Oxford Case Histories in Lung Cancer

Oxford Case Histories in Lung Cancer contains a comprehensive selection of 40 clinical cases that reflects the multidisciplinary approach to the management of lung cancer. Written by authors specialising in respiratory medicine, oncology, pathology, radiology, palliative care, and thoracic surgery, the cases cover both incidents commonly faced in clinical practice, or those that pose particular challenges.

Each case consists of a brief case history, followed by questions and answers to discuss common questions arising during the management of lung cancer. The answers are based on the best available evidence from the latest research, and should help optimise the diagnostic pathways available to patients.

The text is also extensively illustrated with over 75 CT and MRI scans and X-ray images to help the reader develop interpretative skills. The book may also be used in multidisciplinary sessions to help make arguments for patient care decisions based on real-life scenarios. This is an essential new resource for both trainees and recently appointed consultants who will work with patients who have lung cancer, specialist nurses, and lung cancer MDT co-ordinators.

Himender K. Makker, Consultant Respiratory Physician, North Middlesex University Hospital NHS Trust, London, UK,Adam Ainley, Specialist Registrar in Respiratory Medicine, National Heart and Lung Institute, Imperial College, London, UK,Sanjay Popat, Consultant Thoracic Medical Oncologist, The Royal Marsden NHS Foundation Trust, London, UK,Julian Singer, Consultant Clinical Oncologist, Princess Alexandra Hospitals NHS Trust, Harlow, UK,Martin Hayward, Consultant Thoracic Surgeon and Clinical lead for Thoracic Surgery, University College London Hospitals NHS Foundation Trust, London, UK,Antke Hagena, Consultant in Palliative Medicine, North Middlesex University Hospital NHS Trust, London, UK

Dr Himender Makker is a Consultant Respiratory Physician and Clinical Lead for Lung Cancer Service at the North Middlesex University Hospital. He established and developed Lung Cancer MDT team and service.
He is a member of North and East London Lung Cancer Network, and contributes to the National Lung Cancer Audit and supports UCL and National Lung Cancer trials and projects. His research interests include sleep disordered breathing and asthma.


Dr Adam Ainley is a Speciality Trainee Registrar in Respiratory Medicine and General (Internal) Medicine within the North East Thames rotation in London. He undertook postgraduate general medical training in Oxford and London prior to his higher specialist training, and is currently undertaking a PhD within the National Heart and Lung Institute at Imperial College London.


Dr Sanjay Popat is a Consultant Thoracic Medical Oncologist at The Royal Marsden and Honorary Clinical Senior Lecturer in the Molecular Genetics and Genomics Group at the National Heart and Lung Institute, Imperial College London. He is Chair of the British Thoracic Oncology Group (BTOG).
He is a specialist thoracic oncologist, and internationally recognised as an expert in the treatment of lung cancer, mesothelioma, and cancers of the thymus. His research interests include identification and validation of DNA variants that influence thoracic tumour development, identification of biomarkers, and the development of novel therapeutic strategies for thoracic tumours.


Dr Julian Singer is a Consultant Oncologist specialising in lung cancer radiotherapy and chemotherapy at the North Middlesex University and Princess Alexandra Hospitals. He is a member of the Royal College of Physicians, the Royal College of Radiologists, and European Society of Medical Oncology.
He is joint lead for lung cancer at Princess Alexandra Hospital, radiotherapy Lead for lung cancer at London Cancer Network, Oncology lead for breast cancer at Princess Alexandra Hospital and radiotherapy lung cancer lead at North Middlesex Hospital.


Mr Martin Hayward is Consultant Thoracic Surgeon and Clinical Lead for Thoracic Surgery at University College Hospital, London. His research interests include heart failure, lung cancer surgery, and minimally invasive chest surgery.


Dr Antke Hagena trained and graduated in Germany, and completed an MD in Public Health before starting a training post in Medicine. Her interest in Palliative Medicine, which is not a medical speciality in Germany, brought her to London in 1999. She now works at North Middlesex University Hospital and Marie Curie Hospice Hampstead.
Before taking up her consultant post, she returned to Germany to set up a new palliative care unit and community team. Her main interests lie in service development, improving access, and equity of care for patients requiring palliative care support.

