18th November 2020

How your fingernails could point the way to an early diagnosis

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When you press your fingernails together, do you see a tiny diamond-shaped window of light?

If you can’t see this ‘diamond gap’, you could have finger clubbing, which can be a sign of lung cancer. Finger clubbing is seen in 35% of people with non-small cell lung cancer (NSCLC), and in 4% of those with small cell lung cancer.

Finger clubbing is when the ends of your fingers swell up, and it happens in stages. First, the base of the nail becomes soft and the skin next to the nail bed becomes shiny. Next, the nails begin to curve more than normal when looked at from the side. Finally, the ends of the fingers may get larger and swell; it’s thought to be caused by fluid collecting in the soft tissues of the fingers.

While not having this diamond-shaped window does not automatically indicate lung cancer, it can be a symptom. If you think your nails are clubbed, speak to your doctor.

Patient Advocate Brian Gemmell
Brian Gemmell, living with lung cancer.

Brian Gemmell certainly knows the value of recognising finger clubbing as a symptom of lung cancer: it saved his life.

He recalls: ‘’I was not feeling ill, I was feeling healthy. I had no cough, I wasn’t coughing up blood, I wasn’t breathless. My one and only symptom was clubbing of the fingers, where all your fingers swell up and when you put your fingers together you can’t see a diamond. That was my only symptom. Straightaway, my GP had an idea of what it was. He sent me straight for a chest X-ray and referred me to a respiratory consultant.

A PET scan showed that there wasn’t any activity anywhere else in the body, it was confined to my lung. My surgeon was keen to get me in, to operate, to remove my lung.

Getting a lung removed you’re like, ‘Can I survive? What’s my life going to be afterwards’? All these things are going through your mind. I went with what he said, and because he was so positive about it that made me positive as well. As far as I’m concerned, the surgeon did what he said he was going to do, he got me in, did the surgery and fortunately after that, my lymph nodes were clear’’.

Don’t be afraid to see your GP

Brian knows better than most the value of keeping an eye on early signs and symptoms.

He said: ‘’Go and see your doctor If you’ve got anything that you’re concerned about – that’s what a GP is for. Go as soon as you can.’’

‘’If you go and say ‘I’ve got finger clubbing, for example, like me – that’s a red flag. It scares me that other people won’t get diagnosed early. It costs lives. I was fortunate, I got caught early but what about everyone else? If you go early, if you get detected early and caught early, you get treatment. It’s possible. If you don’t go, you’re not in the system so you’re not going to get treatment, you’re not going to get anything.

This year, because of Covid-19, many people worry that they can’t go out to see their doctor or think they may be a burden at a time when the pandemic has caused extra strain on the NHS. That’s wrong. Your GP will see you. The NHS is Still Here for all of us.

As Dr Helen Piercy, a GP locum based in West Lancashire, points out: ‘’It’s always been ok, even when the whole country was in lockdown, to visit your GP’’.

Her advice is clear: If you notice any signs or symptoms that concern you, see your GP.

First phone for an appointment. You will be assessed. You will be invited in, if you need to be seen face-to-face. Don’t be afraid. Pick up the phone.   

Be aware of all the symptoms

Finger clubbing was Brian’s only symptom of lung cancer. Some people may have several symptoms, others may have none. Other signs and symptoms of lung cancer include:

  • A persistent cough that lasts three weeks or more
  • Breathlessness
  • Wheezing
  • Frequent chest infections
  • A cough that changes or gets worse
  • Chest and/or shoulder pain
  • Coughing up blood or blood in your phlegm
  • Unexplained fatigue or lack of energy
  • Hoarseness
  • Swelling in the face or neck.

If you are experiencing any of these potential symptoms of lung cancer – it is vital that you speak to your doctor. The earlier lung cancer is diagnosed, the better options you may have.