CANCER

                  Lung cancer screening

 

What screening is

Screening means testing people for early stages of a disease before they have any symptoms. It is an important part of health care for some cancers. Before screening for any type of cancer can be carried out, doctors must have an accurate test to use. The test must be reliable in picking up cancers that are there. And it must not give false positive results. A false positive result means that a test makes it look as though a cancer could be present when it isn't.

Lung cancer screening in the UK

At the moment there is no national screening programme for lung cancer in the UK. Experts do not consider screening to be a reasonable approach to finding cancer of the lung because of the

• Lack of a sensitive enough test
• Low number of cancers that would be found 
• High costs involved
• Risks of current tests

For screening to be introduced, we need a test that is simple, quick, not too expensive and not harmful. Current tests such as X-rays can't usually show early stage cancers and they have some risks. The lungs are very sensitive to radiation and frequent X-rays may cause lung damage. X-rays can also find lung changes that look like cancer and need to be checked by further tests, such as a biopsy, that can cause problems for some people.

Research into lung cancer screening

There is a lot of research going on into finding out whether it is possible to screen particular groups of people who are at high risk of developing lung cancer. People at high risk of lung cancer include people who smoke and people who have lung disease, such as chronic obstructive pulmonary disease. It is always more cost effective to screen people at high risk, rather than to screen everyone. 

Research is also going on to try to find better tests to find lung cancer early. Trials are looking at using new methods of detecting lung cancer, including fluorescence bronchoscopy and  a new type of CT scan called a spiral CT scan.ptoms

General symptoms of lung cancer

The symptoms of lung cancer may include

• Having a cough most of the time
• A change in a cough you have had for a long time
• Being short of breath
• Coughing up phlegm (sputum) with signs of blood in it
• An ache or pain when breathing or coughing
• Loss of appetite
• Tiredness (fatigue)
• Losing weight

Less common symptoms of lung cancer

Other less common symptoms of lung cancer are usually associated with more advanced lung cancer. They include

• A hoarse voice
• Difficulty swallowing
• Changes in the shape of your fingers and nails called finger clubbing
• Swelling of the face caused by a blockage of a main blood vessel (superior vena cava obstruction)
• Swelling in the neck caused by enlarged lymph nodes
• A constant ache or pain in your chest or shoulder that has lasted some time
• Pain or discomfort under your ribs on your right side (from cancer cells in the liver)
• Shortness of breath caused by fluid around the lungs (called a pleural effusion)

Hormone related symptoms

Some types of lung cancer cells produce hormones that get into the bloodstream. These hormones can cause symptoms that do not seem related to the lung cancer. Doctors call them paraneoplastic symptoms or paraneoplastic syndrome. These hormone related symptoms vary from person to person but may include

• Pins and needles or numbness in the fingers or toes
• Muscle weakness
• Drowsiness, weakness, dizziness or confusion
• Breast swelling in men
• Blood clots (thrombosis)

These symptoms are uncommon with lung cancer but they can happen. So it is important to tell your doctor about any new symptoms you have noticed. If they are caused by hormones from the cancer cells, you can have treatment to help you feel better.

Symptoms of pancoast tumours

Lung cancer growing right at the top of the lung is called a pancoast tumour. These tumours can cause very specific symptoms. The most common is severe shoulder pain or pain that travels down the arm. Pancoast tumours can also cause a collection of symptoms called Horner's syndrome. These are

• Drooping or weakness of one eyelid
• A small pupil in that eye
• Loss of sweating on that same side of the face

These symptoms of Horner's syndrome are caused by the tumour pressing on or damaging a nerve that runs up from the neck to that side of the face.