You usually start by seeing your GP. They will ask you about your general health and symptoms and will also examine you. This might include listening to your breathing and seeing how much air you breathe in and out. Your doctor will then decide whether to do tests or refer you to a specialist.
Making a GP appointment
You can book an appointment by telephoning your GP surgery or in person. You don’t have to tell the receptionist what you want to see the doctor for. Try different times of the day if it's difficult to get through by phone. Accept a booked appointment, even if you think it’s a long time to wait. You could ask about cancellations if you are able to get to the practice at short notice.
When to see your GP
See your doctor if you notice a change that isn't normal for you or if you have any of the possible signs and symptoms of cancer.
Even if you're worrying about what the symptom might be, don't delay seeing them. Your worry is unlikely to go away if you don't make an appointment. The symptom might not be due to cancer but if it is, the earlier it is picked up, the higher the chance of successful treatment. You won't be wasting your doctor's time.
Try not to be embarrassed. What you tell your GP is confidential. Doctors are used to discussing intimate problems and will try to put you at ease.
Getting the most out of your GP appointment
When you see the doctor it can be difficult to remember everything you want to say.
- Write down your symptoms including when they started, when they happen and how often you have them.
- Write down if anything makes them worse or better.
- Tell your GP if you are worried about cancer in particular.
- Take a friend or relative along for support - they could also ask questions and help you remember what the GP says.
- Ask the GP to explain anything you don’t understand.
- Ask the GP to write things down for you if you think it might help.
What happens during your GP appointment
When your doctor examines you, he/she may
- Listen to your chest by putting a stethoscope on your chest and back.
- Feel your lymph nodes (glands) in your neck and under your arms.
- Check your blood pressure, heart rate and temperature.
- Record your height and weight.
- Ask you to breathe into a small device called a spirometer. (The device measures the amount of air you breathe in and out and also measures how quickly you breathe).
- Consider referring you for an urgent chest x-ray
- Might arrange for you to have blood tests.
After your examination, your doctor might refer you to a specialist for further tests.
Referral to a specialist
If your chest X ray is not normal you will be referred to a rapid access clinic. If you have blood in your sputum or persistent symptoms.
If your chest X ray is suspicious, the report will be sent to your GP and you will be referred to the rapid access clinic. You will then be seen by a lung cancer team to have further tests to determine whether or not you have lung cancer within two weeks.
Tests to diagnose
Rapid access clinics provide initial investigations such as a CT scan and bronchoscopy to patients with suspected lung cancer within one or two hospital visits. This reduces multiple hospital visits, patient anxiety and shortens the time period to diagnosis.
Tests to stage
This helps your doctor to know the stage of the cancer and decide on the best treatment.
- CT scan - You might have a CT scan of your body and brain to find out whether lung cancer cells have spread there.
- Bronchoscopy under local anesthetic/ general anesthetic - A bronchoscopy is a test to look at the inside of the breathing tubes (airways) in your lungs. Your doctor can see any areas that look abnormal and take samples (biopsies) to test.
- Bronchoscopy and ultrasound (endobronchial ultrasound) - You might have this test if your doctor has seen an abnormal looking area on your lung using an x-ray or CT scan. An endobronchial ultrasound can show if it’s lung cancer and the size of the tumour. It can also show if the cancer has spread into other areas of the lung or outside the lung.
- Biopsy through the skin - You might have this test if your doctor has seen an abnormal looking area in your lung or airways using an x-ray or CT scan.
- Surgical biopsy - You might have this test if;
- a CT scan has shown an abnormal area in your lung or airways
- the area is difficult to sample, because of its position
- Neck lymph node ultrasound and biopsy - You might have this test if your doctor has seen changes in the lymph nodes in your neck on a CT scan. It can find out if there are cancer cells in the lymph glands.
- Testing for gene mutations - Scientists can look at lung cancer samples in the laboratory and search for gene changes (mutations) that change the way the cancer grows.
Questions you might want to ask your GP:
Your GP might not be able to answer all of your questions. They will tell you what they can at this point. Not knowing is difficult to cope with and can make you anxious.
If they don't think you need any tests or a referral, perhaps ask your GP:
- Can you explain to me why I don’t need to have tests or see a specialist?
- Is there anything I can do to help myself?
- Do I need to see you again?
- Who do I contact if my symptoms continue or get worse, especially during the night or at weekends?