Epidemiology, presentation, diagnosis, and staging
1. Lung cancer in a 53 year old smoker, Adam Ainley, Rebecca Gillibrand, and Himender Makker
2. Lung cancer in an ex-smoker with underlying lung fibrosis, Adam Ainley and Himender Makker
3. Incidental solitary pulmonary nodule in an ex-smoker Afro-Caribbean lady, Adam Ainely, Sashin Kaneria, and Himender Makker
4. Advanced lung cancer on CTPA in a patient presenting to Accident & Emergency department with chest pain and breathlessness, Adam Ainely and Himender Makker
5. Impaired vision in an ex-smoker, Adam Ainley and Himender Makker
6. Late recurrence or second primary lung cancer, Adam Ainley and Himender Makker
7. Endobronchial tumour in a smoker with history of lymphoma, Adam Ainley, Bryan Sheinman, and Himender Makker
8. Progressive breathlessness associated with a right sided pleural effusion, Adam Ainley and Himender Makker
9. PET positive right lower lobe mass, Adam Ainely, Sashin Kaneria, and Himender Makker
10. Histology of right hilar mass in an ex-smoker, Adam Ainley, Rebecca Gillibrand, and Himender Makker
11. Pericardial and pleural effusions in a smoker with metastatic adenocarcinoma, Adam Ainley, Rebecca Gillibrand, and Himender Makker
12. Right lower lobe squamous cell carcinoma associated with hilar and mediastinal lymphadenopathy, Adam Ainley, Bryan Sheinman, and Himender Makker
13. A 30 year old lady with solitary lesion and haemoptysis, Adam Ainley and Himender Makker
14. Asymptomatic metastatic disease in a 71 year man with history of frequent falls, Adam Ainley and Himender Makker
Medical Oncology
15. Metastatic small cell cancer presenting with haemoptysis and left upper lobe collapse, treated with chemotherapy, Oscar Juan and Sanjay Popat
16. Adenocarcinoma identified to be EGFR mutation positive, Oscar Juan and Sanjay Popat
17. Adenocarcinoma identified to be ALK fusion positive, Oscar Juan and Sanjay Popat
18. Relapsed stage 4 adenocarcinoma with insufficient material for genotyping at diagnosis, Nadza Tokaca and Sanjay Popat
19. Squamous cell carcinoma (SCC) of the lung in a patient with previous breast cancer, Spyros Gennatas and Sanjay Popat
20. Non-resolving bilateral consolidation diagnosed as invasive mucinous adenocarcinoma with lepidic predominant pattern (previously known as bronchoalveolar carcinoma) on biopsy, Adam Januszewski and Sanjay Popat
21. Stage IIA adenocarcinoma of lung in a never smoker undergoing adjuvant chemotherapy, Adam Januszewski and Sanjay Popat
22. Malignant pleural mesothelioma (MPM), Spyros Gennatas and Sanjay Popat
23. Lung carcinoid tumour, Spyros Gennatas and Sanjay Popat
24. A 54 year old with T4N2M0 squamous cell carcinoma who developed neutropenic sepsis on second course of chemotherapy, Adam Januszewski and Sanjay Popat
25. A 76 year old with oligometastatic stage IV squamous cell carcinoma who developed diarrhea on treatment with immune checkpoint inhibitors, Adam Januszewski and Sanjay Popat
26. A 55-year-old patient with relapsed stage IV ALK fusion positive adenocarcinoma treated with crizotinib, presenting with headaches, Adam Januszewski and Sanjay Popat
Clinical Oncology
27. Drop Metastasis, Kobika Sritharan and Julian Singer
28. Superior vena cava obstruction (SVCO) due to lung cancer, Kobika Sritharan and Julian Singer
29. Pancoast tumour, Kobika Sritharan and Julian Singer
30. High dose palliative radiotherapy, Kobika Sritharan and Julian Singer
31. Stereotactic radiotherapy, Kobika Sritharan and Julian Singer
Thoracic Surgery
32. A patient with T2N1M0 squamous cell carcinoma, Martin Hayward and Sofoklis Mitsos
33. Long term complications of thoracotomy- chest wall paraesthesia and neuralgic chest pain, Martin Hayward and Sofoklis Mitsos
34. Left pneumonectomy in a 25 year old with carcinoid tumour, Martin Hayward and Nikolaos Panagiotopoulos
35. Postoperative care of 60 year old man with Squamous cell carcinoma but with severe COPD and no other co-morbidities, Martin Hayward and Davide Patrini
36. Preoperative assessment and fitness for surgery- T2N0 M0 Left hilar squamous cell carcinoma in lady with severe COPD, Martin Hayward and Davide Patrini
Palliative care
37. An 84 year old lady with advanced staged disease, dementia and multiple co-morbidities, Antke Hagena
38. Use of nerve block in case of Right Lung Adenocarcinoma, received local radiotherapy and nerve block, Antke Hagena
39. Patient presenting with cough, breathlessness and haemoptysis, previously resected T1N0MO right upper lobe cancer, Antke Hagena
40. Case of Ex-Builder with pleural effusions secondary to mesothelioma, Antke Hagena