Spirometry test

[Stayp0sitive]

Sorry for what is a bit of a stupid, long and rambling post, I had lung function test back in April, stupidly didn't know you were not supposed to smoke before it so carried on as normal till test time early afternoon, also had just finished a course of anti-biotics for a chest infection ( this is when my journey started) I subsequently had very bad results which is kind of putting surgeon off operating. Does anyone know if smoking and chest infection would have made a difference with my results or if they would most likely be about the same. Thankyou for reading

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Hi StaypOsitive

It is usually advised for the person not to smoke for 24 hours prior to the lung function tests as this could impair the results, as could the chest infection.

You could perhaps ask them if they would consider repeating the lung function tests; it may be that they are concerned that your current impaired lung function is not just an anesthetic risk but also to your lung surgery recovery with smoking.

If you are interested in stopping smoking, and it is never too late, you can discuss this with your GP or contact those on our QUIT smoking forum: healthunlocked.com/quitsupport

If you would like to discuss anything further you can call our nurse led helpline number on 0800 358 7200 Monday to Thursday 0900-1700 and Friday 0900-1600 alternatively you can email ask the nurse at [e-mail]

All the very best to whatever treatment you have.

Kind regards

The Roy Castle Support Team

[JanetteR57]

If you smoke all the time, then that it the pattern of your usual breathing - but a chest infection could well affect your breathing pattern.

Years ago the salesmen where I worked used to have an annual health check and for a week before they'd lay off the booze and usual food so their cholesterol/BP were better than the reality.... the only people we're kidding when we do such things are ourselves.

Is there any way you could switch to vaping or quit altogether? I know it's an addiction and not easy to do but those who do have lung cancer and continue to smoke during their treatment, it's evidenced that they have worse outcomes and worse side effects. Eligibility for lung surgery is usually based on several clinical factors - fitness to tolerate the surgery and hopefully avoid unnecessary side effects, position of the tumour and any other conditions the patient has being amongst factors to consider. Recovery can be improved by keeping active and after surgery but smokers are often less active than others.

Could you speak to whoever referred you for the tests and explain you've had a chest infection if that wasn't clear at the time? if it was clear, they'll no doubt consider any impact that may have had - maybe ask if they could be redone for comparison? such services are in high demand so if surgery is an option, they usually like to proceed relatively quickly although the majority of UK patients are detected when surgery isn't a viable option.

[Stayp0sitive in reply to JanetteR57]

Thankyou for your reply, I hadn't been to a gp for about 12 years until March of this year, no ill health or meds for anything, then antibiotics for chest infection and told stage t2b n1 m0 adenocarcinoma lung cancer and emphysema, no symptoms for either, I haven't smoked for 5 weeks now as was told right at the beginn8ng surgery would not be an option if i was still smoking, have not had any kind of treatment yet, have rung hosp and waiting for them to ring back as I'll ask for a repeat test if possible 😊

[JanetteR57]

Well done on not smoking for the last 5 weeks - a great start. Also good that it's been caught earlier. I was like you - hadn't been to the GP for a while but had very strange sudden onset symptoms for me one Friday night and went to A&E (not a good time to go). A chest x-ray was taken and I was put on steroids and antiobiotics and I felt really seriously ill but had no idea what was wrong. Despite having had childhood/early adult asthma and chest infections, this was totally different. Anyway, I was eventually discharged with meds after over 7 hours but readmitted the next night (after midnight) and kept in for a week misdiagnosed as uncontrolled asthma. However I didn't respond to asthma meds but not having been ill or having had the symptoms for long and being a non smoker, no urgency was put on things and a CT was requested for a couple of weeks' time as by then I was coughing too much to have a CT scan. The scan appointment was cancelled as the scanner was broken and parts had to be ordered so more weeks went by before the CT scan then PET scan then surgeon appointment, pulled forward by a couple of weeks. I had open surgery in December and was back at work and swimming by the end of March. That was in 2010/2011 and it turned out my tumour was a 7cm adenocarcinoma also stage t2b but mine wasn't in my lymph nodes so didn't have mop up chemotherapy.

Treatments and investigations have changed immensely since that time and the majority of lung surgery now is keyhole rather than open, treatments are more targeted to specific types and there are many more treatments.

Lung surgery requires not only theatre space and a recovery bed but also a bed in ICU post recovery which is often the major delay factor for many hospitals. Good luck.

[Stayp0sitive in reply to JanetteR57]

Wow what a journey you've had 🩷how are you doing now, I would never do anything that would affect my quality of life and I know the treatment now is so much more advanced but I would be forever wondering if my lung function test was better than my score and had been impacted by smoking and infection, otherwise all tests came back fine for surgery, heart etc was all good, it's the no symptoms of emphysema as I'm a generally fit, healthy person, no harm in asking them they can only say no 😊

[JanetteR57]

I recovered well, thanks - I've worked, travelled and swam ever since - going onto swim much much further than the 130 lengths 2-3 times a week that I was doing before my surgery although recent chest infections have impacted my fitness but I'm forever grateful for my second chance!

I was told my specific rare type didn't respond to chemotherapy so didn't have anything other than 'active surveillance' as follow on 'treatment'.

I've been involved in LC research since the end of 2013 and seen firsthand the many many changes made in all types of treatments for lung cancer - no mode of treatment remains the same as back then - ablation (SABR/cyberknife) didn't exist, EBUS (used for diagnostic) didn't exist, keyhole surgery wasn't around, targeted therapy only existed for a specific mutation (EGFR) and then only on clinical trials and as I didn't have it, that didn't apply to me and immunotherapy wasn't in use for lung cancer. The arsenal now of treatments in different combinations and much greater research has revealed much more about the many different types and stages which respond differently.

Now there are things you can do to prepare for surgery in improving fitness and post surgery and studies are being done on treatments before surgery and after surgery to see what difference they might make.

I agree - no harm in asking - also ask if it was borderline or negative, would any lifestyle changes you could make in terms of the smoking/being more active might improve it enough to make surgery a possibility? good luck.