Cancer Keys: Differentiation of the Cs in Lung Cancer: Cancer vs COVID-19

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Tips on what to include in your referral letter

Tips on what to include in your referral letter

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Potential pitfall:

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.

Helpful hint:

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.

References:

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).

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Read the NICE NG12 guideline here

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Latest from the Blog

Tips on what to include in your referral letter

Tips on what to include in your referral letter

Friday 21st August 2020 Did you miss our free webinar on Suspected Cancer Referrals and COVID-19? Watch it here. Miss Susannah Penney, Consultant Head, Neck and Thyroid Surgeon, receives over 2000 cancer referrals a year. When making a suspected cancer referral, are...

read more

Related Posts

Cancer Keys: False negative chest X-rays

Cancer Keys: False negative chest X-rays

False negative chest X-rays The main investigation for suspected lung cancer in primary care is a chest X-ray. However, reports show that some patients with normal chest X-rays still transpire to have lung cancer. Potential pitfall Although most large lung cancers can...

read more
Cancer Keys: Sudden onset diabetes

Cancer Keys: Sudden onset diabetes

Sudden onset diabetes Symptoms of pancreatic cancer can often be vague; however sudden onset diabetes can be a potential indicator of the disease. Potential pitfall Diabetes, especially Type 2, is common among the general population. However, consideration should be...

read more