Lung cancer

Lung cancer is one of the most common types of cancer, with over 48,000 people diagnosed in 2018. It causes symptoms including a persistent cough, coughing up blood, and feeling short of breath. People may not get symptoms in the early stages, and as a result lung cancer is often diagnosed late. In recent years, better tests and treatments are starting to make a difference and can mean a better outlook for many people.

There are different types of lung cancer, for example, small cell, non-small cell and mesothelioma. It is important for us to diagnose the exact type as this will help to guide the treatment options available to you.

Go to the NHS website and NICE for more information about lung cancer.

The following organisations also provide more advice and support:

Lung cancer referral

Your GP may have referred you to our Lung Cancer service for investigations if you have concerning symptoms such as an ongoing cough or unexplained shortness of breath, or because you have had an abnormal chest X-ray or CT scan. We will aim to see you within 2 weeks to arrange urgent tests to provide you with a diagnosis.

It is normal to worry when you are urgently referred to see a specialist by your GP. However, more than 9 out of every 10 people (more than 90%) referred this way will not be diagnosed with a cancer (source: Cancer Research UK).

What to expect at your appointment

Our lung team will usually offer patients with possible lung cancer a pre-clinic CT scan and rapid access to a range of further diagnostic tests if required after your first appointment.

Your first clinic appointment with the consultant should last approximately 30 minutes. The doctor will ask you a range of questions about your symptoms, your general health and may examine you. They will discuss the findings from your scans and explain what tests to expect.

In order to speed up your pathway, these appointments and tests may be carried out across different sites including King’s College Hospital (Denmark Hill), the Princess Royal University Hospital (PRUH), Beckenham Beacon, Queen Mary’s Hospital Sidcup, or Guy’s and St Thomas’ Hospitals.

During your first appointment, you will meet with a lung cancer clinical nurse specialist (CNS), who will support you and your family throughout your pathway from diagnosis through to treatment.

Investigations and diagnosis

To help us reach a diagnosis you will need various tests, these may include;

CT scan – this may be of the chest, abdomen and pelvis but may also include the brain
endoscopy – such as a bronchoscopy or an endobronchial ultrasound (EBUS)
PET-CT scan
biopsy – this may be under ultrasound/CT or surgical guidance
lung function tests, such as a breathing test
pleural aspiration
MRI scan – this may include the brain

The lung cancer team recognises this can be a very anxious time and we aim to speed up your journey through the diagnostic pathway to ensure you have results as quickly as possible.

After all tests are completed and we have the initial results (usually within 1 week of your biopsy), we will arrange for you to be seen in clinic to be told the results and discuss a plan for your treatment. This will usually involve being referred to a specialist centre that treats patients with lung cancer. If your tests confirm there is no cancer, we will try to contact you by telephone or arrange a face-to-face consultation.

We also aim to identify if there are any specific mutations within your lung cancer, which may affect your treatment options. To do this we may need to send your biopsy for further testing which can take a further 2 weeks from initial diagnosis. This can be very important to identify different targeted therapies that may be available to you.

Treatments

Your care and treatment depend on the type of cancer you have, its size and where it is, how far it has advanced (the stage) and your overall health.

Your care usually includes one or more or a combination of treatments. Depending on the treatment, these may take place at Guy’s Cancer Centre, Queen Mary’s Hospital Sidcup or the PRUH:

surgery: to completely remove the tumour you have a surgical resection

If you do not have surgery, or require further treatment after surgery, you may have:

chemotherapy, medication given intravenously or oral in tablet form
radiotherapy treatment with high beams of X-ray
a combination of radiotherapy and chemotherapy
other systemic anti-cancer treatments such as immunotherapy and targeted treatments

Who to contact

At your first appointment, we will tell you who your key worker is, and how and when you can contact them. Your key worker is usually a clinical nurse specialist (CNS).

Your CNS is an experienced nurse who is able to provide expert advice related to your specific condition or treatment. They will take a key role in supporting your care and will be the central point of contact between yourself and your multidisciplinary team (MDT).

Lung clinical nurse specialists

Princess Royal University Hospital (PRUH)

Available Monday to Friday, 9am to 5pm (excluding bank holidays)
Tel: 01689 864713
Email: [email protected]

King’s College Hospital, Denmark Hill

Available Monday to Friday, 9am to 5pm (excluding bank holidays)
Tel: 020 3299 4152 or 020 3299 4733
Email: [email protected]

Urgent queries

If you cannot get in touch with your key worker, especially out of hours, and you are receiving treatment at Guy’s, please call the emergency number 020 7188 3754.

If your call is urgent and out of hours, please call 111.

If it is an emergency, please call 999 or attend your local Accident and Emergency department.

Our team

Your care will be provided by a group of experts called a multidisciplinary team (MDT). This is a team of doctors, nurses and other health professionals specialising in treating your type of cancer. You can discuss your care with them and ask them any questions you have about your treatment. Our team includes:

Respiratory consultants

These are specialist lung doctors who will arrange all of the diagnostic tests for you to confirm if you have a cancer or not. They do not offer lung cancer treatment but will refer you to the consultant oncologist who will take over your care.

Consultant oncologists

Your oncologist is a specialist cancer doctor who deals specifically with lung cancer treatment. They will discuss the treatment plan with you and what side effects and treatment results or outcomes to expect.

Consultant cardiothoracic surgeons

Your doctor will discuss the option of surgery and can tell you what to expect regarding risks and expected outcome. After your surgery, you will be referred back to the respiratory consultant to monitor you for 5 years or to the oncologist for additional treatment.

How we support you

We want to make sure that you get all the assistance you need to live well with – and after – cancer. There’s a wide range of support available to help you, including physical, emotional and practical advice for you, your family, friends and carers. You will be offered a holistic needs assessment at diagnosis and at different time-points throughout your treatment.

The Everybreath lung cancer support group meets at Farnborough Village Hall the last Thursday of each month.

If you have practical queries or want further information about support groups, please contact King’s Macmillan Information and Support Centre or Dimbleby Cancer Care at Guy’s Cancer Centre and Queen Mary’s Hospital Sidcup.