21st February 2025

A 79-year-old man with a history of dementia and severe COPD presents to his GP with a 2-month history of weight loss and fatigue.

A 79-year-old man with a history of dementia and severe COPD presents to his GP with a 2-month history of weight loss and fatigue. Even prior to his recent deterioration, he was largely housebound due to breathlessness related to his COPD and required assistance from his family for all activities of daily living. A CT of his chest, abdomen and pelvis is carried out to look for an underlying malignancy and demonstrates a 3 cm spiculated right upper lobe lung lesion associated with a right-sided pleural effusion. The pleural effusion is tapped and cytology demonstrates lung adenocarcinoma. No distant metastasis are identifiable on the CT of the chest, abdomen and pelvis. 

What is the most appropriate next step in management of his lung cancer?

Select the SINGLE most appropriate option from the list below. Select ONE option only.