Lung cancer is the third most common cancer in the UK. About 47,000 people are diagnosed with it each year. The lungs are the parts of the body that we use to breathe.
There are two main types of primary lung cancer. These are:
Another type of cancer that affects the lining that covers the lungs (the pleura). This is called Mesothelioma. The condition affects more than 2,600 people each year in the UK.
We aim to meet with you as urgently as the Abnormal Chest X-Ray/CT scan allows, there are many Urgent Lung Clinic Appointments available weekly, you can expect to be contacted to attend this appointment usually within 2 weeks or less.
Our aim is to provide you safe effective care, given by the right people, at the right time in the right place.
Use the section below to help you find answers to some of the common practical questions that you may have. Simply click on the blue panel and it will expand to give more information on the relevant section.
Please check what hospital that your appointment is at before starting your journey.
If you are being seen at the Victoria Hospital you can find useful information by clicking on these links
Wards
If you are being seen at the Queen Margaret Hospital you can find useful information by clicking on these links
Due to our close relationship with NHS Lothian, many of our treatments and investigations are carried out between Fife and Lothian.
Patients will sometimes require to go to the Royal Infirmary of Edinburgh for scans, endoscopic or surgical treatments.
Some oncology patients will attend both outpatient clinics, as well as the cancer treatment centre at the Western General Hospital in Edinburgh also.
Does this mean I have cancer?
No, there are many common conditions that symptoms could be linked to, including the possibility of cancer.
Why do I need to be seen?
It is important we carry out the necessary assessments and tests as quickly as possible. This is done to reassure most of those referred, but also to quickly diagnose and start treatment on the small number that do have cancer. It is important that you attend all the appointments we offer you to ensure there are no delays.
How many appointments do I need?
It is difficult to say how many appointments you will need to attend, If you have an emergency and cannot keep your appointment, please let us know as soon as possible by calling the number on your appointment letter so that we can rearrange your appointment.
Some patients will go straight for tests and investigations. You should receive instructions prior to your appointment. Please follow the instructions carefully otherwise it can lead to tests and investigations being delayed or cancelled. If you are unclear, please call the number on your appointment letter.
Once you have been referred via the referral routes you will meet with the Respiratory Consultant and one of the Lung Cancer Clinical Nurse Specialists. This consultation takes place in the Outpatient department in the Victoria Hospital, you will be asked to go for a breathing test (Spirometry) and blood tests, prior or after the consultation depending on your appointment time. This appointment usually lasts around 45 minutes.
The consultation will comprise of a discussion about you, this is required to gather accurate information around your lifestyle, past medical history, fitness levels, your current symptoms and medications. This provides the team vital information when discussing investigations and treatment personalised to you. The consultant will show you the CT Scan, and what is presented, and what this means for you. At this meeting, all further investigations will be decided (see Investigations Section). You may need one investigation or you may need a few.
You will be given your appointment for a bronchoscopy or EBUS on the day.
You will have the opportunity to discuss and ask questions about what the scan has provided, and what this means for you.
After the consultation, you will have a face to face alone with your Lung Cancer Clinical Nurse Specialist to go over the consultation points, as we know that being potentially diagnosed with cancer can be overwhelming and stressful, and you will need time to absorb the information you have been provided with.
Your nurse specialist will give you an explanation of the further investigations that require to be carried out, alongside signposting to further support, commencing prehabilitation and providing information leaflets on the investigations individual to your case. Your nurse specialist will give you an indication of how long these investigations take to be carried out and when we plan to discuss with you all these results.
Your nurse specialist may provide you with prescribed medication to help alleviate some of the symptoms you are experiencing.
You will be given the contact details of the Lung Cancer Clinical Nurse Specialist, as you may wish to call them shortly after the consultation, to have more clarity on the potential diagnosis, ask more questions as they arise over time, and you discuss your potential diagnosis with family and friends. It is also worth remembering to ask the BRAN questions at this appointment
What are the Benefits?
What are the Risks?
What are the Alternatives?
What if I do Nothing?
If you have been going through investigations and are diagnosed with Lung cancer, a team of health professionals will work together to plan the treatment they feel is best for you.
This team is called a multidisciplinary team (MDT). In Fife, we meet virtually once a week on Monday afternoons. NHS Fife is part of the Edinburgh Cancer Centre based at the Western General Hospital, Edinburgh. Our cardiothoracic surgeon is based at the Royal Infirmary Edinburgh. This meeting allows all health professionals to discuss all the patients virtually across Fife, after completion of investigations and when they available for the team to access and discuss.
