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Lung cancer is the second most common cancer among adults and the leading cause of cancer-related deaths in both men and women, with over 70% of cases diagnosed at an advanced stage.
In Alberta, 1 in 13 people are expected to develop lung cancer in their lifetime though early detection through screening in high-risk individuals is improving outcomes.
Contact the treating oncologist to determine how to refer the patient back to the cancer centre. If the oncologist's contact information is not available, search 'lung cancer' in the Alberta Referral Directory for the most up-to-date information and instructions for referral.
Lung cancer is being increasingly diagnosed in never/nonsmokers. Signs and symptoms of lung cancer are often only present in advanced stage disease (stage 3 & 4).
Presentation of any of the Following
Hemoptysis
New finger clubbing
Suspicious cervical lymphadenopathy
Dysphagia
Features of metastatic lung cancer
Features suggestive of paraneoplastic syndromes
Unexplained Symptoms for > 3 Weeks (or sooner in patients with risk factors)
Cough
Weight loss/loss of appetite
Shortness of breath
Chest and/or shoulder pain
Abnormal chest signs
Hoarseness
Next Steps
Order chest x-Ray (PA & LAT) using diagnostic imaging requisition. For triage include: risk factors, relevant history, area of concern
Order baseline bloodwork (CBC, extended electrolyte, liver function test)
Presentation of Any of the Following
Two or more episodes of hemoptysis (1 tbsp/15ml or more of clotted blood)
Supraclavicular lymphadenopathy
Incidental CT finding: any solid or ground glass nodule greater than 1cm
Abnormal Chest X-Ray Findings Triggering Suspicion of Cancer
Single or multiple pulmonary nodules
Mediastinal or hilar lymphadenopathy
Unexplainable large unilateral pleural effusion
Infiltrate, consolidation or effusion attributed to pneumonia and not resolved in 6-week follow-up X-ray
Next Steps
Order CT scan with contrast of thorax, abdomen and pelvis. Using diagnostic imaging requisition. Include: risk factors, relevant history, previous related test results
Order baseline blood work (CBC, extended electrolyte, liver function test)
Urgent referral to Alberta Thoracic Oncology Program (ATOP)
To be Managed at the Emergency Department
Signs of superior vena cava obstruction (swelling of the face or neck with fixed elevation of jugular venous pressure, prominent veins on chest)
Stridor
Massive hemoptysis (more than 1 cup/250ml in 24 hrs)
New neurological signs (suggestive of brain metastases or cord compression)
Creating Safe Connections: Towards Equity-Informed Preventative Care
Free e-learning course from The University of British Columbia helps primary care providers integrate equity-oriented, trauma- and violence-informed care (TVIC) into their practice. Using lung cancer screening and smoking cessation as examples, it teaches how to address barriers to healthcare access. The course supports policy development for TVIC in clinical settings.
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