief 
• Understanding Peripheral Neuropathy 
• Understanding and Managing Chemotherapy Side Effects 
• Advances in the Treatment of Dry Mouth 
• Managing Diarrhea 
• Mouth Pain and Discomfort: All You Need to Know About Oral Mucositis 
  Fact Sheets

CancerCare Fact Sheets are one-page guides specifically for patients and carers on managing side effects, including:

• Combating Chemobrain: Keeping Your Memory Sharp 
• Ways to Improve Concentration 
  CancerCare
• Cognitive Problems After Chemotherapy 
• Doctor, Can We Talk About Chemobrain? 
• Tips for Managing Hair Loss 
• Tips for Managing Nausea and Increasing Appetite During Cancer Treatment 
• Caring for Your Skin During Cancer Treatments 
• Opening the Doors to Effective Pain Management 
• Coping With Lymphedema 
• Fatigue is a Medical Condition 

Published in Cancer Nursing by (2006, 29: 3, 176-187) Cox, Karen; Wilson, Eleanor; Heath, Lesley; Collier, Jacqueline; Jones, Linda and Johnston, Ian.

Abstract:
Pressure on lung cancer clinics is increasing with the "2-week wait" initiative. This initiative is one of the key targets set out in the National Health Service (NHS) Cancer Plan for the United Kingdom, whereby all patients presenting with symptoms which may be indicative of a cancer diagnosis will be seen by a consultant within 2 weeks of initial presentation at their primary care provider. This has resulted in busy clinics, with the potential for extended clinic waiting times and unmet needs for information and psychosocial support on the part of patients and families. There is increasing interest in the most appropriate mode of follow-up for patients with lung cancer who are under observation, many of whom have completed specific treatments. Such patients may benefit from specialist nurse review for symptom control and psychosocial support. Nurse-led clinics are safe and cost effective in the oncology and research-funded setting. This study aimed to assess the acceptability of nurse-led follow-up in a large general lung cancer clinic seeing approximately 250 new patients annually.

Over a 34-week period, there were 487 follow-up attendances and 94 (19.3%) of these were made by 72 patients deemed eligible for nurse-led follow-up. Sixty patients were approached and 54 (90%) agreed to participate in the study. A questionnaire containing vignette scenarios of nurse-led, telephone, GP-led, and standard (hospital, medical) follow-up was completed by 34/54 (63%) of eligible patients, 10/20 (50%) carers, 20/31 (65%) staff, and 11/38 (29%) GPs. Respondents rated acceptability of the scenarios on a range of issues on a scale of 1 to 5. Patients also completed the EORTC QLQ C30 and lung module questionnaire. Subsequent interviews were carried out with samples of these respondent groups.

Fatigue, dyspnea, cough, and pain were the most common general symptoms. Both standard and nurse-led follow-up scenarios were highly rated by patients and other respondents and both were highly significantly favored over GP follow-up, which was the least favored in all areas of the questionnaire. Telephone follow-up tended to elicit more polarized reactions, both positive and negative. In interviews, in relation to nurse-led follow-up, the importance of clear protocols, training, and easy access to medical review were highlighted.

Provides links to a range of peer reviewed articles and other online resources regarding follow up care for lung cancer patients following treatment, including:

• Follow-up and Surveillance of the Lung Cancer Patient Following Curative-Intent Therapy
• What Follow-Up is Needed After Treatment of Lung Cancer?
• Questions and Answers About Follow-up Care
• Relevance of an Intensive Postoperative Follow-up After Surgery for NSCLC
• What Steps Are Recommended to Prevent Recurrence of NSCLC?

Information and links to resources regarding long term effects following lung cancer treatment, including:

• Collapsed Lung (Atelectasis & Pneumothorax)
• Dyspnea (Shortness of Breath)
• Infections (Pneumonia, Aspergillosis)
• Interstitial Lung Disease (Pneumonitis, Pulmonary Fibrosis, ARDS)
• Pulmonary Embolism

Provides links to a wide range of evaluated resources and learning activities in the areas of supportive and psychosocial care, including survivorship.

This page presents lung cancer survival statistics, including one and five-year survival, survival statistics by age at diagnosis, deprivation and regional and international comparisons.

