Recent Advances in Lung Cancer Treatment and Patient Care in UK Healthcare Case Study

Modern Therapeutic Approaches for Improving Lung Cancer Patient Outcomes

Introduction

The quality of life in lung cancer patients is comparatively poor than other healthy populations as well as the several malignancies patient in the United Kingdom. Lived experience has been defined as a key term that someone has experienced by them. Additionally, lived experience can help individual person by providing them a deep knowledge and minutely understanding the opposite people who have faced certain lived experiences. People with lung cancer have mainly suffered from different kinds of signs and symptoms such as loss of appetite, fatigue, pain, cough, blood in sputum as well as dyspnoea. It has been shown from the lung cancer report of the United Kingdom that among every 100 people with chronic lung cancer around 40 people can survive with their specific cancer in stage 2 for approximately 5 years or a few more than that (Cancerresearchuk.org, 2023). Additionally, the UK-based people with the last stage of lung cancer, 5 people out of 100 people have survived for almost 2 to 3 years after they are properly diagnosed and received adequate treatment (Cancerresearchuk.org, 2023).

Figure 1: Mortality rate of lung cancer in the United Kingdom from 2000 to 2020

The entire mortality rate scenario of the United Kingdom for both males and females due to lung cancer has been critically reflected in the above statistical image. As shown in the above image, in 2020 per 100,000 populations in England approximately 58 males, as well as 58 females, died due to chronic lung cancer (Statista.com, 2022). In addition, during the provided indicative time schedule from 2000 to 2020, there is a significant decrease in the lung cancer-based mortality rate among the male population. Whereas the mortality rate among UK-based females with lung cancer has remained at the same level from 2000 to 2020.

According to the report of the Cancer Research Institute in the United Kingdom, it has been identified that approximately 34,800 people in the UK are died due to severe lung cancer per year (Cancerresearchuk.org, 2023). Lung cancer has been considered a common causative factor for cancer people's death in the United Kingdom. Based on statistical reviewing, it has been reflected that in 2020 the total number of newly diagnosed registered cases was 3,757(Statista.com, 2023). The UK-based people in the age group of 70 to 74 years, especially old males are mainly affected due to lung cancer. 

In the United Kingdom, one of the biggest causes of lung cancer is smoking tobacco. Approximately 7 cases out of 10 cases of lung cancer cases have been caused by exclusive smoking as well as inhaling dangerous cigarette smoke by the passive smoker. The government of the UK has adopted the “NHS Long-term Cancer plan” in focusing on the early diagnosis of lung cancer patients at the initial stage to minimise the mortality rate (Morgan and Baldwin, 2023). Strict implementation of the Smoking Prevention Act as well as proper therapeutic and diet plans can help to improve the health condition of lung cancer patients in the UK.

Literature search

PICO framework has been considered a commonly used research model that helps for structuring a constructive clinical questionnaire along with capturing key components based on focused research question. The main focus area of PICO in research paper involves “Problems, Intervention, and Control along with research Outcomes”.

• P (problems of patients): In the UK population most of the individuals above the age of 70 have developed a risk of lung cancer due to carrying the habit of smoking in their adulthood.
• I (Intervention): Different breathing tests are essential to detect this disease along with biopsy reports. This disease or problem can be easily diagnosed.
• C (control): Effective knowledge and practices could help to control this type of disease in future.
• O (outcomes): This specific type of training or knowledge-giving processes will help adults to reduce or stop their smoking habits.

On the other hand, different key words has been used to search literature from diffrent sources. This key terms include; “Different factors affecting lungs cancer”, “Lung cancer cases in UK”, “Different types of lung cancer”, “Genetic factors for lung cancer”, “Lung cancer and its impact”, “Maintenance of healthy lungs”, “Activity of lungs” and others.

80 research articles have been identified from PubMed, among them 5 research articles have been selected for the present research study. On the other hand, 83 research articles and journals have been identified from Google Scholar whereas 3 research article has been selected for this specific research study. Besides that, 44 research articles have been identified from the ProQuest among them 2 research article have been selected.

