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What to Expect in the Final Stages of Lung Cancer

written by: nanjowe • edited by: Lamar Stonecypher • updated: 2/9/2010

A lung cancer diagnosis is devastating but being prepared by knowing what to expect in the final stages of lung cancer can help caregivers prepare and give the best care possible.

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    About Lung Cancer

    The lungs are vital organs for the body’s survival and when compromised by disease become inefficient. The respiratory system (the body’s ability to take in needed oxygen) is affected and the body starts to exhibit symptoms related to the decline in the oxygen supply. Lung cancer is one such disease; it can affect various parts of the lungs but is commonly found in the cells that line the bronchi and bronchioles. These two are important passageways for the air as it makes it way to the actual exchange point (alveoli) between the air and the blood.

    Two other important parts of the body that may be affected by lung cancer in the later stages are the pleural space and the lymph nodes.

    • The pleura are two sheets that cover the lungs and are important in cushioning the lung and lubricating the lung’s breathing action. The tumors and cancer cells may also spread in the pleural space or the area between the pleura.
    • The lymph nodes or lymph glands are a part of the system that helps fight infection. It is in the lymphatic system that the clear fluid that originates from the blood is filtered; specifically at the lymph nodes.

    Cancer cells in the lymph node are one indication that the lung cancer has metastasized or spread beyond the lungs. Another way doctors can determine the extent of the disease is to check whether cancer cells are found in the fluid accumulating in the pleural space. If the fluid contains cancer cells then a patient is diagnosed with stage 4 lung cancer.

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    Early Lung Cancer Symptoms

    Some of the symptoms associated with early lung cancer include a persistent cough that changes over time, being short of breath, coughing up phlegm that has blood, pain while breathing or coughing, weight loss and constant fatigue. Most people do not seek medical attention until the cancer has significantly affected their day to day life. Sadly, at that point, the disease has advanced.

    A physician normally diagnoses cancer in stages. The staging methods allows the physician to classify how extensive the disease is. The method uses the tumor size, the number of lymph nodes involved and whether the cancer has metastasized or spread to other parts of the body.

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    Late Lung Cancer Symptoms

    Unfortunately many people ignore the early warning symptoms and end up being diagnosed in at this stage. In the final stage the tumor may have grown into the airway, into the bones of the chest wall or into the pleural space. The initial symptoms related to the primary tumor (respiratory distress; shortness of breath, coughing, etc.) may still be present; these symptoms will be compounded by symptoms of the secondary tumors. It is difficult to state exactly what to expect in the final stages of cancer since the disease may metastasize differently from person to person. However, most commonly the cancer spreads to the lymph nodes, neck, armpit, liver and the brain. As the tumors grow in these areas, they may cause localized pain as they push against organs and interfere with normal body functions. In the brain, the cancer may cause headaches, drowsiness, confusion and nausea. Other common final stage lung cancer symptoms include a lack of sweating, facial swelling due to fluid buildup, fatigue, bone pain, and loss of appetite.

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    Treatment Options for Advanced Lung Cancer

    Advanced stage lung cancer cannot be cured. Treatment strategies in the final stages are geared towards keeping the tumor size under control by reducing its growth and making the patient comfortable. That is, treatment is geared towards managing pain; it is not curative care but palliative care.

    • Managing respiratory stress symptoms. Shortness of breath can be caused by a tumor blocking the airway or by a fluid filled pleural space. Radiotherapy or cryotherapy can be used to destroy or shrink the tumor blocking the airway making the patient more comfortable. To treat the fluid in the pleural space, a doctor may recommend either having the fluid drained (thoracentesis), or the having the pleural membranes fused together (pleurodesis) to allow for lung expansion.
    • Managing tumor size. For cancer in the brain or liver the physicians may recommend radiotherapy and/or chemotherapy may to shrink the tumors size and minimizing its impact.
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    Lung Cancer, Non-Small Cell: eMedicine Oncology