February 2020

By Dr Helen McDill, Respiratory Registrar and Interventional Respiratory Fellow, Derriford Hospital, Plymouth NHS Trust

What a fantastic 3 days at BTOG 2020 – I have returned back to work full of ideas and enthusiasm about how to improve our lung cancer pathways from all the fantastic research, presentations and engaging speakers I had the pleasure of hearing at BTOG 2020.

Being lucky enough to gain a scholarship place to present my poster I was excited to attend BTOG 2020 to help develop my interest in thoracic malignancy as a respiratory trainee. Once again the Clayton Hotel in Dublin plays host to this wonderful conference which is superbly organised by the BTOG faculty with an array of fantastic presentation and speakers, excellent receptions both evenings and a constant array of food and drink! It was a pleasure to attend with over 1000 delegates with leading experts from across the world and the community of thoracic oncology.

Having arrived in Dublin after an early flight fuelled with coffee and pastries I started the conference with the respiratory and radiology symposium which gave me a glimpse into the exciting future of respiratory medicine using whole body MR for lung cancer staging and it’s role in mesothelioma imaging, bronchoscopic ablation techniques for lung cancer and a excellent talk by Dr Sanjay Agrawal on the controversial role of e-cigarettes helping to reduce the UK tobacco’s rates as the highest across Europe. The highlight of the morning was a fantastic talk by Dr Lucy Gossage – triathlete with 12 ironman titles and consultant oncologist – who got the whole room on their feet to do the equivalent of a HIT session whilst discussing the benefits of exercise in cancer patients. Her national movement of ‘5K your way’ to encourage cancer suffers to participate in exercise is inspiring and something I will take back to my practice. The highlight at the end of day was a symposium sponsored by Astra Zeneca chaired by the amazing presenter John Humphreys who put the panel through their paces discussing the controversial role of surgery vs chemo/radiotherapy in N2 disease in Stage III lung cancer.

Day 2 kicked off with a warm welcome from Professor Sanjay Popat chair of BTOG steering Committee highlighting the multi-disciplinary focus and attendance at BTOG truly representing the whole thoracic oncology committee. I listened with fascination to research about the quick changing world of translational oncology – new potential molecular targets we will be testing, debates about the role of triple therapy in N2 disease and immunotherapy in addition. Currently working as a lung cancer fellow I was particularly interested to hear about diagnostic bundles to help speed up diagnosis in other units and how we are doing in molecular testing. Dr Christopher Marshall (Respiratory Trainee) gave an excellent presentation on the Leeds symptom awareness campaign that led to an increase in diagnosis in stage I-II curative disease from 28% to 35% and a 8% drop against national mortality, which was very topical with the recent publication of the NELSON study and the ongoing discussions regarding screening.

Day 3 started with Dr Matthew Evison from the Manchester group giving a fantastic talk on the RAPID or pathway on ‘steroids’ approach – he highlighted the role of a patient navigator, access to next day CT and clinic and daily diagnostics, that have dramatically improved times to diagnosis – although this is not achievable in every centre he highlighted the fantastic diagnostic bundles on the Roy Castle website to optimise management. Dr Paul Beckett highlighted how we should be running the optimal MDT and I’m sure everyone in the room who sits in MDT’s took something home from it. Dr Michael Crawford gave an insightful talk on missed lung cancer and how we can develop pathways to alert missed reports. The day ended with a round up of current research projects in mesothelioma showing the exciting future we hopefully have in this field.

I also particularly enjoyed many posters showing the inspiring projects going on in respiratory medicine including screening programmes, alert system to help identification of small cell and the introduction of clinical frailty assessments to aid MDT decisions.

I end as I started – inspired by BTOG 2020 and the thoracic oncology community about the exciting future of translational oncology, the ability to perform rapid diagnosis for our patients and hopefully screening programmes leading to earlier detection of lung cancer and improved survival rates. BTOG has confirmed to me I am very excited about a future specialising in thoracic malignancy in Respiratory Medicine and I hope as trainee representative to encourage respiratory trainee’s up and down the country to join BTOG, attend the conference and engage with development and research opportunities. I’m already looking forward to BTOG 2021!