Lung Faster Diagnosis Service

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St Richard’s Hospital

What happens next?

You have been referred to the Faster Diagnostic Service at the hospital for an assessment of your respiratory symptoms.

This booklet will explain how the Faster Diagnosis Service works and what to expect next.

Further investigations will now be arranged to provide us with more information to rule out cancer or to make a diagnosis. The types of tests will vary from person to person due to the range in presentation of symptoms and pre-existing health conditions. 

Your appointment today

You have been seen in a 2 Week Rule Respiratory Clinic.

Patients are usually referred to this clinic by their GP or health care professional for symptoms that might indicate a serious condition that can sometimes include cancer.

A Respiratory Consultant has seen you to take a history of your symptoms and ask about your general health, medications, smoking history and asbestos contact.

Investigations that you have had prior to attending this clinic will have been discussed with you such as results of a Chest X-Ray, CT scan or blood tests.

Clinic Date:

Consultant Respiratory Physician:

Faster Diagnostic Nurse:

Your investigations so far have shown:

We think this might be:

What tests am I likely to need?

Different tests give us different information about you and your lungs. You may need more than one test.  You will be given more information about the test you need to have including any risks and benefits. You may require one or more of these investigations for us to obtain a tissue diagnosis.

The most common tests are:

• Lung Function Tests: To establish how well your lungs are working. Performed at St Richards Hospital in the Outpatients department.
• Blood Test: To help us find out about your general health. Taken in St Richards’s Hospital Pathology 1st Floor of the Outpatients block.
• CT Scan: This is a type of scan that gives a 3D picture of your body’s organs. Performed at St Richards Hospital Radiology Department.
• PET- CT Scan: This type of scan helps to identify areas of your body where cells are more active than normal.Performed at Portsmouth PET-CT Centre, Queen Alexandra Hospital, Southwick Hill Rd Cosham PO6 3LY.

• Bronchoscopy: This procedure allows the doctor to examine, photograph and when possible, take washings or a small biopsy of tissue from inside the airways/lungs. Performed at St Richards Hospital in the Endoscopy department on a Tuesday or Friday morning.
• Endobronchial Ultrasound (EBUS): Similar to a bronchoscopy but uses ultrasound to take a small biopsy of tissue from lymph nodes in the chest. Performed at St Richards Hospital in the Endoscopy department on a Wednesday morning.
• Ultrasound Guided Biopsy: Uses ultrasound scanning to identify the most useful area in the body, to take a tissue biopsy sample from. This is performed in Ultrasound department at St Richards Hospital.
• CT Guided Lung Biopsy: This procedure uses CT scanning to identify an area in the lung to take a tissue biopsy sample from by passing a needle through the skin under local anesthetic This is performed in department at St Richards Hospital.
• Surgical Biopsy: A surgical procedure to examine lymph nodes in the chest or take a section of tissue from the lung. This type of test involves a general anesthetic and a short stay in hospital.  This will be performed at St Georges Hospital London with an outpatient pre assessment appointment at St Richards Hospital.
• Other tests:

Your results

Once we have the results, your results will be discussed at our multi-disciplinary team meeting which is held on Monday afternoons. This is where a team of health care professionals from different lung specialties agree on your diagnosis and decide what they feel would be the best treatment plan for you. The team includes Lung Cancer Clinical Nurse Specialists, Respiratory Doctors, Radiologists, Medical Oncologists and Thoracic Surgeons.

It is important to remember that every person is individual and no diagnostic and treatment pathway will be the same. Plans can change based on the investigations we do and we may need to call you with further investigations. We will explain what the test involves and can also post or email information to you.

We may speak to you over the phone or in a clinic appointment to discuss the results.

Useful resources

• Macmillan Cancer Support 0808 808 0000  
• www.macmillan.org.uk 

• Roy Castle Lung Cancer Foundation 0333 323 7200 
• www.roycastle.org 

• British Lung Foundation 08458 505020  
• www.lunguk.org

• Smoking cessation
• https://www.westsussexwellbeing.org.uk/local-service 

Consultant team

• Dr Bethia Bradley 
• Dr Paul Tate 
• Dr David Jennings 
• Dr David Lodge 
• Dr Dominic Reynish