Lung cancer is a major cause of cancer-related deaths in men and women. However, since the first edition of Lung Cancer was published 14 years ago, rapid progress in the biology, prevention, diagnosis, and treatment of the disease has been made.

In the United States, lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer death. Even more devastating is its five-year survival rate of only 15.8%. Despite these dismal facts, lung cancer receives little national attention and research and funding for lung cancer lags behind other cancers. The intent of Contemporary Issues in Lung Cancer: A Nursing Perspective is to provide oncology nurses and healthcare professionals with in-depth information on the issues that surround this disease, so that they might impact both education and research and provide better care for their patients. Contemporary Issues in Lung Cancer addresses all aspects of the disease from incidence, risk factors, and the biology of lung cancer, to the latest modes of treatment. Also discussed are controversies in the detection and screening of lung cancer, and the special issues facing individuals with lung cancer.

Thoroughly revised and updated, this Fourth Edition is the most comprehensive, current reference on lung cancer, with contributions from the world's foremost surgeons, radiation oncologists, medical oncologists, pulmonologists, and basic scientists. Coverage includes complete information on combined modality treatments for small cell and non-small cell lung cancer and on complications of treatment and management of metastases. Emphasis is also given to early detection, screening, prevention, and new imaging techniques. This edition has expanded thoracic oncology chapters including thymus, mesothelioma, and mediastinal tumors, more detailed discussion of targeted agents, and state-of-the-art information on newer techniques in radiotherapy. Other highlights include more international contributors and greater discussion of changes in lung cancer management in each region of the world. A new editor, Giorgio Scagliotti, MD from the University of Turin, has coordinated the accounts of European activities. A companion website includes the full text online and an image bank.

Lung cancer is one of the biggest challenges in oncology today. The challenge is due to the recognition of the possibility of prevention in at least 70-80 % of all the cases and the extreme difficulties encountered in the treatment of this neoplasm. Despite the knowledge of prevention measures such as cessation of cigarette smoking the incidence continues to increase in many countries. The increase is particularly notable in females in the west ernized countries where the death rate in females in certain regions sur passes that of breast cancer. Furthermore, in many developing countries lung cancer is now being diagnosed with increasing frequency in both sexes and it is expected to be a major cause of death in those countries later in this century or the beginning of next century if the tobacco consumption will continue its rapid rise. With respect to therapy the 1970'es brought considerable progress in understanding of the clinical behaviour of lung cancer thereby establishing the importance of distinguishing between the major histologic types. Thera peutic advancement was particularly experienced in small cell carcinoma with the introduction of combination chemotherapy after this special dis ease entity among lung cancers was recognized as being a disseminated dis ease in almost all cases at the time of diagnosis. It was expected that the improvement in therapy would have continued in the early 1980'es, not only for small cell lung cancer but also for the other cell types.

This book aims to provide an up-to-date review of the literature in each of the major areas relating to the management of older lung cancer patients, and makes recommendations for best practice and future research. The authors come from a broad geographic spread including the UK, mainland Europe and North America to ensure a worldwide relevance.

Significantly increase your chances of long-term lung cancer survival by using holistic Alternative/Integrative interventions by physicians/ health practitioners.

Defining the Lung Cancer Problem 1 Lung cancer is the leading cause of cancer death in the world. It kills almost as many Americans as cancers of the breast, prostate, colon, rectum, pancreas, and 2 kidney combined, and accounts for 28.6% of all US cancer deaths. With an increase in the 5-year relative survival rate from 13% to only 16% in the more than 2 30 years from 1974 to the present, it will take us another 840 years to eradicate lung cancer deaths if we do not improve the current rate of progress. As discussed in this text, lung cancer prevention has received substantial att- tion. The decrease in smoking in recent decades has helped, but smoking is not the only problem. Lung cancer in people who have never smoked is currently the 5th 3 leading cause of cancer death in the United States. Several factors contribute to the lethality of lung cancer, including the rapidity of tumor growth, advanced stage at diagnosis (due to nonspecificity of early sy- toms and the uncertain efficacy of screening), early development of metastases, and resistance to therapy. Several chapters in this book discuss new molecular targets that may be potentially exploitable in the future, as well as discussing our track record to date in exploiting them.

The European School of Oncology came into existence to respond to a need for informa tion, education and training in the field of the diagnosis and treatment of cancer. There are two main reasons why such an initiative was considered necessary. Firstly, the teaching of oncology requires a rigorously multidisciplinary approach which is difficult for the Univer sities to put into practice since their system is mainly disciplinary orientated. Secondly, the rate of technological development that impinges on the diagnosis and treatment of cancer has been so rapid that it is not an easy task for medical faculties to adapt their curricula flexibly. With its residential courses for organ pathologies and the seminars on new techniques (laser, monoclonal antibodies, imaging techniques etc.) or on the principal therapeutic controversies (conservative or mutilating surgery, primary or adjuvant chemotherapy, radiotherapy alone or integrated), it is the ambition of the European School of Oncology to fill a cultural and scientific gap and, thereby, create a bridge between the University and Industry and between these two and daily medical practice. One of the more recent initiatives of ESO has been the institution of permanent study groups, also called task forces, where a limited number of leading experts are invited to meet once a year with the aim of defining the state of the art and possibly reaching a consensus on future developments in specific fields of oncology.

The "Europe against Cancer" programme has, from its inception, emphasised the key role which general practitioners must play in the actions necessary to achieve its aim of reduc ing the incidence and the mortality from cancer in the European Community. General practitioners, because of their day-to-day direct and continuing contact with patients, playa role not only in primary prevention and education of patients, but also in motivating their patients to accept secondary prevention and screening, some of it carried out by general practitioners themselves. These preventive activities are in addition to their traditional role in the care and management of patients with cancer at home, and increas ingly, their role in active treatment. In view of the importance of the general practitioner in the "Europe against Cancer" pro gramme, the European Commission, with a view to providing general practitioners with up-to-date useful information, has sponsored the production of this series of publications on organ based cancers, especially written for general practitioners. MICHEL RICHONNIER Coordinator ofthe "Europe against Cancer" programme, Commission ofthe European Communities, Brussels Preface To decrease the death rate of lung cancer is today one of the major challenges of medical doctors all over the world. In Europe alone, one person is dying of lung cancer every two minutes. Accordingly, most physicians will regularly in their career be confronted with a patient being either suspect of or having a lung cancer.