Why is early lung cancer detection important?
Lung cancer often doesn’t produce any symptoms in its early stages. It is possible to have a large lung tumour that produces no pain, does not cause a cough and that doesn’t cause bleeding and blood-stained sputum. By the time such a cancer is discovered, it may be very large or it may have started to spread beyond the lung. It is then much more difficult to treat. It is only possible for lung cancer to be cured it its detected in the early stages.
Lung cancer screening can find a lung cancer when it is still small and has not spread. It can then be removed, taking a good margin of healthy lung tissue, leaving you with enough healthy lung tissue that you can still breathe well.
Lung cancer screening
Dr Neal Navani offers lung cancer screening in his private practice at The King Edward VII Hospital in London. If you have a referral from an NHS GP or a private GP, that is fine, but it is also OK to refer yourself for an appointment to discuss lung cancer screening.
Patients fit the criteria for lung cancer screening if they are:
- Aged between 55 and 75
- Long term smokers (20 years +)
- Have no obvious symptoms
Worrying signs to look out for
The UK’s National Institute of Clinical Excellence (NICE) has published guidelines for GPs on suspicious symptoms that might suggest lung cancer. These include:
- Coughing up blood
- An unexplained cough that lasts more than three weeks
- Persistent pain in the chest or shoulders
- Breathlessness or difficulty breathing
- Losing weight for no reason
- Developing a hoarse voice that lasts more than three weeks
What does lung cancer screening involve?
If you come to Dr Navani for lung cancer screening, the first step is to take a full medical history. This involves having a consultation with Dr Navani to talk about your smoking habits, any chemicals such as asbestos or diesel that you may have been exposed to at work, and your general health and lifestyle.
The next step is to have a chest X-ray, which is arranged as soon as possible after your consultation. If this reveals any abnormalities, such as emphysema, shadows or any enlarged lymph nodes, a CT scan would be the next step. Further tests may then follow, depending on what was found in the CT scan:
- A bronchoscopy with endobronchial ultrasound
- Ultrasound-guided needle biopsy
- CT-guided biopsy
An early stage lung cancer can then be treated by surgery and may be followed by chemotherapy or radiotherapy if necessary.
Lung cancer screening and medical insurance
Lung cancer screening is not currently available through the NHS because it is expensive to screen all people over 55 who have been regular smokers. Most patients who have a private lung cancer screen have to pay for the procedure themselves, as insurance policies generally do not cover screening of any kind. However, if lung cancer is found during the screening process, all subsequent tests and treatments are available either by obtaining authorisation from your insurer, or by referral back into the NHS.
The evidence for lung cancer screening
Lung cancer cells from a patient biopsy
Although lung cancer screening is not yet available on the NHS, an increasing body of evidence from clinical studies involving thousands of patients says that screening people at high risk of developing lung cancer can help detect the disease early.
Early detection makes it more likely that treatment can begin before the cancer has spread, so survival rates are much higher.
Major US-based organisations, including the American College of Chest Physicians, the American Cancer Society, the National Comprehensive Cancer Network and the American Society of Clinical Oncology, reviewed the evidence early in 2012.
On the basis of this review, they now recommend that people should be screened for lung cancer using low-dose CT scans and follow up if they:
- Are aged 55 – 74 and have smoked the equivalent of a pack of day for 30 years or more
- Either continue to smoke or have stopped smoking in the last 15 years
The evidence they cited in making this recommendation included three large studies that were considered high quality. The research concluded that early detection of lung cancer did help survival and that the benefits of annual screening with CT scans outweighed any potential risks.