By Joanna Moorhead – The Guardian.
Thirty percent of people with lung cancer will die within 90 days of being diagnosed – how can that prognosis be improved and is it time for a national screening programme?
Finding out you have cancer is never good news: but in the “hierarchy” of malignant disease, lung cancer is one of the hardest to diagnose, one of the trickiest to treat, and one that tends to have a poor prognosis.
At the same time, though, the outlook for patients with lung cancer is improving with the advent of new drugs. What’s more, interventions in some areas of the country have shown that a few relatively easy and cheap measures can improve the rates of earlier diagnosis. As with all cancers, early diagnosis is key to successful treatment.
These sentiments were expressed at a recent Guardian roundtable, sponsored by the pharmaceutical company Bristol-Myers Squibb, that looked into how outcomes for lung-cancer victims could be improved.
The challenge now, doctors and stakeholders attending the discussion agreed, was to encourage people with any suspicious symptoms to visit their GP, and to ensure that GPs referred them for more tests. “This is a curable cancer if it’s caught early enough,” stressed Riyaz Shah, consultant medical oncologist at Kent Oncology Centre.
“There’s also a revolution going on in treatment for patients with terminal illness: they are living longer than ever before. I have patients attending my clinic who were diagnosed three, four, even five years ago,” said Shah.
Among the barriers to early diagnosis, the roundtable heard, was the fact that the symptoms of lung cancer were often vague and unspecific. Tom Newsom-Davis, consultant medical oncologist at Chelsea and Westminster hospital, said even where patients had thoracic symptoms they sometimes didn’t think they were dangerous. Other patients said they had been unable to get to see their usual GP or that they couldn’t get an appointment.
High mortality rate
The unfortunate fact at the present time, said consultant chest physician Dr Mat Callister of Leeds teaching hospitals NHS trust, was that one third of patients with lung cancer die within 90 days of being diagnosed. But there were indications that things didn’t have to be this way.
In some other European countries, Sweden especially, survival rates were considerably better than in the UK: the one-year survival rate in Sweden is 46%, compared with just 30% in the UK. A major difference in Sweden, said Dr Mick Peake, clinical lead at Public Health England, was that people were able to bypass primary caregivers and self-refer to chest consultants.
Worries that GPs are missing chances to diagnose lung cancer were voiced around the table – and this was ahead of research published a few days later in the British Medical Journal, which found patients who died had visited their GP an average of five times in the months before diagnosis…read more.