Links include:

• Lung cancer - one, five and ten year survival rates
• Lung cancer survival rates by age
• Lung cancer survival rates and deprivation
• Regional variation in lung cancer survival rates

The abstract for this article, written by Griffin, J.P; Nelson, J.E; Koch, K.A; Neill, H.B; Ackerman, T.F; Thompson, M. and Hammond Cole Jnr, F (CHEST 2003; 123:312S–331S) is as follows:

Evidence-based practice guidelines for end-of-life care for patients with lung cancer have been previously available only from the British health-care system. Currently in this setting, there has been increasing concern in attaining control of the physical, psychological, social, and spiritual distress of the patient and family. This American College of Chest Physicians’-sponsored multidisciplinary panel has generated recommendations for improving quality of life after examining the English-language literature for answers to some of the most important questions in end-of-life care.

Communication between the doctor, patient, and family is central to the active total care of patients with disease that is not responsive to curative treatment. The advance care directive, which has been slowly evolving and is presently limited in application and often circumstantially ineffective, better protects patient autonomy.

The problem-solving capability of the hospital ethics committee has been poorly utilized, often due to a lack of understanding of its composition and function. Cost considerations and a sense of futility have confused caregivers as to the potentially important role of the critical care specialist in this scenario.

Symptomatic and supportive care provided in a timely and consistent fashion in the hospice environment, which treats the patient and family at home, has been increasingly used, and at this time is the best model for end-of-life care in the United States.

The full guideline is available: http://www.guideline.gov/content.aspx?id=11423

An article discussing the promising results from the first randomized clinical trial of its kind of early palliative care for patients with advanced lung cancer, as published in the New England Journal of Medicine 2010; 363:733-742(http://www.nejm.org/doi/full/10.1056/NEJMoa1000678)

The abstract for this article, written by Kvale, Paul A.; Selecky, Paul A and Prakash, Udaya, B. S (CHEST 2007; 132:368S–403S) is as follows:

Goals/objectives: To review the scientific evidence on symptoms and specific complications that are associated with lung cancer, and the methods available to palliate those symptoms and complications.

Methods: MEDLINE literature review (through March 2006) for all studies published in the English language, including case series and case reports, since 1966 using the following medical subject heading terms: bone metastases; brain metastases; cough; dyspnea; electrocautery; hemoptysis; interventional bronchoscopy; laser; pain management; pleural effusions; spinal cord metastases; superior vena cava syndrome; and tracheoesophageal fistula.

Results: Pulmonary symptoms that may require palliation in patients who have lung cancer include those caused by the primary cancer itself (dyspnea, wheezing, cough, hemoptysis, chest pain), or locoregional metastases within the thorax (superior vena cava syndrome, tracheoesophageal fistula, pleural effusions, ribs, and pleura). Respiratory symptoms can also result from complications of lung cancer treatment or from comorbid conditions. Constitutional symptoms are common and require attention and care. Symptoms referable to distant extrathoracic metastases to bone, brain, spinal cord, and liver pose additional problems that require a specific response for optimal symptom control. There are excellent scientific data regarding the management of many of these issues, with lesser evidence from case series or expert opinion on other aspects of providing palliative care for lung cancer patients.

Conclusions: Palliation of symptoms and complications in lung cancer patients is possible, and physicians who provide such care must be knowledgeable about these issues.

The full guideline is available: http://www.guideline.gov/content.aspx?id=11422

Caresearch is an online collection of evidence based resources relating to palliative care. This Australian web site provides access to scientific abstracts, government reports, refereed journal articles and sources of data. It also contains information on national research and other projects, resources for patients and carers, models of service provision and educational opportunities including online learning packages.

Provides links to a wide range of evaluated resources and learning activities in the areas of palliative care, pain management and end of life planning.

The LOTE for Lung Cancer is a Cancer Australia initiative, funded by the Australian Government. The multilingual resources were developed by The Australian Lung Foundation in collaboration with the Peter MacCallum Cancer Centre.

An Education Brochure, designed to designed to help patients work out questions to ask their doctor; and an Awareness Poster that outlines the possible symptoms of lung cancer to promote early detection of lung cancer, translated into many community languages.

For those diagnosed with lung cancer, finding answers can be a difficult experience. The Lung cancer Alliance has partnered with The Wellness Community and CancerCare to bring you this comprehensive lung cancer resource book. Frankly Speaking About Lung Cancer contains information about diagnosis, treatment, lifestyle concerns and strategies for communicating with your healthcare team.

