Dr C: “Don’t assume a cough is COVID”

New figures show we are missing diagnosing lung cancer patients because people think a dry cough, hoarse voice and breathlessness mean they should simply isolate. Dr C says we need to take action if we have new symptoms

There was a 26 per cent fall in people being treated for cancer between April and July compared with 2019, but while other cancers have improved, urgent referrals for lung cancer in September are still 40 per cent down. The last eight months have been really confusing for people, because if you’re coughing, you’re told to shut yourself away. Also, 45 per cent of people diagnosed with lung cancer are 75 or older, so the hospital isn’t a place they want to be. That, along with all the concerns about not wanting to clog up the health service, is why this is happening. With fears over a second wave, it’s really understandable that people are still staying away from GPs and hospitals.

SPEAK UP EARLY

The drop in urgent referrals for cancer is worrying, because we’re going to miss diagnoses, and the sooner you’re diagnosed, the sooner we can get you on treatment, and the more likely it is to work. We will also be left with a massive backlog of treatments, whereas if we can be consistent in diagnosing and treating cancer and keep everything moving, that’s far better. A few months’ delay in a cancer diagnosis could make the difference between it being curable or incurable. If anyone is thinking they should just wait until the second wave dies down and then go to see their doctor with any worrying symptoms, don’t – go now.

DON’T BE DETERRED

I understand why people are nervous when they get an unpleasant symptom – that’s normal. You may also have had a bad experience with your doctor in the past, and felt you were “bothering them”, but you’re more important than that experience, so although you may not feel like it, if you’re very worried about something, persist and ask to see or talk to someone else. You could feel like you’re wasting people’s time, but you’re not. One bad day for your doctor shouldn’t mean a bad rest of your life for you.

ATTEND SCREENINGS

Cancer survival in the UK lags behind comparable countries like Norway, Canada and Australia, and a lot of that is about cancer not being diagnosed early enough. That sounds like we’re rubbish at spotting cancer, but it’s up to both the health service and patients, because if you’re not turning up for screenings, medics can’t help you. That’s why it’s really important to go to a screening when you’re invited – virus or no virus.

ASK FOR A PHONE CALL

If you’re ill, you will be seen; it may be over the phone, but

I’m a big fan of phone calls – it’s less nerveracking, you can talk things through without having to look at somebody if you’re embarrassed, and you’re given really clear directions about what to do. You can ask for your GP to phone if you’re worried about going in. One of the problems with lung cancer specifically is that people with a cough will feel they shouldn’t go anywhere, including their GP surgery. Remember, you can talk on the phone to your GP, and it wouldn’t take long for us to figure out if it’s an infectious type of cough, or something else. A few questions would get to the bottom of that. If you’re being turned away from your practice, that’s wrong, so be persistent and badger the receptionist for a phone call.

LET US INVESTIGATE

The symptoms of lung cancer are similar to coronavirus: a cough that doesn’t go away or gets worse, hoarseness, shortness of breath, feeling tired or weak, wheezing – but with lung cancer, there’s also loss of appetite and unexplained weight loss. A temperature and how long it’s been around also tells doctors something, as well as how quickly it’s come on, because cancer wouldn’t suddenly come on, it would be a slow progression. Medicine is pattern recognition, so that’s why all the information is really important, it’s how we piece the jigsaw

puzzle together. That includes risk factors like age, because your risk of lung cancer increases as you get older, and due to family history and smoking – so if you have smoked or breathed in a lot of second-hand smoke, you’re more likely to get it.

NEVER IGNORE SIGNS

It isn’t just lung cancer – there are various worrying signs and symptoms you should never ignore. Broadly, that would be any pain, swelling or bleeding from anywhere and at any time – so in your wee or poo, in a cough or during or after sex. All you need to look out for is new symptoms that you haven’t had before that persist and feel worrying, whether that’s persistent pain, persistent nausea and bloating, lumps and bumps that seem odd – if anything has changed and has been going on for a couple of weeks, ask your GP about it. We all get the odd thing now and then, but it goes away, so you’d expect indigestion to go away and you’d feel better, for example – if it’s grumbling on, it could be a sign of ovarian cancer. The vast majority of lumps, bumps, pain and bleeding won’t be cancer, but you still need to ask to make sure. If everything is normal – you’re eating well, sleeping well – and you still have odd, uncomfortable symptoms, you need to see a doctor. Let us decide whether it’s serious. GP surgeries and hospitals have made huge changes, with “hot” and “cold areas”, so people being treated for coronavirus are kept separate – it’s safe.

FEEL SAFE AT HOSPITAL

You may feel like you should stay away because you think the NHS is overloaded, but there will be half-empty wards and clinics waiting to see patients. Urologists and breast surgeons are waiting – not everyone is dealing with coronavirus. I can see why people avoid doctors, when the message was “Stay home, protect the NHS, save lives”, but that isn’t the case now, so please speak up.