COVID-19 is masking the symptoms of the deadliest cancer in UK, experts say.
Lung cancer, which kills more than 35,300 Brits a year, has very similar characteristics to the coronavirus.
The most common symptoms of lung cancer are a persistent cough, chest infections, breathlessness, chest pain, fatigue and a lack of appetite.
Its strikingly similar to Covid-19, which may cause people to think they have the virus and delay getting a cancer diagnosis.
When the UK first went into lockdown in March, the Government’s message was to stay at home if you have a cough or high temperature.
GP surgeries and hospitals urged people to stay away if they had these symptoms in fear of the virus spreading.
But testing was not widely available for months into the pandemic, meaning people could not find out what was at the root of their illness.
As a result, less lung cancer cases have been diagnosed and will lead to deaths, charities say.
Signs of lung cancer you shouldn’t ignore
The main red flags of lung cancer, according to the NHS, are:
- A cough that doesn’t go away after 2 or 3 weeks
- A long-standing cough that gets worse
- Chest infections that keep coming back
- Coughing up blood
- An ache or pain when breathing or coughing
- Persistent breathlessness
- Persistent tiredness or lack of energy
- Loss of appetite or unexplained weight loss
- Coughing blood
- Finger clubbing
There are some key differences between Covid-19 and lung cancer, both of which cause respiratory distress.
Dr Robert Rintoul, the incoming clinical chair of the UK Lung Cancer Coalition (UKLCC) said: “A new dry cough with breathlessness, fever, aching muscles and loss of smell and taste could well be Covid-19.
“However, if you have an unexplained persistent cough for three or more weeks, maybe you have lost some weight, feeling tired, coughing up blood or getting repeated chest infections – that could be lung cancer.”
Although respiratory symptoms are seen in both diseases, Covid-19 is more likely to come on suddenly.
Features more typical of Covid-19 include a loss of smell or taste, muscle pains, fever, and flu-like symptoms for one or two weeks.
How deadly is lung cancer?
Lung cancer is the UK’s biggest cancer killer.
It kills over 35,300 people in the UK each year, which is more than breast, bowel, bladder and cervical cancer combined.
The disease accounts for around a fifth of all UK cancer deaths (21 per cent) and one in seven (13 per cent) of all new UK cancer cases.
Four people die from lung cancer in the UK every hour – someone every 15 minutes.
More women die from lung cancer than breast cancer and, despite being labelled a ‘smoker’s disease’, one in eight people with lung cancer have never smoked.
Lung cancer patients in the UK are diagnosed with more advanced disease than many other countries.
Professor Karol Sikora, a senior oncologist and chief medical officer of the cancer centre Rutherford Health, said: “Lung cancer patients are definitely getting their diagnosis delayed.
“Part of the story is that they are fobbed off by GP receptionists who tell everybody with a cough or shortness of breath to call NHS 111.
“So when they eventually get a chest X ray it has already spread from the primary site.
“The outcome for stage 1 disease is good – 75 per cent cure but once the nodes are involved it’s less than 25 per cent.
“The patients also commonly have repeated chest infections which confuse the picture.”
Professor Mick Peake OBE, current chair of the UKLCC, said: “Fear of engaging with health services, halting the national programme of lung cancer screening pilots, and restricted access to diagnostic tests have all contributed to a drop in urgent two-week wait GP referrals in England.
“Government guidance to stay at home with a cough, a key symptom of lung cancer, has also caused further confusion.”
What are the symptoms of lung cancer and Covid-19?
The main symptoms of lung cancer are:
- a cough that doesn’t go away after 2 or 3 weeks
- a long-standing cough that gets worse
- chest infections that keep coming back
- coughing up blood
- an ache or pain when breathing or coughing
- persistent breathlessness
- persistent tiredness or lack of energy
- loss of appetite or unexplained weight loss
Less common symptoms of lung cancer include:
- changes in the appearance of your fingers, such as becoming more curved or their ends becoming larger (this is known as finger clubbing)
- difficulty swallowing (dysphagia) or pain when swallowing
- a hoarse voice
- swelling of your face or neck
- persistent chest or shoulder pain
The main symptoms of coronavirus are:
- a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
- a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
- a loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal
It can also cause:
- shortness of breath
- a fever or chill
- chest pain
- aches and pains
- skin rash
Sources: NHS, CDC, WHO
Around a third of lung cancers are diagnosed through referrals after a person goes to their GP with symptoms, and another third when people go to A&E with more serious symptoms, such as coughing up blood.
Staggering figures show there were 57 per cent less A&E attendances in April this year compared to last year. In September, visits were still down by 26 per cent year-on-year.
Another third of lung cancer cases are found when people have routine operations, and doctors come across worrying scans.
But routine operations on the NHS have been cut back drastically to make room for Covid-19 patients during the first wave, and are still not back to normal levels.
The number of people admitted to hospital for routine treatments in England was still down 27 per cent year-on-year in September, and 43 per cent in August.
Drop in referrals will lead to deaths
The number of people urgently referred to a lung cancer specialist for an X-ray dropped by 75 per cent during the first wave of the Covid-19 pandemic, according to the UKLCC.
A report from the charity last month said this will potentially lead to more deaths than usual.
This would reverse the progress made in lung cancer survival over the last 10 to 15 years.
Between 2005 and 2015, five-year lung cancer survival almost doubled in England from nine per cent to 16 per cent.
Early detection of cancer, including lung, is critical for the best chance of survival. But lung cancer is notoriously caught at a dangerously late stage.
Even before the pandemic, 75 per cent of people are not diagnosed until their cancer has already spread and is less treatable.
Only 15 per cent for people diagnosed with the most advanced stage of disease will survive a year compared to 80 per cent of those diagnosed in the earliest stage.
Call for awareness
The UKLCC is calling for a ‘Be Clear on Lung Cancer and Covid-19’ campaign from the Government to increase awareness of lung cancer symptoms and differentiate with Covid-19.
Health authorities in Greater Manchester are already working on a campaign, according to the Manchester Evening News.
Adverts will be plastered in bus shelters reminding people who have had a cough for three weeks that they need to get it looked at and not assume that it is due to Covid-19.
Another new report today from lung cancer organisations, including the UKLCC and Roy Castle Lung Cancer Foundation, has urged against the use of phone calls to deliver bad news to lung cancer patients during the pandemic.