Frankly Speaking About Lung Cancer is designed to be used by lung cancer patients and their caregivers throughout their cancer experience. Our hope is that the information will empower and educate you. Although our Website already provides information about lung cancer—diagnosis, finding the best care, symptom management, a glossary, and more—Lung Cancer Alliance hopes this book will give you an "all-in-one" spot source for information you need when diagnosed with lung cancer.

Frankly Speaking About Lung Cancer contains eight separate sections, each focusing on a different aspect of cancer experience.

PowerPoint format slides are also available and cover lung cancer diagnosis, staging and treatment.

Further information for consumers is contained on the site in the About Lung Cancer section.

This DVD, Lung Cancer, Understanding, Managing, Living looks at what happens when a person is diagnosed with lung cancer through to available treatments and living with cancer.

It provides expert medical information from a team of health professionals involved in caring for people with lung cancer, as well as experiences from people living with lung cancer.

If you or someone you love has lung cancer this DVD may help you understand and make sense of what is happening, and what others have experienced.

The whole DVD (and other resources)can be ordered from the Kylie Johnston Lung Cancer Network or each chapter can be downloaded as an online video from the website:

This booklet is about cancer that begins in the lung. It tells about diagnosis, staging, treatment, and comfort care. Learning about the medical care for people with lung cancer can help patients take an active part in making choices about their own care.

Te booklet has lists of questions that oatients may want to ask their doctor. Many people find it helpful to take a list of questions to a doctor visit. To help remember what the doctor says, patients can take notes or ask whether they can use a tape recorder or have a family member or friend with them when they talk with the doctor - to take part in the discussion, to take notes, or just to listen.

With Every Breath: A Lung Cancer Guidebook was written for people who have recently been diagnosed with lung cancer and their loved ones. One of the most difficult and yet changeable circumstances of dealing with lung cancer is a lack of knowledge. It can be very intimidating to be faced with potentially life-changing decisions while feeling you do not have the information you need to choose wisely. 

Filling that gap by providing you with medical and practical information is what this book is all about.

www.asbestos.com is committed to providing the latest, up-to-date information to visitors in the hope of spreading awareness about the dangers of asbestos cancer. This website offers information on all asbestos issues ranging from occupational exposure to mesothelioma treatment options.

As a leading asbestos and mesothelioma resource, www.asbestos.com offers more than 2000 pages of the most comprehensive and cutting edge information on the web.

A complementary site for Pleural Mesothelioma patients with information and treatments specific to this condition is available: http://www.pleuralmesothelioma.com/

Consumer information from Cancer Council NSW regarding the incidence, mortality, prevention, detection, symptoms, risk factors and treatment of small cell lung cancer and non-small cell lung cancer.

Information is also available on the national, state and territory Cancer Council websites:

• National: Small Cell Lung Cancer
• National: Non-Small Cell Lung Cancer
• Cancer Council Victoria Lung Cancer Information
• Cancer Council SA Lung Cancer Information
• Cancer Council QLD Lung Cancer Information
• Cancer Council ACT Lung Cancer Information

Information about lung cancer - including cancer of the windpipe (bronchus), which is called bronchial cancer. There is information about symptoms and causes, tests for lung cancer, treatment, living with lung cancer, and current research.

HealthInsite aims to improve the health of Australians by providing easy access to high quality, reviewed health information.

Websites can apply for HealthInsite accreditation, endorsing the site as achieving a high standard of accuracy, currency and presentation of information.

Links to a number of evaluated, approved websites containing information about lung cancers.

Links are also provided to other HealthInsite pages containing specific information on risk factors, prevention and treatments for lung cancer or on mesothelioma.

LIVESTRONG.COM is dedicated to being a valued online source of inspiring, relevant, interactive and useful health-related information.

This site contains the latest information lung cancer including risks, symptoms, diagnosis, types, staging, treatment and end stage.

Interactive tools such as a symptom checker, slide shows and a quit smoking program are included on the site.

Resources on this site focus on informing lung cancer patients, their loved ones, and the general public about lung cancer. 

The literature and resources have been reviewed to offer relevant and easy to understand information about lung cancer.

Topics include:

Lung cancer patients or carers who would like to connect with other people in a similar situation are invited to participate in The Australian Lung Foundation’s Lung Cancer Telephone Support Groups.

The support group gives patients and carers the unique opportunity to share experiences and knowledge, connect with other patients or carers, offer support to one another over the phone and access emotional support and up-to-date information.

