Lung cancer or covid-19? Messages for primary care

Interview and article by Christine Clark

The key message for primary care is about using the guidance document, Differentiation of the Cs to enable health care professionals to triage patients more accurately, says Professor David Baldwin, chairman of the lung cancer CEG. 

Primary care services need to make it relatively easy for patients who are concerned about their symptoms to obtain some telephone advice – and at present that is not happening in many practices, explains Professor Baldwin. At the moment we are in a situation where a large number of people are sitting at home with their cancer getting worse because it is getting to a later and later stage.  The other major concern is that many patients will never be diagnosed with lung cancer and their deaths will be recorded as ‘pneumonia’ or ‘possible covid-19’. The numbers of cancer patients coming through the system have fallen but cancers will not have stopped developing. The problem with lung cancer is that the median survival [at diagnosis] is only six months so already 35% of people will have died. This is the reason why this issue is urgent and important, he says.

Messages for Primary care

Differentiation of the Cs is a document that the lung cancer CEG hopes will help to mitigate the mixed messages about presentation with lung cancer. Professor Baldwin would like GPs to read the document and consider how it could work in their practice, and, in particular, consider how to “re-open the gates” for people who think they might have lung cancer.

“I’ve seen one or two you tube videos made by GPs explaining to patients how important it is to get in touch if they think they might have lung cancer. That’s incredibly helpful but it’s only getting to a small minority. We need to do this nationally”, says Professor Baldwin. “We need to get back to where we were before – making fantastic progress with lung cancer prior to the covid pandemic and primary care is an absolutely essential cog in the machine”, he adds.

Community pharmacists

“I regard community pharmacists as part of the primary care team and the interface between the patients and healthcare team”, says Professor Baldwin. He suggests that community pharmacists read the document and understand that they have got an incredibly important role in guiding patients to the appropriate further action. “In fact, any health care professional who interfaces with patients should read this document and use the opportunity to get the message over”, he says. 

Di­fferentiation of the Cs in Lung Cancer: Cancer vs COVID-19 can be found at:  

https://www.healthylondon.org/wp-content/uploads/2020/03/Differentiation-of-the-Cs-in-lung-cancer_-Cancer-vs.-COVID.pdf

Read and watch the full series on our website or on YouTube