Beaumont RCSI Cancer Centre

Lung Cancer

Lung CancerAbout Our Lung Cancer Service

Each year in Ireland over 2700 people are diagnosed with lung cancer. It is the fourth most common cancer in Ireland, after prostate, breast and colorectal cancer. However, it is the cancer that leads to the highest rate of cancer deaths in Ireland and worldwide. Beaumont RCSI Cancer Centre is one of 8 cancer centres designated by the National Cancer Control Programme to treat lung cancer and we have a Rapid Access Lung Cancer Clinic for patients referred by their Doctor with a suspicion of lung cancer.

We use a multidisciplinary team approach to coordinate our care for you. We hold a weekly multidisciplinary team meeting (MDM) where a broad range of professionals, including Respiratory Physicians, Cardiothoracic Surgeons, Specialist Nurses, Medical and Radiation Oncologists, Pathologists and Radiologists, meet to plan tests that are needed by you and to make decisions about your treatment.

We maintain strong links with Our Lady of Lourdes Hospital Drogheda as there is often a crossover of patients between our hospitals with investigations or treatment, and also St James’s Hospital which provides lung cancer surgery for our patients.

We are proud to have become a member of the White Ribbon Project in 2021, an international advocacy service for patients with lung cancer. This project was founded in the USA in 2018 and “it seeks to amplify a message that lung cancer awareness must include prevention, early detection, treatment, research, and survivorship.”

  • Your Lung Cancer Team

    Respiratory Consultants

    Professor Ross Morgan – Respiratory Consultant Beaumont Hospital

    Professor Emmet O’Brien – Respiratory Consultant Beaumont Hospital

    Professor Dan Ryan – Respiratory Consultant Beaumont Hospital

    Dr Ian Counihan – Respiratory Consultant Our Lady of Lourdes Drogheda

    Nurse Specialists

    We have a number of nurse specialists in the lung cancer service. The role of our Lung Cancer Coordinator nurses is to provide information, education and support to you throughout your cancer journey. You will meet with them in the RALCC or as an inpatient on the wards and can phone them if you have any questions after your visit. Our Advanced Nurse Practitioner leads a surveillance and survivorship service for patients. The lung nodule surveillance clinic is used for patients with lung nodules where there is a lower suspicion of cancer but need a series of CT scans over time to monitor a lung abnormality. The survivorship clinic is for patients that have had radical treatment for lung cancer e.g. Surgery, Stereotactic Radiotherapy or Radical chemotherapy/radiotherapy.

    • Salomy Palpath Matthew Lung Cancer Coordinator Beaumont Hospital 01 8528378
    • Careline Geisha Kirubakaran Lung Cancer Coordinator Beaumont Hospital 01 8528792

    If your care will take place in Our Lady of Lourdes Drogheda you can contact the Clinical Nurse Specialist there.

    Grainne Cogan or Smitha Kenson 041 9837601 Ext 8314 Bleep 686

    Lung Cancer Surveillance and Survivorship Clinic

    The lung cancer surveillance and survivorship service is a nurse led service. It is managed by a Registered Advanced Nurse Practitioner (ANP). The ANP is a nurse with expert knowledge and experience in the management of lung cancer. The ANP has specialist training and skills to make independent decisions about your care and treatment. The service is designed for patients who have finished their cancer treatment and require monitoring for signs of cancer recurrence or to manage any long term and late effects of the treatment. The service also aims to help improve the general physical health of people attending through healthy living information and to achieve your best possible health to live well beyond cancer.

    • Claire Bolton Advanced Nurse Practitioner Beaumont Hospital 01 7974222

    Cardiothoracic Surgeons:

    Surgical management of lung cancer takes place mostly at St James Hospital. Surgeons from St James attend the multidisciplinary team meetings. This ensures that all patients have an opportunity for surgical review

    • Mr Ronan Ryan
    • Mr Gary Fitzmaurice
    • Mr Vincent Young

    Medical Oncology:

    Medical Oncology consultants provide expert opinion at the MDM about the best type of systemic treatment (e.g. chemotherapy, immunotherapy or targeted therapy) for your type of lung cancer.

    • Professor Oscar Breathnach
    • Professor Jarushka Naidoo

    Radiation Oncology:

    Radiation Oncology consultants provide expert opinion at the MDM about radiotherapy and its potential role in the treatment of your lung cancer.

    • Dr Nazmy El Beltagi
    • Dr David Fitzpatrick

     Pathology Consultants

    A Pathologist looks at the cells from your tumour biopsies under a microscope to determine the type of lung cancer you have. This helps us in deciding the best treatment for you.

