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

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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).

Cancer Keys are brought to you by GatewayC.

Download this Cancer Key here

Read the NICE NG12 guideline here

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Latest from the Blog

NEW COURSE: Managing Physical Effects

NEW COURSE: Managing Physical Effects

Tuesday 5th January 2021 We are delighted to announce that the new Managing Physical Effects course is now available on GatewayC. According to Macmillan, at least 1 in 4 patients will experience consequences of their cancer or treatment that affect their quality of...

read more
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GatewayC’s top tips from 2020

Monday 4th January 2021 2020 certainly provided challenges and many new learning opportunities for primary care professionals across England. With this in mind, we have rounded up some of our most popular 2020 tips. Take a look below! COVID-19 and neutropenic sepsis...

read more

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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...

read more