Lung cancer has a poor prognosis. It is reasonably common in general practice, needs good palliative care, and requires co-operation between several health care teams to be managed well. This article deals with meeting this challenge within the British NHS, but the issues discussed have implications for other health care systems.

The National Cancer Guidance Group (NCGG) recommends that all patients with lung cancer should be treated by a multidisciplinary team led by a respiratory physician, that both the primary health care team and the palliative care team should be fully involved, and that all decisions regarding the patient’s management should be rapidly and effectively communicated between these three teams.1 The report of the Standing Medical Advisory Committee (SMAC) published in 1994,2 among others, clearly recognises the place of primary care in the management of lung cancer and emphasises the need for co-operation between disciplines: “The nature and frequency of the disease means that the work of general practitioners and their colleagues must be integrated with that of secondary, tertiary and palliative care if high quality services are to be provided”.

Achieving this level of communication and co-operation is crucial if those treating patients with lung cancer are to deliver high quality care.