Lung and pleural cancers

Question 1

When would you offer urgent chest X-ray (2 WW)?

Answer 1

In people aged 40 and over if they have:
1) two or more of the following unexplained symptoms, or if 2) they have ever smoked and have 1 or more of the following unexplained symptoms:

Cough
Fatigue
Shortness of breath
Chest pain
Weight loss
Appetite loss (new NICE recommendation for 2015)

Question 2

When would you consider an urgent chest X-ray (2 WW)?

Answer 2

Persistent or recurrent chest infection.
Finger clubbing.
Supraclavicular lymphadenopathy or persistent cervical lymphadenopathy.
Chest signs consistent with lung cancer.
Thrombocytosis (cytokines stimulate pdtion of platelets)

Question 3

When do you urgently refer to specialist -2 week wait?

Answer 3

Urgently refer for lung cancer or mesothelioma
(appointment within two weeks) in patients with:
• Chest X-ray findings that suggest lung cancer
or mesothelioma
OR
• Patients aged 40 and over with unexplained
haemoptysis.