Spotting lung cancer early is crucial. Here’s what you should know

This article was first published at Spectator Health on 17 December 2015.

Britain tends to lag behind other European countries in terms of its cancer survival rates. A few years ago this was most definitely the case with lung cancer. In 2005 only nine per cent of patients survived for five years after diagnosis. Now, after a remarkable jump in progress, it is predicted that for those diagnosed in 2013 the rate will be 16 per cent — still low, but actually only slightly behind world-leading rates such as Sweden’s or North America’s.

The reason, says Dr Mick Peake, clinical lead for the National Cancer Intelligence Network, is a massive increase in specialist surgeons — up from 40 to more than 80. Previously about half of lung operations had been performed by heart surgeons.

This greater expertise means that surgery is much more commonly a treatment. And, for lung cancer patients, surgery is by far the best option. If caught early enough the tumour can simply be cut out — vastly preferable to gruelling rounds of chemo and radiotherapy.

Dr Peake cites two other factors in the improvement in Britain’s rates. One is data. From 2004 data was collected on hospitals’ performance on lung cancer. (Some hospitals’ results were alarmingly poor, says Dr Peake.) The other is more surgeons joining multidisciplinary teams to assess patients’ treatment. An expert surgeon is then well-placed to decide if surgery might be possible.

For lung cancer, even more so than for most other cancers, early diagnosis is crucial. Four in 10 cases are spotted during some sort of emergency hospital admission. In these cases the survival rate is very low – 12 or 13 per cent are alive after a year. But if you are diagnosed after a GP referral your chances of surviving go up to nearly 50 per cent.

These figures are undeniably bleak. But to improve our odds of beating lung cancer, and to lower the death rate generally, there are two things we should know — what the early symptoms are and whether we are likely to be at risk.

So, risk. About 85 per cent of cases are caused by smoking. The other biggest cause is a natural gas called radon, which is present in higher levels in Cornwall, Wales and the north of England. (An interactive map is here.) A small percentage of cases is explained by second-hand smoking and air pollution.

Symptoms, unfortunately, aren’t easy to spot. An advertising campaign had the line: ‘Been coughing for three weeks? Tell your doctor.’ Actually, says Dr Peake, it’s not that simple. Most smokers have some kind of permanent cough — so often the warning sign is when that cough changes.

Dr Peake explains: ‘It becomes more persistent, or more frequent, and it might start disturbing your sleep. You often produce more phlegm or the phlegm alters in some way, becomes slightly discoloured or green or has blood in it. Or sometimes it might hurt a bit when you cough, or you have might chest pain.’

Most people, Dr Peake suggests, are aware that something has changed. ‘They might say “I had a cough for six weeks” – actually they had a cough for five years,’ he says, but its character altered six weeks ago.

For some, though, there is not even a cough. In that case, what to look out for is ‘any new symptoms — breathlessness, weight loss, chest pain — that do not go away’.

The threshold for concern should be very low, Dr Peake says. ‘A lot of people are very reticent about disturbing their GP,’ he says. But most lung cancers will be picked up by a single chest X-ray, so there is no downside to a check-up.

The latest figures have been compiled by the UK Lung Cancer Coalition, an alliance set up to raise survival rates. They were released in its report Ten Years On: The Changing Landscape of the UK’s Biggest Cancer Killer.