Surgical oncology referral

Lung cancer is the third most common cause of death in the United Kingdom and has an annual incidence of 35,000 cases and a similar number of deaths each year. 

Lung cancer accounts for about a quarter of all cancer deaths and 80 percent of patients die within one year of diagnosis. The majority of the cases are in current or ex-smokers.

Predominant symptoms/signs at presentation

Any of these symptoms should raise the possibility of lung cancer:

  • Haemoptysis

  • Unexplained or persistent ( > 3 weeks):

    • Cough

    • Breathlessness

    • Wheeze orstridor

    • Chest/shoulder pain

    • Weight loss

    • Hoarseness

  • Abnormal chest signs (esp. unilateral)

  • Signs of SVC obstruction (swelling of neck/face with fixed elevation of JVP)

  • Features suggestive of metastases (e.g. brain, bone, liver, lymph node)

  • Finger clubbing

In most cases, it is appropriate to arrange an urgent chest X-ray before referral to a chest physician.

Chest X-ray

  • Abnormal in the vast majority of symptomatic lung cancer patients

  • Patients with suspicious chest X-rays will be automatically referred to a chest physician (unless GP specifically requests otherwise)

  • Normal chest X-ray does not exclude lung cancer

Urgent referral to chest physician

  • Normal chest X-ray but high clinical suspicion of lung cancer (e.g. persistent haemoptyses in smoker / ex-smokers)

  • Abnormal chest X-ray in patient not automatically referred to chest physician by X-ray department

  • Symptoms / signs needing urgent assessment (e.g. SVC obstruction)


Patients are referred to us by local general practitioners, district general hospitals, secondary specialist centres, and other tertiary centres from all over the UK and the world. We provide the diagnosis, staging and surgical treatment of cancer, interventions aimed at symptoms control and long-term follow up when required.

If you need to refer a patient to us, please visit our refer a patient page.