Doctor issues plea after startling number of lung cancer cases diagnosed in ER

A new study on lung cancer in Nova Scotia shows an alarming number of lung cancer cases are diagnosed in the emergency department, and the prognosis for those patients is grim.

The results are driving Dr. Daria Manos, a Halifax radiologist, to plead with people to seek medical advice if they suspect they have ongoing issues with their lungs and breathing.

“It is horrible when you see somebody come through the [emergency department] with a cough and leave with a diagnosis of lung cancer,” she said.

Manos, head of thoracic radiology at the QEII Health Science Centre, worked with other radiologists, an emergency department physician and an epidemiologist to study all the lung cancer diagnoses in the province in 2014.

Their work, the first study of its kind in Nova Scotia, was published recently in the CMAJ Open.

Alarming numbers

Of the approximately 1,000 lung cancer cases, a third were diagnosed in the emergency room. Of those patients, three-quarters died within one year.

“I worry a little bit that these results will be scary for Nova Scotians,” said Manos, who is hoping that the awareness will drive people to have their symptoms checked sooner.

Those symptoms include coughs that won’t go away, a new shortness of breath, or coughing up blood.

Many might assume that the emergency department visits are high because of Nova Scotia’s shortage of family physicians, but Manos is quick to point out that’s not the case.

In 2014, 10 per cent of the population didn’t have a family doctor, according to Statistics Canada. Manos said of those diagnosed in the ER, only seven per cent were without a family doctor.

People may ignore symptoms

One of the key problems, she said, is that people are ignoring their symptoms.

“Often, unfortunately, with lung cancer, they’re ashamed because of the high association with smoking,” she said. “And another reason is that they’re afraid of the cancer diagnosis.

“So they may have a rumbling suspicion in the back of their head that, ‘Geez, this might be a sign of lung cancer and they just don’t want to deal with it.'”

The results also give added weight for her push to establish an early detection program in Nova Scotia, she said.

While the province screens for cervical, colon and breast cancers, Manos said the health-care system needs to screen lungs as well.

“It’s necessary,” she said.

The Nova Scotia Health Authority has said in the past that a screening program could be possible in the future, but it will take time and money to set up.

In the meantime, Manos said people need to realize that cancer treatment has come a long way.

“Your best chance of survival and doing well is finding your cancer early. So I would hope that people would be encouraged to seek medical attention early instead of sitting on those symptoms and ignoring it,” she said.