Lung cancer - a philosophical, ethical, and personal perspective

Lung cancer is a formidable worldwide health problem causing more deaths than breast, prostate, and colorectal cancer combined. Eighty percent are non-small cell type (NSCLC) and less than one in five patients can have a curative resection. Decisionmaking in treating cancer, and lung cancer specifically, requires an understanding of the basic ethical principles as well as a priortization of values beyond medical knowledge alone. Choosing a treatment plan can be difficult because of the multiple confronting dilemmas occurring simultaneously. Economic analysis also is required of every major treatment strategy proposed. Active patient involvement is helpful in making these important and difficult choices at the same time clinicians must be mindful of their roles as healers, educators, and innovators of knowledge in a disease that has a five year mortality rate of nearly 90%. Finally, because end of life care issues are so common with this illness, clinicians must be aware of their importance in making dying easier for so many individuals. (C) 2001 Published by Elsevier Science Ireland Ltd.