Your Mesothelioma or Lung Cancer Diagnosis

Your consultant will review your medical history and imaging, assess your current symptoms and if required may recommend additional diagnostic procedures, which take place at Bupa Cromwell Hospital.

The range of diagnostic tests and other services available in the Lung Cancer and Mesothelioma Clinic include:

  • Bronchoscopy and biopsy (direct examination of the airway with a fibreoptic instrument and a camera - this is performed under sedation)
  • Chest Computed Tomography (CT) and CT-guided biopsy
  • Chest MRI
  • Chest X-ray
  • EBUS-TBNA transbronchial needle biopsy under ultrasound guidance
  • Echocardiogram and Coronary Angiography (Echocardiogram, this is an ultrasound of the heart. Coronary Angiography, involves an injection of contrast placed into the heart arteries to diagnose or rule out coronary artery disease)
  • Liquid biopsy looking at circulating tumour DNA in blood sample
  • PET-CT
  • Pulmonary function test (spirometry) and full cardiopulmonary exercise test (MVO2 max)
  • Ultrasound scanning

The results of the investigations will be assessed on site by a Consultant Radiologist, a Consultant Oncologist and a Consultant in Thoracic Surgery.


Second opinion diagnosis

You may already have a diagnosis and may be looking for a second opinion on your problem.

Our consultant’s team are very experienced with the management of complex cases. We receive referrals from all over the world for second opinions or complex treatment.

We often see patients who have been turned down for surgery elsewhere due to poor lung function, co-morbidities or extensive tumours. We often operate on patients who would not be offered surgery at other centres, with good outcomes.

Our team is familiar with minimally-invasive procedures or extended resections for lung cancer and operations following induction therapy with chemotherapy or radiotherapy.

We do accept patients presenting with complications following previous surgery. We also welcome patients presenting with relapse of lung cancer or any other thoracic tumour following previous treatment.

Our consultants will be glad to give their views on your problem and help you make the best choice possible.

You can either visit us in London or send your documents and imaging by post or email for our review. Please note, if your documents are sent for review payment arrangements will have to be made prior to the consultation.


Multi-disciplinary approach to Lung Cancer and Mesothelioma diagnosis

Difficult decisions and treatment are discussed by leading consultants in:

  • Anaesthesia
  • Clinical Oncology (radiotherapy)
  • Critical Care Medicine
  • Haematology
  • Histopathology
  • Medical Oncology
  • Microbiology
  • Nuclear Medicine
  • Palliative Care
  • Radiology and Interventional Radiology
  • Thoracic Medicine and Interventional Bronchoscopy
  • Thoracic Surgery

Occasionally, we may obtain opinions from colleagues in:

  • General, Hepato-biliary and Laparoscopic Surgery
  • Neurosugery
  • Urology


Physiotherapy and Nutrition

We believe that active and passive physiotherapy is an essential part of treatment following thoracic surgery. We rely on an experienced team of Thoracic Physiotherapists who will discuss your operation and establish a rehabilitation program with you, prior to your operation. Our Physiotherapists will visit you several times daily after your operation.

Optimising your nutritional status is essential before and after a thoracic operation. It is widely demonstrated that adequate nutritional status is key to improving effectiveness of your treatment, long term survival, quality of life and limit complications after surgery.

Our team of experienced Dieticians are able to assess your needs and implement an individualised nutrition plan before and after your operation. They can also provide you with support should you require chemotherapy treatment after your operation.


Pain control

If you are scheduled for surgery, one of our Anaesthetists will come and discuss with you the type of anaesthetics required and the postoperative analgesia. For most complex cases, an epidural catheter or a paravertebral catheter are used to give you the best possible pain relief following your operation.

These are usually placed by the Anaesthetist or the Surgeon in theatre, before or during your operation. Local anaesthetics are continuously infused near your spinal cord through a small catheter placed in your back and left in place for two to four days. Alternatively, the Surgeon may inject local anaesthetics directly into the chest wall at the end of your procedure and the anaesthetist will set up a patient-controlled analgesia system (PCA) by connecting a small venous cannula to a pump and a patient-activated button while you are in the recovery area.

This will allow you to inject small boluses of morphine intravenously every time you press the button. Once the chest drains have been removed and the pain is mild to moderate, pain will usually be controlled by pain killers given orally (morphine or related drugs).