Monday was a celebration. The announcement of targeted screening for those at highest risk of lung cancer was the most significant step forward in improving early detection of lung cancer in our history. It was a hard worked moment and needed to be enjoyed and savoured.
But now, we go again… because the job is far from over.
We understand there is some frustration that lung cancer screening is not going to be made available to everyone. Like with the three existing cancer screening programmes – breast, cervical and bowel – there is an age criterion for participants. Lung screening also has the added condition of a smoking history.
Smoking – whilst by no means the only – remains the biggest cause of lung cancer, accounting for around 70% of all cases. This is one of the reasons why the plans for the initial implementation of lung cancer screening currently target people who smoke or have previously smoked.
Another factor is also the risk of regular screening. Currently, the best diagnostic tool we have for lung cancer is a CT scan, which involves a low dose of radiation. Exposing people with very low risk of developing the disease would likely suffer, on balance, more harm than benefit if they were screened regularly for lung cancer.
For us, yesterday’s announcement for a national targeted programme for lung cancer is the start of something. It is the beginning of improving early detection of lung cancer for everyone, and our work does not stop because of its implementation. In fact, it’s more important ever and we will RACE forward.
Research
Research is what secured the implementation of lung cancer screening, and research is what will continue to pave the way to better understand this disease, develop new treatments and find new ways to catch it early.
Our charity was founded because no one want to fund lung cancer research and that research is what spearheaded the initial risk models which are now part of screening.
Since then, we have continued to fund research into early detection and patient experience. Projects have included:
- a simple and statistically robust method for general population screening using only a mouth swab from the patient
- a highly predictive model for detecting lung cancer from a blood test
- identifying changes to cell protein levels that occur just before a precancerous lesion becomes a cancer to stop lung cancer progression.
We are also partnering with Research ALK+ve to support research into this specific type of lung cancer.
From next year, we are also going to be investing further into the next generation of lung cancer researchers by extending our existing research fellowship programme.
Dr Helen Morgan is the latest research fellow. She shares how important the fellowship has been to her:
The lung cancer research fellowship has provided me with the opportunity to dedicate time to just doing research and further my own research skills.
The brilliant thing about being specifically a Roy Castle Lung Cancer Foundation Fellow is how patient-focused the charity is. People with lung cancer and what’s important to them, is always at the heart of this charity.”
Awareness
Despite the vast number of people it affects, there remains a real lack of awareness about lung cancer, and deep-seated misconceptions. However, raising awareness of lung cancer is not easy; it is not something people want to talk, or even think, about. We therefore have to find innovative and unique ways to present lung cancer, so more people take on board these vital messages.
From virtual reality to using comedy, we continue to find new ways to talk about lung cancer and challenge the dangerous misunderstandings around the disease.
One of our most successful campaigns was Still Here where we worked with winners of Britain’s Got Talent, Attraction. The shadow theatre company created a beautiful and bespoke performance bringing lung cancer out of Covid’s shadow, demonstrating the importance of recognising lung cancer symptoms, and acting on them.
Over 2.2million watched the video online, with 42% watching the full three-and-a-half-minute story. It was also aired on BBC Two.
We are currently working on our plans for this year’s campaign for lung cancer awareness month in November. Please get in touch if you would like to share your story to help raise awareness.
Communication
As the UK’s leading lung cancer charity, we see it as our responsibility to talk openly about lung cancer… and what better way to do that than heading into communities with the biggest pair of inflatable lungs you’ll ever see?! It makes us very difficult to avoid!
In 2022, and in partnership with NHS England, our team embarked on a six-week roadshow called Let’s Talk Lung Cancer after a survey found a quarter of respondents (24%) admitted they would do nothing or wait if they had a symptom such as persistent cough.
The aim of the roadshow was to:
- talk more openly about the disease
- address dangerous misconceptions
- have more positive conversations about lung cancer
- highlight all the different symptoms of lung cancer, and
- offer support, advice and encourage to those experiencing potential symptoms.
Lung cancer is a disease that no one wants to talk about, but it is vital that we do because these conversations can save lives. We need to lose the stigma and nihilistic perceptions around lung cancer and be more open about this disease that affects so many of us.
Yes, lung cancer is currently the UK’s biggest cancer killer but being able to recognise its many different symptoms and taking immediate action can change this, helping people get diagnosed earlier when lung cancer is easier to treat.”
Paula Chadwick, chief executive
Community engagement remains a key part of our work and we continue to build on this roadshow. The team are regularly out and about ready to talk all things lung cancer, with plans to replicate the Let’s Talk Lung Cancer roadshow now underway.
Evaluate
In order to improve, we need to understand what has already been done, what worked and what didn’t.
In March, we held a workshop with around 40 healthcare professionals across the lung cancer pathway – from GPs to radiographers, chest physicians and oncologists, as well as key members from NHS Cancer Programme team – to discuss the work that has been done to improve earlier detection in symptomatic patients, and where the gaps are.
One of the common themes was around chest x-ray and encouraging GPs to refer symptomatic patients sooner.
Chest x-rays are such a useful test for so many different things. As a GP, it is normal for us to send a patient for bloods test for all sorts of symptoms. It would be big step forward if we could normalize chest x-rays in the same way.
Dr Katherine Hickman, GP in Bradford
We are now working with GPs and radiographers to understand and overcome the barriers for sending people for chest x-ray and improve communication between primary and secondary care.
There were also discussions led by consultant chest physician, Dr Matthew Evison, Professor David Baldwin and our first research fellow, Dr Emma O’Dowd.
Dr Evison shared the details of a new drop-in chest x-ray service being piloted in Greater Manchester which allows people with symptoms to refer themselves for a chest x-ray, without needing to see a GP. Prof Baldwin and Dr O’Dowd highlighted their plans for a cancer concern hotline, which people worried about symptoms can call and be referred for appropriate tests.
The aim of both initiatives is to make it as easy as possible for people with symptoms to get checked, with hope to roll these schemes out to other parts of the country.
We will be releasing a full paper with ideas generated from the meeting later in the year. This will be shared with the NHS, with recommendations of how we can speed up a person’s route to diagnosis.
As dedicated as ever
For the last 33 years, our charity’s sole focus has been on lung cancer, and it remains our one and only priority. We are delighted by the announcement for screening; it is validation for all our hard work and proof that lung cancer is finally getting the attention and funding it deserves.
From here, we push on. We keep working hard so the results keep coming… confident that it won’t take another 33 years before we spearhead another step forward in improving the early detection of lung cancer for everyone.
