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Developments in the Management of Patients with Lung Cancer in the United Kingdom Have Improved Quality of Care

¹ Department of Thoracic Surgery, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom

Correspondence and requests for reprints should be addressed to B. Naidu, M.B.B.S, M.Med.Sci., M.D., F.R.C.S.(Cth), Department of Thoracic Surgery, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Bordsley Green East, Birmingham B9 5SS, UK. E-mail: babu.naidu{at}heartofengland.nhs.uk

ABSTRACT

The management of patients with lung cancer has undergone significant improvement in the last decade in the United Kingdom. The 5-year survival for all patients diagnosed with lung cancer had remained unchanged at 5% over the previous decade, well behind Europe and the United States. Together, government and medical bodies produced guidelines based on best available evidence. The dissemination of these guidelines into clinical practice became the remit of Cancer Networks. The establishment of Multidisciplinary teams (MDTs) has streamlined care and allowed individual teams to discuss patients' management within a wider body of expertise. The Cancer Network quality assurance team assesses the MDTs to ensure that standards are maintained. Though the efficacy of the MDTs in improving quality and consistency of care for patients with lung cancer is irrefutable, the effects on overall survival rates are less certain. The majority of patients have advanced incurable disease at presentation. Changes in awareness of the general public and in the primary care setting are required to address this issue. Severe co-morbidities in patients with potentially curable disease can also preclude operative treatment. The delivery of specialized care for patients with lung cancer has improved dramatically in the United Kingdom with the advent of national guidelines and the local MDT. These measures may not be enough in remedying the poor long-term survival of patients with lung cancer in the United Kingdom without attention to underlying cause. A holistic attitude to the "Big Three" smoking-induced diseases offers hope of novel approach to this problem.

Key Words: lung cancer • multidisciplinary teams • health improvement