"It is seen as a disease of the working classes. Everyone knows the cause. It has connotations of guilt so patients are not demanding enough. As a result it doesn't get the support or attention it deserves but, paradoxically, it is one of the most aggressive cancers."
Lung cancers fall into two main categories: 25 per cent are small-cell lung cancers (SCLC), the rest, non-small-cell lung cancers. Most lung cancer patients die within a year of diagnosis.
This is why clinical trials into other forms of treatment are so important. For the past 18 months Professor Spiro has been involved in the Big Lung Cancer Trial, a project to see whether chemotherapy has any role in the treatment of NSCLC and whether it could be used to help survival after surgery.
Leslie Abelson, 65, a retired businessman from Northwood, Middlesex has good reason to be thankful for one of the professor's earlier trials. Five years ago he was diagnosed as having lung cancer - and given little hope of survival. Then he was told about the doctors at University College London who were doing some clinical trials. " I met Professor Spiro and he explained that I would either be treated by radiotherapy only, or by chemotherapy only, or by a combination of the two. I ended up having the double. It was the first time that I began to think things might be OK."
Patients like Mr Abelson are living proof of the importance of clinical trials. Professor Spiro says: "Leslie was told he was incurable, yet he was cured. Yes, he was lucky - but if we hadn't done anything he would have been dead long ago."