• lung cancer
• postoperative pain
• quality of life

Postoperative pain and breathlessness following lung cancer surgery are important causes of disability. The prospect of such symptoms may influence the decision to proceed with surgery. Incapacitating intercostal neuralgia, unlike other surgical pain, often does not go away. Intolerable breathlessness caused by removing lung tissue from a patient who already has poor lung function can result in severe limitation of exercise tolerance. Is it really worth it when the survival outcomes in lung cancer are so poor anyway?

A surgeon’s main interest is radical clearance of the tumour and long term survival of the patient. Success is judged in terms of operative mortality and 5 year survival. The referring physician, on the other hand, may perceive that the patient will be left physically and emotionally handicapped by surgery and refer him or her for chemotherapy or radiotherapy instead, even though there is little evidence that these treatments are less debilitating and cure rates are known to be lower. What price …