Lung cancer

Lung cancer is a term used to describe a growth (sometimes called a nodule, a mass or a tumour) of abnormal cells inside the lung. Lung cancer is actually not one type of cancer. It is a range of different cancers that occur in the lungs. The abnormal cells grow to form a lump.

Lung cancer is often associated with people who have smoked however 10-15% of people diagnosed with lung cancer have never smoked.

Your GP may have referred you to hospital because you have had a worrying symptom such as cough, weight loss, chest pain, coughing up blood or change in voice. Sometimes a cancer may be detected “incidentally” whilst you are being investigated for another reason.

It is likely that the first team you will meet is the respiratory team – chest doctors. Your GP will refer you to be seen by a specialist team at any one of our hospitals (including Homerton hospital) where you will have the tests required to make the diagnosis. It is likely you will meet a specialist nurse who will support you throughout your diagnosis and treatment.

Once a diagnosis and treatment plan has been made, you will be invited to see the specialist team at St Bartholomew’s Hospital. This will either be the oncologists or thoracic surgeons.

Further information about lung cancer can be found on the Macmillan website.

Your investigations

You may have to undergo several tests to determine exactly what type of lung cancer you have and what stage it is for the doctors to be able to advise what is the best treatment for you.

Initially you will need to have a CT (computerised tomography) scan of your chest and abdomen. You may need further scans.

It is likely you will have a biopsy of either the tumour in the lung, the lymph glands within your chest or sometimes a biopsy of an organ the cancer has spread to. It is very important for the doctors to know exactly what type of lung cancer you have as there are a number of different treatments that depend on these results.

The pathology team will do extensive tests on the tumour cells in the laboratory to determine what is the best treatment option for you.

Waiting for your test results can be a difficult time. It may take several weeks for test results to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse can also provide support.

Your treatment options

Our lung cancer team has regular multidisciplinary team meetings (MDTs) where a group of health professionals with expert knowledge iwill manage your investigations and treatment.

You do not attend the meeting but a member of the lung team, usually your clinical nurse specialist , can tell you about the results of the meeting. You may be given a choice of treatment options, which your specialist will discuss with you. You might be invited to take part in a clinical trial. You do not have to agree to take part in a clinical trial and it will not affect the treatment you are given if you choose to not take part.

If you do not understand what you've been told at any time, let the staff know so they can explain again.

Before you have any treatment, you will need to give permission (consent). Further information about types of treatment used for treating lung cancer is available on the Macmillan website.

Your appointments

You will see your specialist doctor in the clinic after the multidisciplinary team has met. This is likely to be with either an oncologist or a surgeon at St Bartholomew’s hospital.

 Your doctor might talk to you about:

  • The aims of treatment
  • Possible side effects
  • How treatment might affect you
  • You can also talk to them about any concerns you may have.

It may be a good idea to take someone with you when the treatment options are first explained. You may also find it useful to have a list of questions ready to make sure you get the information you need.

All surgery and radiotherapy is performed at St Bartholomew’s Hospital. Most drug therapies are given at St Bartholomew’s Hospital but some drug therapies can be given at Newham Hospital or Whipps Cross Hospital.

If you need hospital transport, this can be arranged. In some cases we can also help with the cost of transport please ask your specialist nurse or visit the Macmillan Information Centre at the hospital.

Your care team

The lung cancer team at Barts Health include the following staff:

Respiratory physician

A doctor trained in looking after conditions affecting the lungs and doing some of the tests required to make a cancer diagnosis

Oncologist

A doctor trained in treating cancer patients.

Thoracic surgeon

A doctors who specialises in surgery of the lungs.

Consultant radiologist

A doctor who is expert in interpreting x-rays and scans. They may also perform biopsies (taking tissue samples) with the aid of imaging techniques.

Consultant pathologist

A doctor who looks at tissue samples under a microscope to search for cancer cells.

Clinical nurse specialist (CNS)

An experienced cancer nurse who acts as your key worker. They will give you advice and support as you go through investigations and treatment and support you through your care pathway.

Member of the palliative care team

The palliative care team specialise in relieving pain and other symptoms, including psychological difficulties caused by cancer.

Multi-disciplinary team co-ordinator

The co-ordinator provides administrative support to the lung cancer team and aims to smooth the pathway from referral to treatment. The lung team is a team of experts, and will work with you to conduct and provide the best care plan possible.

If you have any concerns, please talk to the team who will be considerate of your decisions and wishes.

Information for professionals

GP referrals for suspected lung cancer should be made via the trust multi-disciplinary rapid access diagnostic centre using the dedicated referral form and sending it via ERS.

The service can be found under 2WW – suspected lung and pleural cancer.