Lung cancer is difficult to detect early but one way we’re getting ahead of the game is with lung health checks. These programmes did have to pause at the peak of the pandemic. However, we want them back up and running as soon as possible as they are best chance to diagnose lung cancer when it can be cured. The team in Manchester has restarted its health check with the mobile CT scanner back in the supermarket car park, as chest physician, Matt Evison, explains:
Lung health checks are a program that invites patients aged between 55-80* who have ever smoked. Whether that’s now, whether that’s in the past, whether it’s long in the past and they get invited to a lung health check.
We send invitations out. They phone up and make an appointment for their health check. They have a number of different health checks when they come through. We look at breathing tests. We look at the risk of having a heart attack or a stroke and we look at the risk of developing lung cancer.
We have some calculators and ways of assessing the individual risk of each person and if it’s above a certain level we’ll offer them to have a CT scan then and there, on the truck in the supermarket car park. By doing that we’ve shown we’ve picked out a very high number of early lung cancers with no symptoms and because it’s a very early stage and an early diagnosis, that’s the time when we can offer treatment designed to try and cure the disease.
The great tragedy of lung cancer is that it often presents or causes symptoms at a very late stage. Your lungs have little in the way of nerves in them, so you cannot feel something growing to say something doesn’t feel right to get yourself checked out.
So the whole drive behind the lung health checks is to take patients that could be considered at higher risk of lung cancer and go looking for it before it may cause any symptoms because the earlier we find it, the more treatable it is.
Our lung health check in Manchester, and others like it around the country, did have to stop towards the end of March at the outset of the pandemic with Covid cases rising very rapidly. At that moment there was a real concern that the NHS would be overwhelmed and all resources were being put into that front line care.
However, here in Manchester, we started our lung health check program again in August.
It’s had to change a lot. Just as we do in hospitals, we’ve mirrored many of those interventions so, if someone has a lung health check they’re called the day before and asked about symptoms. If they are attending a face to face appointment or CT scan, the booking system has changed to spread those out significantly through the day so that that person will be the only person in the waiting room.
There is a one-way system through the truck where they have their lung health check on and again, all staff and visitors are in PPE and in masks. There is hand sanitiser when you walk into the truck, every time you move on and when you leave the truck. There is also an enhanced cleaning program between every patient and in each area of the truck.
We’ve had to stop doing certain things that were part of the lung health check, so the breathing tests is a very forceful breathing manoeuvre to breathe out into a machine as a maximum effort so they’ve been taken out. That’s been a necessary step but the program is now continuing, its back up and running, we’re absolutely delighted that it is.
There’s lots of people coming for their scans and the feedback’s been very good. People feel reassured to see that social distancing is maintained throughout and that all the staff are wearing appropriate PPE. They are pleased to have the opportunity to sanitise their hands at lots of steps through the process. They are relatively simple things but are very reassuring.
If someone is invited to a lung health check, we really want them to attend and that goes for lung health check, chest x-ray appointment, CT scans, appointment with their GP. Whatever it is, if anyone has symptoms in their chest and they’re worried about them, we are here to look after them. We’re here to make sure that they’re safe, and it just may save a life.
There is so much that can be done in lung cancer. Treatments are changing so quickly. Now what we do today is different to what we did two years ago, which is different to what we did two years before that. It’s changing that quickly. And the earlier we find, if it’s there – the earlier we find it, the better, the more that can be done.