Inclusion criteria

• Language has been selected as UK English
• Only full text articles has been selected with author and Doi
• Only selected newspaper articles journal and books
• Collected data from websites such as WHO, Statista and other authentic sites
• Collect article in a range of 2019 to 2023
• Has focused on UK-specific data

Exclusion criteria

• No other language from UK English has been used
• No unethical or biases content has been selected
• No blog writing has been used
• No data from Wikipedia or investopedia has been used
• Have not collected any data from the articles that has published before 2019
• Has not collected worldwide data

By adding all the PRISMA filters this research has finally selected 10 articles for literature review. This articles has been selected based on the quality and content of the literature. 

Literature Review

Article 1: “Association between age, deprivation and specific comorbid conditions and the receipt of major surgery in patients with non-small cell lung cancer in England: A population-based study.”

The main aim of this present research paper is to investigate the socioeconomic disparities as well as find out the protagonist factors' role in the major surgical treatment of lung cancer patients in England. In this present research paper, the primary quantitative research method has been used by accumulating the lung cancer diagnosed-related data from 31,351 patients in England (Belot et al. 2019).

It has been understood from this present research paper that this research study has provided strong evidence about the presence of “cerebrovascular disease”, and “congestive heart failure” along with “chronic obstructive pulmonary disease” within the human body. In addition, the presence of three crucial heart-related diseases in the people of England can reduce the chance of surgery recipients at the very early stages of the individual patients (Belot et al. 2019). PET-Scan helps to diagnose patients with lung cancer based on age and gender.

Article 2: “Disability, psychological distress and quality of life about cancer diagnosis and cancer type: a population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer."

The major aim of this present research article is to find out the long and short-term mental as well as the physical impact of severely cancer-affected people. In this present research study, the Questionnaire data method has been used based on a cohort study that has covered the entire cancer-affected population of Australia (Joshy et al. 2020).

It has been shown that the present research article has focused on physical disability, and reducing QoL along with distress is commonly seen after being affected by cancer. Additionally, this specific research article has also highlighted various types of cancer, cancer research area, cancer support, cancer diagnosis as well as proving extensive cancer care (Joshy et al. 2020). This present research study has critically analysed that the number of cancer survivor patients was 22,505 and the number of people without cancer was 244,000.

Article 3: “Association between progression-free survival and patients’ quality of life in cancer clinical trials”

The main aim of this present research paper is to provide relevant information based on the quality-of-life outcomes the cancer-affected patients as well as physicians in the oncology care unit. In this present research paper, a secondary research method has been used for collecting cancer-related phase 3 clinical trial reports by effectively using the secondary sites like Medline and PubMed (Hwang and Gyawali, 2019).

Depending upon the present research paper, it has been evaluated that it has covered the association of the largest study area between the quality-of-life outcomes as well as PFS. In that case, 147 cancer-based clinical trial life data have been identified from 2010 to 2015 (Hwang and Gyawali, 2019). Besides that, this present study has also included 38 clinical trials from 2000 to 2016 which had no indicative association between quality-of-life outcomes and PFS.

Article 4: “Association between Breast Cancer and Second Primary Lung Cancer among the Female Population in Taiwan: A Nationwide Population-Based Cohort Study”

The main purpose of this present research article is to discover the special association between second primary lung cancer as well as breast cancer among the Taiwan-based female population. In this present research article, the comprehensive database method based on Taiwan's “National Health Insurance Programme” has been used for collecting relevant breast and lung cancer-related primary report data (Lin et al. 2022).

It has been minutely understanding from the present research article that the major findings of this specific retrospective study breast cancer patient have a relatively high risk of developing second primary lung cancer. The chance of getting both breast cancer as well as second primary lung cancer is high among the younger female along with comorbid groups (Lin et al. 2022). This present study has also highlighted multiple subtypes of both breast and lung cancer along with unrecognised aetiology for further cancer development.

Article 5: “Lung cancer awareness and palliative care interventions implemented in low-and middle-income countries: A scoping review”

The major aim of this specific research paper is to determine the map evidence based on lung cancer awareness as well as implementing the palliative intervention cares in Sub-Saharan along with other LMICs. In this present research paper, “the mixed method appraisal tool” has been used for gathering topic-based relevant informative databases from Google Scholar, PubMed, Science direct, and the WHO website along with the EBSCO host (Nwagbara et al. 2020). 

