In the first of a series of experts' articles about cancer, still the commonest cause of death in the region, North Yorkshire-based Dr Chris Wheatley, of the Cancer Care Alliance, writes about lung cancer.

NOWADAYS, the prevention and treatment of cancer involves the patient and his/her GP and Primary Care Team, as well as cancer specialists and their teams, often at more than one hospital. This means doctors and hospitals have to co-operate very closely, so networks of hospitals and Primary Care Trusts (PCTs) have been set up to help this happen. Locally, this is the Cancer Care Alliance of Teesside, South Durham and North Yorkshire (CCA), involving six hospitals and ten PCTs. The most effective way of reducing deaths from cancer is to prevent a cancer developing in the first place, or at least to have it diagnosed at as early a stage as possible. The following is a guide to combating lung cancer:

LUNG cancer is the commonest cause of death from cancer in our (CCA) area for both men and women. Although more women develop cancer of the breast, treatment is much more successful, so more actually die from lung cancer. The average survival time for a patient with cancer of the lung is about four months, though this can sometimes be extended to a year or more by chemotherapy etc. A curative operation is only possible in a few very early cases, so prevention is certainly the best course.

What can be done to prevent getting lung cancer?

This is the most preventable of the common cancers, with at least 90 per cent of cases occurring in smokers. It has also been estimated that about 1,000 passive smokers develop lung cancer in the UK each year.

So the message is simple - if you are a smoker, stop! After stopping, the risk gradually reduces so that after ten years, it is almost as low as that of a non-smoker. A great deal of help is now available from your GP and the rest of the primary care team. Many practice nurses now run smoking cessation clinics and can arrange for patches or tablets to be provided on prescription.

If you are a non-smoker, try to avoid situations where you are exposed to other people's smoking. If your local pub or club always has a smoky atmosphere, encourage the landlord to have an effective non-smoking area, or even better, a totally smoke free establishment.

Are there any screening tests?

Unfortunately, no. Unlike for breast and cervical cancers, there are not yet any tests that will detect lung cancer before it is properly developed. The best we can do is to detect the cancer as early as possible, and this depends as much on the patient reporting symptoms to his/her doctor as it does on the GP promptly arranging an X-ray or specialist referral.

What symptoms to look out for

Any of the following symptoms may be suggestive of lung cancer:

* A new, persistent cough lasting for longer than four weeks

* New and persistent chest pain

* Breathlessness

* Coughing up blood

* A chest infection lasting more than two to three weeks, which does not respond to one course of antibiotics in a smoker or ex-smoker.

Anyone with one or more of these symptoms should report them to their GP, who will arrange an urgent chest X-ray. Smokers over the age of 45 are particularly at risk and should report any worsening of their health such as loss of weight, loss of appetite, or a new wheeze etc.

In a nutshell

* If you do not want to die from lung cancer, do not start smoking, but if you already have, stop!

* Avoid breathing other people's smoke.

* Report any of the above symptoms to your doctor.