    Radiology Consultants

    A Radiology consultant will review your scan imaging to determine the location and how widespread your cancer is. This helps to decide what treatment is most suitable for you.

    Cancer Data Manager

    Our Cancer Data Manager collects details about your treatment. This information is used to monitor the quality of care we give through audit. This gives us a picture of our overall activity so we can effectively plan our service to meet your needs.

  • Referrals and appointments

    Your Doctor may refer you to our Rapid Access Lung Cancer Clinic (RALCC) if they suspect you have lung cancer.

    Contact: 01 8093484

    You may also be referred as an inpatient or from another service to our Respiratory Consultants.

     

  • Rapid Access Lung Cancer Clinic

    Why has my doctor sent me to the Rapid Access Lung Clinic (RALCC)?

    Your family doctor (GP) or Hospital doctor has sent you to the lung clinic as they are concerned about your symptoms or the recent findings of your chest X-ray or CT scan. Your doctor would like you to be seen by a specialist lung doctor.

    Where will I find the Rapid Access Lung Clinic?

    The lung clinic is located in the main outpatients department in Beaumont Hospital. The clinic is situated in clinic B and runs on Monday afternoons. If unsure where the main outpatients department is, please ask at main reception for directions.

    What happens at the Rapid Access Lung Clinic?

    Please note: You may be required to have a CT scan before attending the clinic, if this required you will be informed.

    If you take any medications, please bring a list of these to the clinic as it will helpful for the doctor who is going to see you. We advise that you bring someone (relative/ friend) with you to the clinic as it may be difficult to remember everything the doctor and nurses have discussed with you.

    1. Firstly you will be checked in by the Rapid Access Lung Clinic secretary.
    2. At the clinic, the doctor will ask you about your symptoms, examine you and decide if further tests are required.
    3. The lung nurse specialist will meet with you and help to organise and co-ordinate any further tests that may be needed.

    Once you have attended the clinic, you will be given phone contact details of the Rapid Access Lung Nurses. This phone service will be open for you to avail of support and advice during your diagnostic tests. Many of these tests are performed as an outpatient or as a day case admission. This means you are very unlikely to need an overnight stay in the hospital for any of your investigations.

  • What is Lung Cancer?

    Cancer occurs when cells in your lungs change and begin to form a lump or nodule and this growth is known as a tumour. Cells from this tumour may break away from the growth and spread to other parts of the body.

    A Pathologist will identify the type of lung cancer you have by looking at cells from the tumour with a microscope. Determining the type of lung cancer you have will help decide the type of treatment best suited to you.

    Non Small Cell Carcinoma (NSCLC)

    There are four main types of NSCLC

    Adenocarcinoma: The most common type of lung cancer. Adenocarcinomas are usually found in the outer regions of the lungs where mucus is made.

    Squamous cell carcinoma: This type of lung cancer can be found in the squamous cells (flat cells) that line the inside of the airways.

    Large cell carcinoma: This type of lung cancer may appear in any part of the lung tissue. The cells appear large and round when examined under a microscope. These cells can tend to spread quickly.

    Not otherwise specified (NOS): This is when the cells have been looked at under the microscope and the doctor cannot be sure which non-small cell lung cancer they are.

    There are >12 types of ‘molecular’ subtypes of lung cancer based on the results of testing the genomic features of the tumour. This applies to non-squamous lung cancers.

    Small cell lung cancer (SCLC)

    Approximately 1 in 7 of all lung cancers are a small cell type.  Small cell lung cancers tend to behave differently to non- small cell lung cancers. Small cell lung cancer usually starts to develop in the airways in the centre of your chest. It can grow at a rapid rate and unfortunately can spread quickly too.

    Mesothelioma

    Mesothelioma is a rare type of cancer and affects the cells in the protective lining that cover the lungs. This lining is known as the pleura. Usually this cancer occurs to individuals who may have been exposed to a chemical called asbestos in the past.

  • Signs and Symptoms of Lung Cancer
    • A cough that does not go away or gets worse.
    • Coughing up blood or rust-coloured sputum (spit or phlegm)
    • Chest pain that is often worse with deep breathing, coughing, or laughing.
    • Hoarseness.
    • Loss of appetite.
    • Unexplained weight loss.
    • Shortness of breath.
    • Feeling tired or weak.
  • Risk Factors for Lung Cancer

    Smoking: Smoking causes about 9 in every 10 lung cancers. The risk increases with the amount of time you have smoked, the number of cigarettes you have smoked and if you started young. Low-tar cigarettes do not reduce your risk.

