Potential pitfall: Metastatic spinal cord compression (MSCC) is a medical emergency which can result in paralysis. Many patients living with cancer have pain; within primary care it can difficult to differentiate between significant pain which may be due to MSCC, and...
Cancer Keys: Differentiation of the Cs in Lung Cancer: Cancer vs COVID-19
Latest from the Blog
Thursday 21st May 2020 Managing a patient’s fear of cancer recurrence and health anxiety can be difficult. After treatment, many patients want to have the reassurance that they are cured. Generally it is not possible for health care professionals to say with absolute...
Myeloma investigations If you are suspicious of myeloma following blood results, there are two pertinent investigations that can be ordered in primary care to give a strong case for referral: 1. Serum protein electrophoresis test 2. Bence-Jones protein urine test...
Prostate cancer and family history Family history can play a helpful role within a potential prostate cancer diagnosis, when symptoms alone can be vague. Potential pitfall Some of the early symptoms of prostate cancer could be associated with a less serious condition,...
Overlapping lung cancer and COVID-19 symptoms means that the message to patients about early diagnosis is negated by the messages necessary to control the COVID pandemic.
Consider the following action if a patient presents with features more suggestive of lung cancer and overlapping symptoms of a cough, breathlessness and fatigue:
- Arrange an urgent nasal/oropharyngeal swab for SARS-CoV-2 PCR and if negative:
- Refer for Chest X-ray or direct to lung cancer service for CT and triage on the National Optimal Lung Cancer Pathway
- If PCR positive, manage according to current COVID-19 guidelines and review after 2 weeks if hospital admission not required; consider 2 week wait referral in patient recovered from COVID-19 in whom lung cancer suspected
- If symptoms require urgent attention, consider emergency admission
Please note: the NICE NG12 guideline recommends offering an urgent chest X‑ray (to be performed within 2 weeks) to assess for lung cancer in people aged 40 and over if they have 2 or more of the following unexplained symptoms, or if they have ever smoked and have 1 or more of the following unexplained symptoms including a cough, fatigue and shortness of breath.
Evison, M. et al (2020) Differentiation of the Cs in lung cancer: Cancer vs Covid-19. Available at: https://www.healthylondon.org/wp-content/uploads/2020/03/Differentiation-of-the-Cs-in-lung-cancer_-Cancer-vs.-COVID.pdf (Accessed 29 June 2020).
Cancer Keys are brought to you by GatewayC.
Download this Cancer Key here
Read the NICE NG12 guideline here