Lung Cancer Referral

1
Lung CancerReferral

• BCH central referral service not set up
• GP referrals - suspicious CXR - seen 2 weeks
• Often failure to arrange CXR first - poor
  selection. Further GP education re NICE referral
  guidelines
• GP CXR reports to Resp Physician except UHD
• Regional Lung Cancer Group

2
Lung Cancer - Diagnostics

• Bronchoscopy - usually 5 working days
• BCH -5 UHD -1
• RVH -½ (? Where 2 more sessions)
• CT Scans - within 2 weeks
• - same day bronchoscopy
• PET Scans - 2-3 weeks but secretarial reporting
  delay of 2-3 weeks
• Histo/cytology - 3 days. Not available on IT

3
Lung Cancer - MDM

• Established BCH for 20 yrs - for BCH RVH Mater
  Downe LVH and Ulster
• Works well re treatment decision
• No lead pathologist
• Insufficient oncologists
• No secretarial/admin/audit support
• No IT support re database
• Lung Cancer nurses help data gathering/audit

4
Lung Cancer - Treatment

• Surgery - usually within 4 weeks
• Oncology - 2 oncologists overwhelmed
• - recruitment difficulties
• Palliative care - good support
• Lung Cancer nurses essential

5
Lung Cancer- Future Challenges

• Medical Manpower
• -Specialist Lung Cancer Physician-endobronchial
  therapy and autofluorescense bronchoscopy
• -Specialist Lung Pathologist and Lead Cancer
  Path
• -Additional Lung Oncologists
• Good N-I cross-board IT support/programme for
  data set to enable adequate audit
• Secretarial/admin/IT help to allow rapid
  communication/results to GP and team from OPD,
  Endoscopy, Radiology/PET and MDM