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Last Updated: Wednesday, 23 February, 2005, 03:08 GMT
Call for lung cancer fast-track
X-Ray of lungs
Lung cancer diagnosis should be fast-tracked in Scotland
Lung cancer patients should be fast-tracked and granted greater access to specialised scanning, according to new guidelines.

An estimated 4,000 people die from lung cancer in Scotland every year with 4,400 new cases diagnosed annually.

About 90% of patients are smokers or ex-smokers and the guidelines warn only the control of tobacco use will reduce the numbers affected.

It also suggests communication between patients and specialists is improved.

Survival rates for lung cancer have changed little in the last 25 years and less than 10% of patients are alive five years after diagnosis.

These lung cancer guidelines are about making sure patients get the right treatment when they need it
Prof Gordon Lowe

The Scottish Intercollegiate Guidelines Network (SIGN) produced the guidelines after working with the National Institute for Clinical Excellence (NICE).

They are intended for use by chest physicians, surgeons, radiologists, pathologists, medical and clinical oncologists, pharmacists, public health practitioners, nurses, general practitioners, palliative care teams and allied health professionals.

The guidelines cover all aspects of the management of lung cancer patients and provide information for discussion with patients and carers.

The measures call for a fast-track model for patient assessment to shorten the interval between visiting a GP and being treated.

They warn delays in this process may cause "distress" to patients and carers, even if there is no direct medical impact.

Quality of life

At present a quarter of lung cancer patients do not see a chest specialist but the new guidelines call for more patients to be referred.

Experts believe urgent referral increases the likelihood of patients receiving active treatment and of improved quality of life.

SIGN chair Professor Gordon Lowe said: "These lung cancer guidelines are about making sure patients get the right treatment when they need it.

"The recommendations highlight many positive developments in the diagnosis and management of this disease.

"If we are able to ensure early diagnosis for patients and the many evidence-based recommendations made in this guideline are implemented, we can help improve the length and quality of life for people with lung cancer."

As well as improving cancer treatment, we need to do more to prevent it
Andy Kerr

The guidelines endorse current practice which recommends all suspected lung cancer patients receive CT scanning, regardless of chest X-ray results.

But it notes scans still require confirmation from some other means before a decision is made to operate on a patient.

The new document advocates the increased use of PET scanning, a more sensitive way of seeing cancer tissue in the body, as a means of reducing futile surgery.

It is also useful for identifying patients who will benefit most from radical treatment.

The guidelines recommend lung cancer surgery should take place in high-volume centres and call for chemotherapy to be considered as a support to surgery for non-small cell lung cancer.

It notes up to 40% of cancer patients report severe communication problems at the end of life and it calls for a more "patient-centred" approach.

Complex issue

Health minister Andy Kerr said the Scottish Executive's proposed ban on smoking would help stop the disease.

He said: "As well as improving cancer treatment, we need to do more to prevent it.

"That's why we are introducing our ban on smoking in public places.

"At the same time, we know that lung cancer affects less affluent people more often and that survival is poorer.

"That is why we are also working on many fronts to tackle poverty across Scotland."

Call to tackle lung disease
07 Mar 03 |  Scotland


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