Depending upon this present research paper, it has highlighted that most tobacco users have suffered from lung cancer due to a lack of knowledge based on pre-disposing risk factors. This present research has also provided the major evidence on palliative care along with timely access to palliative care services for lung cancer patients (Nwagbara et al. 2020). The present research study has also illustrated the importance of palliative care for promoting the quality of life of patients with lung cancer.

Article 6: “Mortality of lung cancer as a second primary malignancy: A population?based cohort study”

The main aim of this present study is to critically examine specific cancer-diagnosed patients' survival with lungs-2 as compared to lungs-1. In this specific research article, a population-based cohort study of lung cancer patients has been done by accumulating the relevant lung cancer-related enormous data from “ the SEER programme of the National cancer institute” (Deng et al. 2019).

Based on the specific research study, it has been reflected that the average survival period of patients with second primary lung cancer is around five years after the diagnosis process but not more than that. Additionally, the patients with first primary lung cancer are prone to more survival chances than those before one (Deng et al. 2019). This present research has also highlighted that certain associated cancer-independent characteristics along with desired cancer treatment.

Article 7: “Obstructive Sleep Apnea and Lung Cancer: A Systematic Review and Meta-Analysis”

The major aim and objective of this particular research study are to examine the effective association between obstructive sleep apnea along with lung cancer mortality rate. Four electronic databases have been used in this present research article that includes PubMed, Cochrane Library, and Embase along with Scopus (Cheong et al. 2022). 

Depending on this specific research article, it has illustrated that a meta-analysis of lung patients from 4 observational databases reflects patients with OSA have approximately a 30% higher risk of getting lung cancer (Cheong et al. 2022). It has been suggested that long-term follow-up of clinical studies and lung cancer-based biological models can help to better performance elucidating this relationship

Article 8: “Application of artificial intelligence in the diagnosis of multiple primary lung cancer”

The major aim of this specific research paper is to evaluate the agreement of AI diagnosis as well as a pathological diagnosis for providing future application evidence based on multiple primary lung cancer. In this present research paper, the primary quantitative survey method has used 53 participants (Li et al. 2019). 

It has been critically identified from this present research paper that AI acts as a relevant diagnostic aid for providing more accurate diagnostic results based on multiple pulmonary nodules. This present research study has also offered systematic plans along with better treatment procedures for patients with multiple primary lung cancer (Li et al. 2019).

Article 9: “Radiofrequency ablation of primary non-small cell lung cancer: A retrospective study on 108 patients”

The major aim of this present research article is to analyse the impact of radiofrequency ablation based on primary non-small cell lung cancer. In this specific research article, the primary research method has been used by collecting relevant data from 108 lung cancer patients who are going through under CT-guided RFA process (Gao et al. 2019).

Depending on the present research paper, it has understood that the maximum diameter of the lung cancer lesions is greater than 3 c.m. at the early clinical diagnosis stage. The incorporation of cisplatin as well as carboplatin chemotherapy combined with RFA acts as a positive factor for the diagnosis of primary non-small cell lung cancer in 108 patients (Gao et al. 2019). 

Article 10: “Relationship between nutritional status and quality of life in patients with cancer”

The main aim and objective of this present research paper are to evaluate the importance of global quality of life along with identifying its various dimensions within cancer patients. In this specific research study, a transversal observational-based epidemiological study has been performed within 23 hospital words over 2 weeks (Pola?ski et al. 2021).

It has been minutely understood from this particular research study that there has a strong association between impaired quality of life as well as weight loss. This present study has provided the implementation of various intervention strategies for improving the quality of life among cancer patients (Pola?ski et al. 2021). This present research paper has also illustrated that the significant involvement of nutritional therapy has acted as integral oncological support.

Proposing a change based on the literature review

Video-assisted thoracoscopic surgery

The use of "video-assisted thoracoscopic surgery (VATS)" techniques in lung cancer surgery is on the rise, but little is known about how they affect patients' "health-related quality of life (HRQL)". This prospective research evaluates the patient's HRQL one year after VATS for "non-small cell lung cancer (NSCLC)" and assesses the viability of gathering such information from patients following either VATS or open lung resection (Avery et al., 2020).

