Figures from the National Lung Cancer Audit have given the first tangible insight into the impact of Covid-19 on lung cancer. Surgery is down. Emergency presentation is up, all pointing to later diagnosis. However, with so much focus now on lung cancer and ensuring its recovery, can something positive come out of the pandemic?
Richard Tunningley smiles as he sips his coffee. He’s travelled down from his home in Knottingley, West Yorkshire to our head office in Liverpool to share his experience of being diagnosed with lung cancer during the pandemic.
From his demeanour, you can be forgiven for assuming his story is a happy one. The reality is very different; the pandemic clearly played a part in delaying his diagnosis.
After contracting Covid in March 2020, Richard was left with an aggressive cough. He had several telephone consultations with his GP, but the pandemic meant he couldn’t get a face-to-face appointment until August, when he saw a nurse. Three x-rays later and then a subsequent CT scan, Richard was eventually diagnosed with stage 4 lung cancer, just before Christmas.
“I’m not angry about the time that it took to get the diagnosis. Obviously, the whole world was going through an unprecedented situation with the coronavirus pandemic and people were trying their very best to control the situation. It’s just a fact of life that at that moment in time, when I was probably needed to see a GP, it just wasn’t available.
Whilst my cancer was not curable, it is treatable, and I am so grateful for that. The targeted treatment I am on allows me to lead a very normal life. I’m suffering very minimal side effects, and I’m doing all the things that I’ve done prior to my prognosis.
“I am a very positive type of person. I always try and see the positive things so for me now, every day is an extra day and life continues; there’s laughter, there’s tears, there’s arguments, there’s celebrations. It’s normal.”
Dealing with the unknown
Sadly, Richard’s story is not an uncommon one, even without a global pandemic. The nature of lung cancer and its often vague symptoms means many people yoyo back and forth to their GP before being referred.
But with Covid still an unknown entity to a certain degree, healthcare professionals are left unsure of its potential long-term effects. So, when Bettina contacted her GP having had Covid and was started to get short of breath, immediate action was taken.
“I contracted first Covid near the beginning of November and was still testing positive towards the end of December. I then work up one morning and found myself feeling quite breathless. My son, who is a GP, said I should contact my doctor. I did, and she referred me straightaway to the hospital.
I was diagnosed with pneumonia and given antibiotics. I was then asked to return for a second chest x-ray X dates later. It was after the second x-ray that I was then sent for a CT scan and referred to a lung specialist.
After a series of tests, I had an appointment to see a consultant. Lung cancer was not in my head; I presumed this was all Covid-related and so I didn’t take anyone with me. The diagnosis came as a complete shock.”
Bettina has since had surgery, undergone chemotherapy and is now on a targeted therapy, recently approved for patients with early-stage EGFR+ lung cancer after studies showed it halved the risk of recurrence.
“It was an aggressive treatment plan,” recalls Bettina. “I really struggled with the chemotherapy. I wanted to quit after two rounds and the targeted therapy, whilst milder, is not without its side effects.
“But it has been worth it, especially as my first grandchild was born at the end of last year. She’s a joy. I’m now back out walking my dogs. We walk two miles every day. Life is good and I have Covid to thank for that.”
Avoid history repeating
Timing was on Bettina’s side. Having just witnessed the devastating effects of Covid on the world over the past year and with very little then known about long Covid, investigation into her symptoms was swift.
However, there is now concern that the presumption of long Covid could mask potential lung cancer symptoms and delay diagnosis. It’s a worry that is shared by Bettina’s eldest son, Dr Chris George, a general practitioner in Cambridgeshire.
“I don’t think Mum would have been referred as quickly as she would have been had she not had Covid. I’d go as far as saying Covid probably saved her life.
However, I know Mum’s case is rare and that Covid in general has led to less people being diagnosed as they have followed government messaging and experienced difficulty getting appointments. It is absolutely vital now that we do not see similar delays because of long Covid and the crossover of symptoms.
Mum’s diagnosis has had a huge impact on my awareness of lung cancer. I have learnt so much more about the symptoms and broad range in which people can present and I am proud to be working with and supporting Roy Castle Lung Cancer Foundation in improving awareness amongst the general public, and GPs like myself.”
Chris’s desire to avoid history repeating is one he shares with Richard.
“My advice to anyone that’s experiencing the symptoms that I had was really consider going and see a GP,” he concludes.
I’m a typical male. I wouldn’t normally go bother a doctor I don’t usually see a GP but if a cough is not going away, then there’s a reason why it’s not going away. You need to go and get checked out if you’ve got those symptoms. It’s really important.
I don’t want people to have to go through what I’ve gone through and not just those individuals, but their families too. It affects family so much and if I can help someone get early diagnosis, have treatment and have a successful outcome then I’ll have achieved something.”