Members of the Lung MDT Team in Fife:
The MDT will meet together to discuss the results of these tests and plan your treatment. They will consider a number of things, including:
Once we have discussed your case and a decision has been made, this is when you will meet with your Lung Cancer Nurse Specialist a few days after the MDM, to discuss your treatment options, and to be provided with the next stages of the journey (Oncology, Surgery or Best Supportive Care). Even after you have been diagnosed and a treatment plan is made, you may need more tests to find out more about the cancer, so all treatments can be accessed.
Your Lung Cancer Clinical Nurse Specialist will continue to assess your current symptoms, provide all information from the MDT meeting and supply you with vital information leaflets on the decided treatment. A clinical letter will be sent to your GP to update them of your decision, and the next steps in your cancer journey. Your Lung Cancer Clinical Nurse Specialist will refer you to a team called the MacMillian -Improving Cancer Journey Team who are experts in information sharing, financial support, vital signposting and holistic person centred support.
Investigations for lung cancer may include bronchoscopy and endobronchial ultrasound, CT guided biopsy or positron emission tomography. Click on each link to learn more.
Treatment for lung cancer may include surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy drugs or a combination of these. Click on each link to learn more.
Best Supportive Care focuses on quality of life and aims to help you live as well and as comfortable as possible, rather than curing the cancer. Best Supportive Care can:
Best Supportive Care is usually provided by a combination of people, including: GPs and District Nurses, Cancer Specialist Nurses and Specialist Palliative Care.
The Lung cancer nurse specialists (LCNSs) are highly skilled professionals, working at the heart of multi-disciplinary teams (MDTs).
Your care team comprises:
Lung cancer nurse specialists:
Anne Wilson
anne.wilson3@nhs.scot
Ed Cairns
edward.cairns@nhs.scot
Rebecca Smith
Trainee Lung Cancer Clinical Nurse Specialist
Lung Cancer Nurse Specialist Secretary:
Norma Henderson norma.henderson@nhs.scot
We provide high-quality, safety-critical, patient-centred care for patients with a lung cancer diagnosis. Working on the front line of cancer care, LCNSs manage and deliver complex and personalised care to patients from the point of diagnosis throughout their cancer journey. We provide information and support to help patients and their families understand different treatment options, manage the symptoms of disease and any side-effects of treatment, and to live as well as they can for as long as they can.
The wider team includes many other professionals in Lung Cancer Care: Respiratory Consultants, Oncology Consultants, Acute Oncology Team, Respiratory and Oncology administrative support colleagues.
Acute Oncology Service: this team of health professionals will be involved in your care only once established on systemic anti-cancer treatment. Their purpose is to support you if you develop any side effects of treatment (chemotherapy, radiotherapy or immunotherapy). After they assess your symptoms they will provide the support you require, be it a specific medication, a GP review or potentially admission into the Victoria Hospital. Your allocated oncologist will provide the cancer treatment helpline number when you meet with them to discuss, consent and proceed to this type of systemic anti-cancer treatment.
This is where you will find information about how you can help yourself before surgery.
This term Prehabilitation (prehab) means getting ready for cancer treatment in whatever time you have before it starts.
If you feel you need some support, we provide a range of practical and emotional support. Our Maggie's Centre provides support and information for patients.
Asbestos Action
Tel : 01382 225715
Fife Carers Centre
Tel : 01592 205472
MacMillan Cancer Support
Tel : 0808 808 0000
MacMillan Fife Welfare Benefits Partnership
Tel : 0345 1400 091
Fife Social Work Department
Tel : 03451 551503
NHS Fife Smoking Cessation
Tel : 0800 025 3000
The Roy Castle Lung Cancer Foundation
Tel: 0800 358 7200
Scottish Intercollegiate Guidelines Network (SIGN)
National Institute for Health and Care Guidance (NICE)
The most effective way to feedback about your patient experience is to use the Care Opinion website. Care Opinion allows you to truthfully share your experience with us and with others. This site is moderated and your comments will be both seen and reviewed.
We provides a range of ways in which you can communicate with us. You can use our website with its accessible functions. These will help you find and understand the information you need. You can also find a variety of translated materials in community languages and in British Sign Language.
If you require interpreting services, you can contact us by emailing fife.EqualityandHumanRights@nhs.scot, by calling 01592 729130, or using our SMS text service on 07805800005 which is available for people who have a hearing or speech impairment.