Suspected respiratory cancers

Harrogate and District NHS Foundation Trust

Definition/Description

Refer for USC if CXR suggestive of lung cancer or if CXR is negative but there are significant clinical concerns

Red Flag Symptoms

Aged >40 yrs and

  • has unexplained haemoptysis
  • has unexplained cough, fatigue, dyspnoea, chest pain, weight loss, and/or appetite loss AND:
    • is a smoker / ex-smoker / has asbestos exposure
      OR
    • has two of the above symptoms and has never smoked
  • Persistent / recurrent RTI
  • Finger Clubbing
  • Supraclavicular or persistent cervical lymphadenopathy
  • Chest signs consistent with lung cancer / pleural disease
  • Thrombocytosis

Guidelines on Management

Request URGENT CXR at time of referral if recent x-ray is not available*

If:

  • Has unexplained cough, fatigue, dyspnoea, chest pain, weight loss, and/or appetite loss AND:
    • is a smoker / ex-smoker / has asbestos exposure
      OR
    • has two of the above symptoms and has never smoked
  • Persistent / recurrent RTI
  • Finger Clubbing
  • Supraclavicular or persistent cervical lymphadenopathy
  • Chest signs consistent with lung cancer / pleural disease
  • Thrombocytosis

Please do CXR*

  • If has unexplained haemoptysis
*CXR is mandatory for clinic appointment.
Please ensure ‘high suspicion of cancer’ box is ticked and highlighted in referral text on radiology referral so it can be appropriately prioritized by the radiology department. A streamlined service for respiratory cancers is in place at HDFT so no need for CT to be requested prior to 2ww appointment.

Referral Criteria/Information

Consider bloods for U/E, LFT, FBC, bone profile and clotting.

If not undertaken patient will be sent ICE form with appointment for bloods to be done PRIOR to 2ww appointment. This may need to be facilitated in primary care.

Associated Policies

There are no associated policies.

Specialties

Respiratory North Yorkshire Urgent Suspected Cancer North Yorkshire

Places covered by

  • North Yorkshire

Hospital Trusts

  • Harrogate and District