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Appointment & Tests

First appointment

Please note, you are more than welcome to bring someone with you to the appointment

Prior to your first appointment you may need to have a CT (Computerised Tomography) scan. This may have been organised by your GP or the hospital before your first appointment or you may be asked to have this done on the day of your appointment. This test is a special scan which enables your consultant to see in more detail any abnormal areas that may have been seen on a chest x-ray.

If a CT scan has been requested a hospital member of staff will contact you either by letter or telephone. If you do need a CT scan, please report to Reception x-ray department, level 2, BRI. Please ensure you have nothing to eat or drink two hours before to the scan.

  At your first appointment, the consultant will probably want to do the following:

  • History- the consultant will take a detailed history and will want to know about any symptoms that you have been experiencing, any previous medical problems and what medication you are currently taking. It may be helpful to bring a list of medications with you. It is particularly important that you tell us if you are on any blood-thinning medications e.g. warfarin, clopidogrel or rivaroxaban
  • Physical examination- the consultant will want to examine you.
  • Blood tests- the consultant may ask you to have some blood tests.
  • Chest X - ray- If you haven't had a chest x-ray you almost certainly need one but this will normally have been requested by your GP and completed before your hospital appointment.
  • Simple breathing tests- you may be asked to breathe into a small machine which can help to show how effective your breathing is.
  • If you have enlarged lymph glands in your neck or fluid in your chest, we may want to take a sample with a syringe and needle. This is a simple test that can be done in the clinic and can speed up the diagnosis

 You should be offered the opportunity to meet the lung specialist nurse during or after this appointment. Your lung specialist nurses will give you contact details and will ensure that all your questions are answered and that you and your family have support if you need it.

Tests you may need

The consultant may want to arrange some of the following tests listed below (this will be on a seperate day to your first appointment). You will be given written information about some of the tests that explains them in more detail when you are seen at the hospital.

  • Breathing tests:You will be asked to blow into a machine that can accurately measure the effectiveness of your breathing.
  • Bronchoscopy:This test allows us to to see inside your main breathing tubes. Usually samples or biopsies are taken. It is done as an outpatient and usually involves attending the hospital for a morning or afternoon. You will need someone to take you home and stay with you after the procedure.**link to Bronchoscopy leaflet**
  • Endobronchial ultrasound - This is a procedure which is similar to a bronchoscopy, which allows your doctor to look into your breathing tubes but also allows the doctor to take samples of the glands in the centre of the chest using an ultrasound scanner. If you need to have this test, it will be carried out by a specialist at Southmead Hospital.** Link to EBUS leaflet**
  • CT (Computed Tomography) guided biopsy:An investigation that allows an x-ray doctor to take samples of abnormal areas seen on the CT scan. This can help to establish what they are. This is usually done as an outpatient but you will need someone to take you home and stay with you after the procedure.
  • CT/ PET scan:This is another detailed type of CT scan. If you need a PET scan you will need to travel to Cheltenham to have this done.
  • Bone scan:A special type of x-ray scan that can show abnormal areas in the bones.
  • Pleural tap: Sometimes there is fluid in the lung that we may remove for comfort or diagnostic reasons. This is usually done in the pleural clinic in the respiratory department, level 2, BRI
  • MRI or Ultra Sound scan:In some patients these tests are also needed. They are done by the x-ray department and are done as well as,or sometimes instead of the CT scan.
  • Mediastinoscopy:This is a minor operation carried out by the chest or thoracic surgeon under a general anaesthetic. They can look at the area in the centre of the chest (mediastinum) and take samples (biopsies) when appropriate. If you need this test, you will be referred to see a surgeon first.

The Multi-Disciplinary meeting

When the results of the tests that you have had are available, the consultant will discuss your case at a weekly Multi-disciplinary Team Meeting (MDT). At the meeting your symptoms and test results are discussed by the whole lung cancer team. This ensures that any treatment recommended to you is the best and most appropriate.

You don't attend this meeting.

The team includes respiratory physicians, oncologists (cancer treatment specialists) chest/ thoracic surgeons, x-ray specialists, the lung cancer nurse specialist and other specialists who are experienced in caring for people with suspected cancer.  

The meeting takes place once a week, every Friday 11:30am to 1pm and a member of the team may contact you after the meeting if they need to discuss any future tests or appointments.

Results will not be given over the phone.

Second appointment

At your second appointment your consultant or nurse specialist will tell you of the results of your tests. They will usually be able to tell you if you have a lung cancer or not and what is the best treatment for you if you do have lung cancer.  Occasionally extra tests may be needed before the diagnosis is certain.

If lung cancer is confirmed we will also give you an explanation of the cell type. This is important because different cell types need different treatments. You should also be told if the cancer seems to be confined to the lung or if it has moved anywhere else in your chest or body.

You will be told the likely treatment plan decided by the discussion at the Multi-Disciplinary Team Meeting. This will often mean you will be referred on to see another specialist  such as  a surgeon or oncologist (cancer specialist).