As stated by Avery et al., 2020, Patient recovery following VATS resection is well understood by patient-reported HRQL evaluation utilising general and disease-specific instruments that have been designed and validated at numerous time periods. Since the negative effects of the VATS pulmonary resection on patients with NSCLC were not previously considered, they may be more extensive and long-lasting than previously believed. Researchers found that using the VATS approach for lung cancer resection rather than open surgery prevented subtle and persistent HRQL changes (Avery et al., 2020). Patients receiving VATS surgery had a higher likelihood of preoperatively identified low-stage tumours, better chest scores, older age, or recent smokers as baseline patient characteristics.

Surgery continues to be the primary therapy for early-stage lung cancer, which accounts for the majority of cancer-related fatalities globally. According to Lim et al., 2019, Thoracotomy was used to remove malignancy from the lungs before "video-assisted thoracoscopy (VATS)" was developed. The database for different surgical methods now relies mostly on short-term hospital outcomes and is based on non-randomised, small randomised trials.

Lim et al., 2019, assess the efficacy and cost-effectiveness of minimum access versus open surgery in order to educate current UK (National Health Service; NHS) practise, public health policy, and individual surgeon and patient decision-making. “Video-assisted thoracoscopic lobectomy” versus “conventional open thoracic lobectomy” for lung cancer (VIOLET) is a British study comparing the efficacy, cost-effectiveness, and acceptability of the VATS lobectomy and laparotomy in the treatment of lung cancer (Lim et al., 2019). It highlights the need for well-designed and carried-out RCTs.

AI-powered lung nodule algorithm for detection and 3D segmentation

Lung cancer imaging test failure is a highly frequent cause of malpractice claims. As per the opinion of Weikert et al., 2019, the misdiagnosis has a variety of causes, including recognition of mistakes and search satisfaction. Thus, it is crucial to develop methods to reduce observer error. In this respect, "computer-aided detection (CAD)" of pulmonary nodules is becoming more and more popular. Deep learning algorithms, which have the benefit of utilising automated features, have recently posed a threat to conventional CAD systems that depend on visual confirmation to minimise false positives (Weikert et al., 2019).

In the CT component of PET/CT, the assessed AI-driven algorithms provide excellent identification and segmentation of T1 lung lesions and good detection and segmentation of T2 tumours. Weikert et al., 2019 stated that several characteristics that affect the detection rate were discovered via radiomics analysis. Better recognition was correlated with finer, less diverse, and rounder textures. After detection, segmenting lung lesions is the next stage, and if done correctly, radiomics, AI, opens the door for a variety of secondary analyses that are now being developed in the context of tailored therapy.

Postoperative delirium

Postoperative delirium has been considered a systematic process that mainly happens during the post-operative conditions of older adults. It is known as the most common postoperative complication among older adults. The major underlying causative symptoms of delirium are electrolyte imbalance, drug, infection as well as immobilisation. There are certain major symptoms of post-operative delirium such as restlessness, combative, and irritability along with agitated ness. According to Hayashi et al. (2019), it has shown that postoperative delirium has occurred in two patients as a single complication and both of them have been required to admit to ICU but there is no chance of mortality. After proper rehabilitation, patients with postoperative delirium have discharged from the hospital. Based on the current guidelines of postoperative treatment, it has been observed that postoperative delirium has occurred frequently less than once specially in the expected older age group by the consequence of individual screening as well as counselling after lung resection for primary lung cancer.

Self-Care Guidelines on Chemotherapy

Lung cancer has acted as common cancer across the world that has a higher symptom burden along with a severe morbidity rate. In the case of effective symptom management of lung cancer has significantly required well-comprehensive self-care strategies based on chemotherapy. Effective implementation of the self-care guidelines drops statistically significant positive impact in minimising the severity among patients based on lung cancer symptoms. Positive association of individual self-care guidelines along with chemotherapy plays a beneficial role in slightly improving the patients’ symptoms of lung cancer (Mahrous and Sherif, 2021). No specific significant differences have been shown between the effective implementation of pre as well as post-individual self-care guidelines that can mildly affect a patient’s life. Lung cancer-based health education programmes along with their relevant disease management can help to improve the health condition of lung cancer patients. As stated by Mao et al. (2022), the use of a general self-efficacy scale among nurses helps to critically evaluate the before and after the intervention of patients with lung cancer and receiving chemotherapy. On the other hand, the negative impact of patients' self-efficacy is arising from the Hospital Anxiety as well as Depression Scale (HADS).

