(For treatment side effects and complications only)
Lung cancer is the third most common cancer in the UK.
Approximately 46,400 people are diagnosed each year. More than 4 out
of 10 people diagnosed with lung cancer in the UK are aged
75 and older. More than 8 out of 10 lung cancers are caused by smoking.
Clinical research increases patient’s options, but requires a multidisciplinary team keen to go the extra mile to provide them. In Merseyside lung cancer is one of the most common cancers, but we are lucky to have a world leading thoracic oncology diagnostic/molecular pathology service, lung cancer scientists of international recognition affiliated to the University of Liverpool, and a top-notch surgical service provided at Liverpool Heart and Chest. The Clatterbridge Cancer Centre sits comfortably within this network, and we are developing our clinical research programme to:
The formal classification of lung cancer is
changing thanks to new biological insights. Old clinicians knew that cancers
that may look similar under the microscope may have very different speeds of
growth and have broadly diverse responses to the same treatment. We can now
identify lung cancer better with the support of the diagnostic and molecular
pathology laboratory, and aim to improve it through the UK SMP2 study (see
In broad terms, lung cancer can be divided
between Small Cell Lung Cancer and Non-small cell lung cancer.
Small Cell Lung Cancer (SCLC) originates from cells
in the lung of neuroendocrine origin and is commonly related to smoking habit.
They tend to be rapidly growing tumours that press on the central structures of
the chest such as the windpipe, the gullet or major blood vessels. They spread
rapidly, hence most patients present with advanced disease. These patients
commonly have rapid weight loss and tiredness. Unfortunately, immune therapy
has not shown significant effectiveness in this patient population to date, and
novel approaches to achieve disease control are constantly brought forward by scientists
Non-Small Cell Lung Cancer (NSCLC)
originates from endothelial cells, the cells that line the inside of the lungs.
These cells are adenoid cells with mobile little hair-like structures that
behave like an automatic mini-mop, constantly cleaning the lungs. If these same
cells have been exposed to constant injuries, be it smoking, contamination or
infections, they may have changed into squamous, more resilient cells. Those
who have given up smoking may have noticed that they cough more as their cells
go back into their original adenoid form.
These NSCLC tumours are more diverse than
previously thought. To date we have identified three major genetic anomalies
that drive the growth of the cancer and can be controlled for long periods of
time using tablet targeted treatments. These called “driving mutations” are
more common in patients that have never smoked, and are rare cancers. Targeted
treatments knock out the “driver mutation” with a high level of effectiveness,
achieving disease control in most patients, at the expense of some toxicity.
Soon, we hope to open a national study led by
Clatterbridge clinicians working closely with the Liverpool Heart and Chest
surgeons, where we will identify patients that have this lung cancers at a
stage when they can be cured with surgery, give them a very potent inhibitor,
shrink the cancers and take them out afterwards, hoping that we may increase
the cure rates of surgery.