Hi, I'm Doctor Kenneth Fink. I'm a Medical Oncologist at Zimmer Cancer Center of New Hanover Regional Medical Center, Wilmington, North Carolina. Lung cancer is a, is a very, serious disease, and one of the most common killers in, in our country and in, in the world. Unfortunately, 75% of, of patients who are diagnosed with lung cancer are actually found in the later stages. Only about one out of four are found in the early stages and, and have a chance of, of being, of being cured of the disease. So, unfortunately, once a person is diagnosed with lung cancer, the odds are, are pretty high that, that unfortunately their, their life will end. So we're doing better with survival in lung cancer and folks are definitely living much longer, in fact, living twice as long as they lived say thirty or forty years ago when diagnosed with lung cancer. But still, the, the voiding, avoiding death with lung cancer is a very difficult thing. Death from lung cancer is, is not, obviously is not something people want to think about as they're being diagnosed with lung cancer, they want to think about how they're going to be living, but at, at, at the end there's fairly good sign that, that their death will be imminent. The doctors can tell, and patients can too. We use something called the performance status to really tell us whether, what's going on. When a person's performance status is perfect, they can do everything. Obviously, they're going to live a long time. As their performance status becomes reduced, we know that their death may be getting closer. We have a system where we can tell if you have, if you're in bed for example more than twelve hours a day and you need some help with your activities, you're at a performance status of three, and, and you're probably going to be getting, getting sicker. It's much harder for us to treat people who have that, that poor of a performance status. Once a person is spending more time in bed than that, and needs yet more help, we would call that performance status four, and we know their, their death is near. Performance status five would imply that your death has occurred. We have a great system called the hospice system and folks are usually at home with their loved ones, and with very highly skilled trained nurses called hospice nurses who come in. They come in as frequently as needed. They may come in once a week if a person has a performance status of say two or three, but may come in more often if the performance status is declining. People tend to be worried about pain and this type, and difficulty breathing. Those symptoms are usually taken care of through the hospice system. People are, are given various kinds of pain therapies, usually different forms of morphine are used, or morphine itself are used, and, and patients tend not to feel the, the agonizing symptoms that they otherwise would, from, from cancer, so definitely the unfortunate event in lung cancer is, is that this tends to be an end stage disease, with only a few patients surviving, and the care for patients in the end stages has gotten, end stages has gotten much better, with, especially with the hospice system.