    Passive smoking: Inhaling other people’s cigarette smoke increases the risk of lung disease and cancer. But the risk is still much less than if you smoke yourself.

    Chemicals: Certain chemicals such as asbestos, uranium, metal dust and fumes, nickel, paints, diesel exhaust, nitrogen oxides. These risks are higher if you smoke as well.

    Air pollution: May be a cause in certain countries, for example PM2.5.

    Radon gas: Radon is a radioactive gas found naturally in the soil. But if your home traps it inside, it can build up and cause harm.

    Family history: If you have a parent, brother or sister who has had cancer which started in their lung, your risk is doubled.

  • Investigations for Lung Cancer

    What tests may need to be organised after the clinic appointment?

    Chest X-Ray: A picture of your lungs.

    CT Scan: This gives a detailed picture of inside your lungs. For more information about CT Scan click here.

    PET scan: Full body scan that gives clarity on any abnormalities which may have been seen on CT scan. Unfortunately this scan cannot be done in Beaumont Hospital. The doctor and lung nurse can give you more information about this test if needed.

    Bronchoscopy: This test allows the doctor to have a lung inside your lungs with a tiny camera. If you are having a bronchoscopy done your doctor and lung nurse can give you more information.

    Endobronchial Ultrasound (EBUS): An EBUS is another type of camera test to look inside your lungs. If you are having an EBUS done your doctor and lung nurse can give you more information.

    Radial Endobronchial Ultrasound (EBUS): A radial EBUS is another type of camera test to look inside your lungs, which combines a camera test and an ultrasound. If you are having a radial EBUS performed your doctor and lung nurse can give you more information.

    CT guided lung biopsy: A CT guided lung biopsy takes a tiny sample of lung tissue with the help of the CT scanner. This test is a day procedure and if this is required your doctor and lung nurse can give you more information.

    Pulmonary Function Tests: Also known as PFT’s, they are non – invasive breathing tests. They can help your doctor decide treatment and help diagnose certain lung disorders.

    PD-L1 testing: The lung biopsy sample will undergo a special test, to identify whether a patient is a good candidate for immunotherapy treatment.

    Molecular testing: The lung biopsy sample +/- a blood sample may undergo a special test, to identify the features of the lung cancer that may lead to a targeted treatment option.

    Once further tests have been completed, these results will be discussed at a multidisciplinary meeting and a treatment decision is made.

  • Treatments for Lung Cancer

    Once you have been diagnosed with lung cancer you may need to have more tests done to stage your cancer. Staging is where we check the size of the cancer and how widespread it is. The multidisciplinary team meets weekly and will review all your test results to decide the treatment that suits you best. You may have a single treatment or a combination of treatments. Your Doctor and Nurse will discuss your treatment options with you in the clinic when you have been diagnosed and give you more information about your treatment plan. You can contact the nurse specialists after clinic if you have any questions about the information you have received or need support. The main treatments used for Lung Cancer are.

    Surgery

    If you have an early stage cancer and are medically well enough you may be suitable for surgery. You will need breathing tests to check how well your lungs are functioning and will meet a cardiothoracic surgeon.

    Radiotherapy

    Radiotherapy can be given on its own or in combination with other treatments. It can be given as a curative treatment on its own for early cancers. This is known as Stereotactic Radiotherapy. It may also be given in combination with chemotherapy or on its own to manage symptoms from cancer such as breathlessness or pain. For more information click here.

    Systemic Anti-Cancer Therapy

    Systemic anticancer drug therapies are medicines that include chemotherapy, targeted drugs and immunotherapy. These are prescribed by a medical oncologist. For more information on these medicines click here.

     

  • Supports and Contacts

    Irish Cancer Society

    Beaumont Hospital Daffodil Centre

    Opening Hours: Monday to Friday 8am -4pm

    Tel: 01 7974880

    ARC Cancer Support Centre

    557/559 South Circular Road, Dublin 8

    Tel: 01 7078880

    Gary Kelly Cancer Support Centre

    George’s Street, Moneymore, Drogheda, Co. Louth

    Tel: 041 980 5100

    Irish Lung Cancer Community

    The ILCC is Ireland’s first patient advocacy group dedicated to lung cancer. The group hold regular fireside chats and other events to support patients that their families affected by lung cancer. Click here to find out more

    White Ribbon Project

    Marie Keating Foundation

  • Have you thought about quitting smoking?

    If you do smoke, it is never too late to quit. If you would like advice on how to do this please speak to any of our doctors or nurses.

    Beaumont Quit Smoking advisors 01 8092941

    Quitline 1800 201 203 or try the webiste QUIT

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