# Lung Cancer - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class RD25 - condition scope only, no dose · Lung Cancer - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK482357/ · No dose - referral pathway, no medicine given in primary care · Lung Cancer - disease-level clinical article (lung-cancer-full.txt) - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Lung Cancer - disease-level clinical article (lung-cancer-full.txt) ## Treatment metadata - Recognise, refer urgently for staging and treatment (Recognition & Referral) ## Complete treatment card ```text LUNG CANCER Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class RD25 - condition scope only, no dose · Lung Cancer - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK482357/ · No dose - referral pathway, no medicine given in primary care · Lung Cancer - disease-level clinical article (lung-cancer-full.txt) Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (8) - About 50 to 75% of people with lung cancer report a cough [cough] - Thin, mucoid sputum in large volume when coughing suggests mucinous adenocarcinoma [cough · sputum] - About 15 to 30% of people with lung cancer cough up blood [cough] - About 20 to 40% of people with lung cancer have chest pain [chest pain] - By the time of diagnosis, up to 25 to 40% of patients feel breathless - Bone pain from metastasis occurs in up to 20% of non-small cell lung cancer patients at first presentation [bone pain · metastasis] - Anorexia, nausea, constipation, and lethargy are typical symptoms of hypercalcemia from lung cancer [constipation · lethargy · nausea · poor appetite] - Shoulder pain is a presenting feature of superior sulcus (Pancoast) tumors [joint pain · shoulder pain] SIGNS - what you find (2) - Superior vena cava syndrome shows dilated neck veins, facial and arm swelling, and a plethoric look [raised JVP] - Pancoast tumors can produce Horner syndrome and bony destruction with wasting of the hand muscles [muscle wasting] TESTS (7) - Contrast CT of the chest extending to the adrenal glands is the standard initial staging study - A lymph node of 1 cm or more on its short axis on CT is regarded as highly suspicious for malignancy - CT alone has only 55% sensitivity and 81% specificity, so it is not adequate for staging by itself - PET scanning is more accurate than CT, at 80% sensitivity and 88% specificity - A chest x-ray in SVC syndrome often shows a widened mediastinum or a right-sided hilar mass - Mediastinoscopy is 78% sensitive and 100% specific, with about a 0.08% risk of death - Endoscopic ultrasound sampling reaches 89% sensitivity and 100% specificity, matching endobronchial ultrasound IF NOT THIS - what else fits (8) - Bacterial pneumonia - Bronchitis - Mycoplasmal pneumonia - Pleural effusion - Pneumothorax - Tuberculosis - Viral pneumonia - Fungal pneumonia Source StatPearls "Lung Cancer" - disease-level clinical article Status traced to the source above 1. RECOGNISE, REFER URGENTLY FOR STAGING AND TREATMENT (RECOGNITION & REFERRAL)[1st line] Adult Primary malignancy of the bronchus, lung or trachea, strongly linked to smoking. The definitive management depends on cell type and stage and it belongs to a lung-cancer multidisciplinary team. In stage 1 non-small cell disease the article puts surgery at the centre, the operation being a lobectomy or a pneumonectomy with sampling of the mediastinal lymph nodes; at stage II it prefers surgery with chemotherapy afterwards. Stage IV it calls incurable, the aim there being longer survival and lighter symptoms rather than cure, with every advanced non-small cell tumour checked for the mutations that have a matching inhibitor. Small cell disease responds strongly to chemotherapy but recurs often, and is treated according to its stage. Refer urgently for imaging, tissue diagnosis and oncology assessment. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Primary malignancy of the bronchus, lung or trachea, strongly linked to smoking. The definitive management depends on cell type and stage and it belongs to a lung-cancer multidisciplinary team. In stage 1 non-small cell disease the article puts surgery at the centre, the operation being a lobectomy or a pneumonectomy with sampling of the mediastinal lymph nodes; at stage II it prefers surgery with chemotherapy afterwards. Stage IV it calls incurable, the aim there being longer survival and lighter symptoms rather than cure, with every advanced non-small cell tumour checked for the mutations that have a matching inhibitor. Small cell disease responds strongly to chemotherapy but recurs often, and is treated according to its stage. Refer urgently for imaging, tissue diagnosis and oncology assessment. Caution RED FLAG - Malignant spinal cord compression or brain metastasis (new focal neurological deficit, severe unremitting back pain with leg weakness): assess urgently and refer. RED FLAG - Superior vena cava syndrome (dilated neck veins, facial/neck/upper-limb edema, plethora) is a distinct emergency presentation of lung cancer. There is no drug row on this card and that is a finding, not a gap. Every drug this article names - platinum chemotherapy, the EGFR and ALK tyrosine kinase inhibitors, the PD-1 and PD-L1 antibodies, bevacizumab - is systemic cytotoxic or targeted oncology therapy, dosed by body surface area, mutation status and blood counts by an oncologist. This app does not dose systemic cancer therapy for anyone, and the article states no dose for any of them. Symptom relief in advanced disease is delivered by oncology and palliative care, and the article's own tools for it are not prescriptions. Chemotherapy eases pain and cough and may extend survival; palliative radiotherapy relieves symptoms in 41% to 95% of patients with lung cancer, and is central to controlling the pain of metastasis, brain and bone especially. Where the airway is obstructed - and the article puts central airway occlusion at almost 30% of lung cancer patients - bronchoscopic laser destruction with a stent afterwards gives immediate relief. (Lung Cancer - StatPearls - NCBI Bookshelf, NBK482357) The one intervention that IS yours, at every single visit. The article makes stopping smoking the most important preventive measure there is, for everyone, and asks that the link between smoking and lung cancer be put to the patient at every visit. (Lung Cancer - StatPearls - NCBI Bookshelf, NBK482357) It names no drug for it - the regimens are listed under Smoking Cessation. RED FLAG - Haemoptysis, unexplained weight loss with a persistent cough, or new hoarseness or chest pain lasting several weeks, especially in a smoker. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)