Patient Group Telephone Meetings occur on the 3rd Thursday of each month from 9.30am to 10.30am.

Carer Group Telephone Meetings occur on the 4th Thursday of each month from 9.30am to 10.30am.

For further information or to participate, phone 1800 654 301

Fact sheets regarding the most common lung cancers in adolescents and young adults:

• Small cell lung cancer
• Non small cell lung cancer
• Mesothelioma

The downloadble/available by order fact sheets include information about dignosis, remission, hereditary and cancers in the family.

Consumer targeted overview of lung cancers including information regarding risk factors, signs and symptoms, diagnosis, treatment and links to a patient resource centre.

This site contains well researched and comprehensive content about the symptoms, diagnosis, and treatments for lung cancer and related malignancies, paying specific attention to the clinical aspects of lung cancer, with comprehensive resources on types, specific treatments, and clinical trials.

Comprehensive information regarding lung cancer, the risks, symptoms, latest treatments and therapies.

MedicineNet.com is an online, healthcare media publishing company. It provides easy-to-read, in-depth, authoritative medical information for consumers via its robust, user-friendly, interactive website.

This page contains information, images and slide shows relating to lung cancer, its causes, symptoms, diagnosis, staging and treatment.

Users can also register for an online patient discussion forum.

MedlinePlus is the National Institutes of Health's Web site for patients and their families and friends. Produced by the National Library of Medicine, it brings you information about diseases, conditions, and wellness issues in language you can understand. MedlinePlus offers reliable, up-to-date health information, anytime, anywhere, for free.

You can use MedlinePlus to learn about the latest treatments in lung cancer, look up information on a drug or supplement, find out the meanings of words, or view medical videos or illustrations. You can also get links to the latest medical research in lung cancer or find out about American lung cancer clinical trials.

Among other resources, an interactive Lung Cancer tutorial is also available on the site.

An interactive tutorial for patients and their families regarding lung cancer, anatomy, causes, symptoms, diagnosis and treatment.

The text of the tutorial can be downloaded as a PDF.

Committed to providing the most comprehensive and up-to-date information on pleural mesothelioma cancer, PleuralMesothelioma.com is the Web's most inclusive resource solely dedicated to this rare cancer.

Focusing exclusively on pleural mesothelioma, the most common form of mesothelioma cancer, this site delves deeper into pleural mesothelioma with the hope of further educating health professionals and patients on their diagnosis and treatment options.

A website containing information regarding mesothelioma and asbestos cancers, the causes, diagnosis and treatment.

Mesotheliomatreatment.net provides up-to-date information about the dangers of asbestos exposure and the illnesses that can result.

Information is provided regarding prevention strategies and possible sources of asbestos; symptoms of mesothelioma, diagnosis, prognosis and clinical research about traditional and alternative treatments.

National Centre for Asbestos Related Diseases (NCARD) is a research centre funded by the federal government as part of the Government's Strengthening Cancer Care package with measures aimed at prevention, treatment and support for cancer patients and their families.

NCARD is a collaboration of researchers who have a national and strategic focus for research into asbestos related diseases and cancers and provides a platform to build on Australia's existing research expertise and encourages strong organisational and linkages to ensure our research is systematic and complementary to existing research efforts in the area of asbestos related diseases.

The website provides information regarding NCARD projects and publications and provides links to information regarding asbestos related diseases including mesothelioma and lung cancer.

The National Comprehensive Cancer Network® aims to provide people with cancer and the general public state-of-the-art cancer treatment information in easy-to-understand language.

The NCCN Guidelines for Patients™, based on the NCCN Clinical Practice Guidelines in Oncology, are meant to provide information to help you when you talk with your doctor about treatment options that are best for you at each stage of the cancer journey. However, these Non-Small Cell Lung Cancer guidelines do not replace the expertise and clinical judgment of your doctor.

Comprehensive information regarding the following lung tumours:

• Lung Cancer
• Mesothelioma
• Non-Small Cell Lung Cancer
• Small-Cell Lung Cancer

This site provides information regarding the use of radiation therapy to treat lung cancers.

Information includes:

A Downloadable Brochure is also available on the site.

Discussion of the treatment options available to lung cancer patients depending on the stage of the tumour and specific information about radiation therapy for lung cancer.

Links to other radiology resources are included on the site.