Lung Cancer: Case Study (Edexcel GCSE History)
Revision Note
Author
Zoe WadeExpertise
History
The Fight Against Lung Cancer in the 21st Century - Summary
Lung cancer is the second most common cancer in Britain. It mainly impacts people over the age of 40. The 70-74 age group has the highest number of cases. There were over 48,000 cases of lung cancer between 2016 to 2018. The percentage of patients who survive more than ten years with lung cancer is only 10%. The majority of all lung cancer cases are preventable. Around 85% of sufferers are smokers or ex-smokers. Occasionally, breathing in chemicals like radon gas can result in a person developing lung cancer. There were very few cases of lung cancer in the 19th century. The University of Dresden in Germany noted that only 1% of all tumours were lung cancer. By 1918, this statistic increased to 10% and, by 1927, to 14%. In the 1920s, smoking was very fashionable. Tobacco companies aggressively advertised cigarettes from the First World War onwards. Many companies created slogans and used celebrities in their adverts. This shows that tobacco companies wanted to influence society's attitude towards smoking. Some advertisements hired fake doctors to reassure customers that smoking was good for their health. By 1950, up to 80% of British men were regular smokers. A study by the British Medical Council proved the link between the rise in lung cancer cases and people smoking cigarettes. Despite the warnings, people continued to smoke. In 1973, almost 26,000 deaths were due to lung cancer. The British government began the fight against lung cancer in the 21st century. The NHS uses the latest technology for accurate diagnosis and effective treatment. The government has introduced laws to change and influence public behaviour in an attempt to deter smoking. Lung cancer remains a risk to public health today |
Diagnosis of Lung Cancer
Lung cancer is very hard to diagnose
Patients can mistake their symptoms for other conditions
Cancerous tumours in the lungs are hard to detect before they become very large
There is no national screening programme for lung cancer
Before advances in technology, diagnosis of lung cancer relied on using an X-ray machine
A patient would have an X-ray taken of their lungs
The doctor would examine the X-ray for signs of a tumour
Using X-rays is not an effective way to diagnose lung cancer
abscesses in the lungs could be mistaken for cancer
Survival rates depend on rapid diagnosis of cancer
X-rays did not provide an image with enough detail to accurately diagnose lung cancer
Stages in Identifying Lung Cancer
Modern diagnosis now requires a patient to have a CT scan
Dye is injected into a patient. This creates a clearer image of the lungs
If the patient's CT scan shows signs of cancer, there are two pathways:
Doctors perform a PET-CT scan. Instead of dye, a small amount of radiation is injected into the patient before the scan. A doctor will then look for cancerous cells in the lungs
Doctors perform a bronchoscopy. A camera called a bronchoscope is inserted into the body through the mouth. When it reaches the lungs, the doctor will collect a biopsy of cells for analysis
When cancer is diagnosed, the doctor can analyse how severe the cancer is and create a treatment plan
Cancer is measured in stages between 1 and 4. Stage 1 cancer is small and in one area. Stage 4 cancer is advanced cancer. This cancer has spread to other parts of the person's body
Process for Diagnosing Lung Cancer
A flowchart showing the steps to diagnosing lung cancer
Worked Example
Describe two features of diagnosing lung cancer in the 21st century
4 marks
Answer:
Lung cancer is very hard to diagnose (1); Patients often mistake their symptoms for other conditions (1)
Technology is key to diagnosing lung cancer (1); Patients are given a CT scan to detect signs of cancer (1)
Exam Tip
When answering ‘Describe two features of…’ questions, the four marks are given to you for:
Identify - write a relevant point based on the question topic (1)
Describe - add some specific own knowledge about the point you have made (1)
To achieve full marks, you must do these steps twice
Treatment of Lung Cancer: Science & Technology
Lung cancer treatments depend on how early a doctor can diagnose the tumour
Radiotherapy
The process aims radiation at a tumour to reduce its size
Radiation can target the tumour from outside the body or a catheter can administer radiation next to the tumour
Radiotherapy is an effective treatment for different sizes of tumours
Small tumours may be destroyed without the use of surgery
It may slow down the growth of larger tumours
Chemotherapy
Chemotherapy involves injecting drugs into the patient over the course of multiple treatments spanning several months
Some drugs kill the cancerous tumours or slow their growth
Other drugs will treat the symptoms of the cancer
Chemotherapy can cause severe side effects such as:
Extreme sickness
Hair loss
A higher risk of catching infections
Transplants
If cancer has spread within the lung, the patient can receive a healthy lung from a donor
Patients can recover without the use of a transplant. Humans only need one lung to survive
Genetic research
Scientists are exploring the use of genetics to treat lung cancer
Some tumours shrink faster with chemotherapy than others
Scientists believe that tumours have a variety of genetic mutations which react differently to chemotherapy
Within the next generation, it is possible that lung cancer can be treated with pharmacogenomics
This is when scientists adapt treatments to suit each individual's DNA structure
Exam Tip
Students often think that radiotherapy and chemotherapy are the same treatment. Both treatments aim to destroy or reduce cancerous growths. Radiotherapy uses radiation whilst chemotherapy contains a mixture of chemicals. Chemotherapy tends to be used when radiotherapy has been unsuccessful or the cancer is more aggressive. Think of radiotherapy as step 1 in a cancer patient's treatment and chemotherapy as step 2. It is possible to combine radiotherapy and chemotherapy. This is known as chemoradiation.
Prevention of Lung Cancer: Government Action
The British government did not want to fight the tobacco industry
The government earned £4 billion from tax placed on tobacco
Many British citizens worked for tobacco companies
They had never told citizens to stop a habit before
It became clear that the government needed to act
Deaths linked to smoking were costing the NHS £165 million each year
The government approached preventing lung cancer in two ways:
Influence public behaviour by communicating the risks of smoking on public health
Pass laws which demanded that the public change their behaviour or face punishment
How Did the Government Influence and Change the Behaviour Around Smoking in the 21st Century?
Influencing attitudes to smoking | Changing laws about smoking |
Reducing the places tobacco companies could advertise. Adverts were removed from TV in 1965 and from sports like Formula 1 in 2005 | In 2007, the government raised the legal age to purchase cigarettes from 16 to 18. This aimed to prevent teenagers from smoking |
Increasing education about the harm of cigarettes. Schools began to teach about the dangers of smoking, the chemicals inside cigarettes and the increased risk of developing smoking-related diseases | The 2007 Health Act banned smoking in all indoor public spaces. In 2015, this extended to cars which contained children under the age of 18. This aimed to reduce the impact of second-hand smoke on children. These laws were criticised for taking people's freedom of choice away |
Removing cigarettes from displays in shops. Cigarette packets were moved into cabinets so consumers have to ask to purchase them | The government increased tax on cigarettes to make them more expensive to the consumer. This intended to make smoking unaffordable, providing a motivation for smokers to quit |
Exam Tip
You could compare the government's approach to lung cancer in the 21st century to their attitude towards cholera in the 19th century. In both scenarios, the government was slow to react to scientific research. John Snow showed dirty water caused cholera in 1855 but the government waited 20 years to build a new sewage system in London. Similarly, the government knew cigarettes increased the risk of lung cancer in 1950 but delayed action until the early 2000s. This is a good example to use in a comparative exam question regarding the government's action against disease in the 19th and 21st centuries.
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