Cancer green therapy in the treatment

Chemotherapy has been considered the major effective therapy for improving the condition of “non-small cell lung cancer” at the stage of IIIb or IV. The rate of survival chance of lung cancer patients receiving chemotherapy is 6 % for approximately 5 years. Cancer Green Therapy is known as a noble cancer treatment therapy that is mostly used in the China. Cancer Green Therapy of China is a mixed combination of cryoablation along with the specific formula of traditional Chinese medicine. It has been critically observed that receiving of cancer green therapy based on cryoablation combined with Chinese traditional formula by patients with "non-small cell lung cancer" can help to increase their survival period as well as provide a better quality of life (Sun et al. 2020). Positive implementation of cancer green therapy plays a significant role in promoting lung cancer patients’ efficacy as well as safety for better progression of the overall cancer treatment process. The treatment by implementing cancer green therapy can help to improve the quality of life outcomes among patients with “non-small cell lung cancer. According to Wang et al. (2022), it has been suggested that post-operative high-quality nursing care for patients with “non-small cell lung cancer” drops positive impact on improving the quality of life. Significant implementation of high-quality nursing care plays a vital role in decreasing the inflammation of lung cancer patients along with promoting the self-prognosis, especially for postoperative patients with “non-small cell lung cancer”.

Family-oriented dignity therapy

“Family-oriented dignity therapy plays a significant role in giving the best treatment method to patients with lung cancer and undergoing for chemotherapy. Positive incorporation of the both fidelity, as well as precursory factors, helps to promote the regulatory effect based on family-oriented dignity therapy. In addition, effective implementation of certain reinforcement therapy including providing reading material, and audio along with various supplementary videos helps to improve the health condition of the patients with severe lung cancer (Xiao et al. 2023) Additionally, the development of a flexible approach, multiple achievements as well as exploring new lessons helps the lung cancer patients for better expressing of self-feelings that helps in the future research perspectives. The strong recommendation of this specific therapy helps to enhance the intervention effect of lung cancer.

Trilaciclib medication

Trilaciclib has been considered an inhibitor administration which has been given through intravenous CDK4/6 based on chemotherapy treatment for lung cancer patients. This specific medication has preserved within the haematopoietic stem, immune system function as well as progenitor cells. Providence of trilaciclib medication to the lung cancer patients can help to minimise the damages which have caused by receiving various chemotherapy. The major benefit of Trilaciclib medication is to enhance the total number of red blood cells, and white blood cells along with platelets (Daniel et al. 2021). The positive effect of this specific medication is to decrease the requirement of blood transfusion along with significantly increasing the immune system and body’s ability of the patients with lung cancer. Effective introduction of Trilaciclib medication among the lung cancer patients who are receiving chemotherapy can help to prepare the patient's body for fighting against the multiple infections

Conclusion

It has been concluded based on the above entire discussion that lung cancer is responsible for severely affecting the quality of life among patients in the United Kingdom. It has been illustrated in the literature review part after critically reviewing the lung cancer-based research paper that the effective application of Artificial intelligence helps in primary-stage lung cancer patients. Additionally, the present research study has also highlighted that lung cancer may severely lead to distress, physical disability as well as poor quality of life within lung cancer patients. Incorporation of various proposed changes such as cancer green therapy, chemotherapy-based self-care guidelines, Trilaciclib medication and dignity therapy along with postoperative delirium can help for rapid lung cancer recovery.

It can be concluded from the above discussion that the detrimental consequences of the VATS pulmonary resection on NSCLC patients were not previously taken into account, they could be more severe and pervasive than previously thought. Examine the effectiveness and financial viability of minimal access vs open surgery to inform current UK practice, public health policy, and individual surgeon and patient decision-making. Recent developments have put traditional CAD systems, which rely on visual confirmation to reduce false positives, at risk from deep learning algorithms, which have the advantage of using automated characteristics. After identification, segmenting lung lesions is the next step.

References

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