Mrs CJ
Mrs CJ is 71 years old. She smoked for about 30 years, but stopped just over 20 years ago. Since retirement, she enjoys being active – mostly running after one of her grandchildren. She is a central part of her grandchildren’s lives, often doing the school drop-off and pick-up. She has a diary packed with walking groups, dinner with friends and she goes to a music concert every week. Being told she had lung cancer was not only devastating – it was also a terrible inconvenience! She was determined to make the most of her retirement.
After the initial shock, Mrs CJ was adamant that her cancer diagnosis was not going to dominate her time and she was determined to maintain her quality of life. I met her alongside a thoracic surgeon and after a discussion of the differences between surgery and stereotactic radiotherapy, she opted for SABR. This decision was mostly driven by her desire to avoid overnight stays in hospital – even for a very short time.
A week after her radiotherapy planning scan, she started treatment. She had three SABR treatments, on Monday, Wednesday and Friday of the same week. We were able to schedule her appointments for a time that suited her – 09:30, after dropping two of her grandchildren off at school. She was in the hospital for up to 45 minutes each time and then got on with her day as usual.
For two weeks after SABR, Mrs CJ noticed she was more tired. On three occasions she went to bed for a short nap in the late morning. She also thought that her cough may have been slightly worse for a week or two, but she couldn’t be sure. She then returned to feeling like her usual self.
In the first year after treatment, Mrs CJ had a scan and an appointment with me every few months. She was able to go on a summer holiday that had been planned before her diagnosis without any problems. She gets a little anxious each time we meet to get scan results, but I always remind her that the vast majority of patients are cured of lung cancer after the treatment she has received.
For the remainder of our follow-up, I see Mrs CJ twice a year for a scan and to ask about her symptoms. Five years after her treatment, she doesn’t require any further follow up appointments and she returned to life as normal.
Mr MP
When I first met Mr MP, he’d already received two years of treatment for his advanced (Stage 4) lung cancer. He’d received treatment with chemotherapy and immunotherapy with a good response.
For three months before our first appointment, he’d been experiencing pain in his right hip. Previously, he wasn’t taking any pain killers. When we met, he was on a high dose of morphine, a strong pain killer, and was struggling with its side effects (drowsiness and constipation). A scan confirmed that, unfortunately, the cancer had spread to his right hip joint and was progressing, leading to his pain and reduced mobility.
Mr MPs greatest pleasure had been to play half a round of golf every Friday. He hadn’t felt able to do this for the last 8 weeks as he was in too much cancer-associated pain.
Following discussion about his treatment options, he decided to go ahead with palliative radiotherapy for symptom control.
He attended for a radiotherapy planning scan and received a single radiotherapy treatment the next day.
When I met him 3 weeks later, he was taking less than half of the strong painkiller that he’d been taking when we met. I arranged for a physio to see him in his own home. When we meet 2 months after treatment, he only requires paracetamol to control his pain and has managed a couple of rounds of golf.