A hoarse voice that lingers for weeks.
asserted
that → linger → weeks
For most otherwise fit and healthy people – and for most doctors – these symptoms would not ring alarm bells.
asserted
symptoms → ring → bells
But one of Britain’s leading oncologists warns that these all-too-easily dismissed signs could indicate lung cancer – the deadly disease increasingly being diagnosed in younger people.
uncertain
signs → lead → people
Speaking at the annual meeting of the European Society for Medical Oncology (ESMO) in Madrid, Dr James Wilson is among experts calling for changes to referral guidelines amid concerns that too many patients are being diagnosed only after their cancer has spread.
asserted
cancer → speak → concerns
The private cancer specialist at the prestigious Cromwell Hospital in London believes any adult – regardless of age or smoking history – with a persistent cough that fails to improve after two to three weeks should be offered a chest X-ray.
asserted
that → believe → ray
Most will not have cancer, he says, but it is a quick, relatively inexpensive way to investigate symptoms that might otherwise be dismissed.
uncertain
that → have → symptoms
Currently, NHS guidelines recommend an urgent chest X-ray for people aged 40 and over who have an unexplained cough and have smoked, or who have never smoked but have other symptoms, such as breathlessness, fatigue or weight loss.
asserted
who → recommend → breathlessness
And, in recent years, the profile of lung cancer patients has shifted.
asserted
profile → shift → patients
Smoking and advancing age remain the biggest risk factors for lung cancer.
asserted
Smoking → advance → cancer
Yet specialists are also seeing patients in their 20s and 30s – some of whom have never smoked – presenting with advanced disease.
asserted
some → see → disease
Lung cancer is Britain’s biggest cancer killer, causing about 33,000 deaths a year with some 50,000 people diagnosed annually
This has prompted concerns that current referral guidelines, which focus on older adults, could mean younger patients are missing out on a lifesaving early diagnosis.
uncertain
patients → cause → diagnosis
‘Lung cancer does not discriminate based on age,’ Dr Wilson tells The Mail on Sunday.
asserted
Wilson → discriminate → Sunday
‘Anybody can get it and we need people to know that lung cancer is not uncommon in people who don’t smoke.
asserted
who → get → people
‘It’s easy to think that you’ve just been shouting too much, or are coming down with a virus, but if it’s persistent and worsening, it needs to be checked.
asserted
it → ’ → virus
‘Don’t let your GP fob you off.
asserted
GP → let → you
If you have any new symptoms – including a cough, chest pain, breathlessness, hoarse voice – that are persistent and worsening, you should be sent for a chest X-ray, no matter your age.’
asserted
you → have → X
Certainly, lung cancer was the last thing on Charlie Maxwell’s mind when she first noticed a twinge of pain in her left ribs and back.
asserted
she → notice → ribs
The 44-year-old was returning from holiday and assumed she had simply pulled a muscle lugging around her heavy backpack.
asserted
she → return → backpack
But the pain didn’t go and she had difficulty even blowing her dog whistle or sleeping on her left side.
asserted
she → go → side
‘The fact that it didn’t hurt when I moved, but did when I blew air into a whistle, or laughed, was strange,’ she says.
asserted
she → hurt → whistle
‘But as a former rugby player, I knew there’s nothing you can do for rib pain, so I left it.’
asserted
I → know → it
Charlie Maxwell, 44, says she wishes she had listened to her strange and unexplained symptoms earlier
Then, visiting her sister in Spain, Charlie found herself suddenly breathless while walking up a flight of stairs.
asserted
herself → say → stairs
She says: ‘I had been swimming and walking earlier that day with no issues, but when I went up even just one flight of steps I had to stop to catch my breath.
asserted
I → say → breath
I made a note to check with my GP.’
asserted
I → make → GP
But because Charlie was young and had never smoked, she could not be referred for further scans on the two-week cancer pathway.
uncertain
she → smoke → pathway
Instead, she was advised to go straight to A&E, where she was eventually given a chest X-ray.
asserted
she → advise → ray
While at first given the all-clear, and told to return home, Charlie received an urgent call two weeks later – a radiologist checking her file had found a shadow on her lung.
asserted
radiologist → give → lung
Within days she received the official diagnosis: stage four lung cancer that had already spread to her rib.
asserted
that → receive → rib
Today, Charlie is doing well – her disease, while incurable, has shrunk and is stable.
asserted
disease → do → ?
But she wishes she had listened to her strange and unexplained symptoms earlier.
asserted
she → wish → symptoms
‘I didn’t understand then how far cancer can get before you feel it,’ she says.
asserted
she → understand → it
‘Now I encourage everyone that if you have something that doesn’t feel right, to get it checked.
asserted
it → encourage → something
Don’t assume that pain or changes are normal.’
asserted
pain → assume → ?
Lung cancer is Britain’s biggest cancer killer, causing about 33,000 deaths a year with some 50,000 people diagnosed annually.
asserted
people → cause → deaths
Almost half of patients are 75 or over when diagnosed, with rates highest among those aged 80 to 84.
asserted
rates → diagnose → those
But about 15 per cent of lung cancers occur in people who have never smoked – accounting for an estimated 6,000 deaths a year.
asserted
who → occur → deaths
An analysis of lung cancer patients at Guy’s and St Thomas’ Hospital in London found that 16 per cent of those who had never smoked were under 50, compared with just 5 per cent of patients with a smoking history.
asserted
who → find → history
Dr James Wilson says: 'Lung cancer does not discriminate based on age.
asserted
cancer → say → age
Anybody can get it and we need people to know that lung cancer is not uncommon in people who don’t smoke'
asserted
who → get → people
Crucially, catching lung cancer early can make an enormous difference.
asserted
catching → catch → difference
…and 39 more, not listed.
The Aporia
