Avoiding delays to diagnosis

Lung cancer can be a very difficult disease to spot because symptoms can be so easily attributed to something far less sinister. As a result, many people often see their GP on multiple occasions before being referred for further tests.

We spoke to executive chair of the primary care respiratory society and primary care nurse, Carol Stonham, for some help and advice about how a patient could speed up their route to diagnosis.

A problem we find with people with respiratory symptoms is they sometimes get the wrong treatment and a delay in diagnosis. That can be really frustrating and it’s knowing how to tackle that part of the system.

My advice would be firstly when somebody asks you the questions first time round, they’re quite fresh questions. You might not really know the answers. You may not really have thought about those answers until someone asks that question so if you need to be seen a second or third or fourth time, it’s about revisiting the whole history of what’s happening and making sure you give that information to the clinician.

It may be a different clinician who you’ve never spoken to before so it’s really useful information. It may be the same clinician you saw previously but two things can happen – your answers can get better, more accurate or more thoughtful and the clinician might well have forgotten the answers you gave last time and only made brief notes. That shouldn’t be the case but does happen, so each time you go in it’s about starting from the beginning saying “I’ve had this cough. I’ve had for four months. I’ve one or two courses of antibiotics. I don’t think they’ve made any difference“.

Then be really forthright and frank about what you think is wrong with you. “I don’t think this was an infection. Could this be something more serious? Is this something that needs more investigation? Do I need a chest x-ray?

Put that thought into the person’s head so even if they say absolutely not, I’ve considered all that, it is still worth having that whole conversation.

It’s around making sure you revisit the history. It’s about being as honest and accurate as you can about what’s happening and again. If you see one clinician and you feel your treatment isn’t appropriate, don’t just sit back and say “they messed it up last time, I don’t feel any better“, It’s about going back and saying “Thank you for that treatment but actually I don’t feel any better. What else can we try?

Just to make sure that your healthcare professionals are aware that you’re there and that this is an ongoing problem. If they don’t see you, they will assume that everything is better and you do not need to be seen, so it’s worth just being persistent. Make sure you talk through the whole thing and tell the person what you think is wrong with you to put that idea into their head as much as anything else and let them know what you’re thinking.