Why that TB diagnosis could turn out to be lung cancer

Portrait of a woman on a white background. [Photo: Courtesy]

Nearly half of lung cancer patients die after being misdiagnosed with tuberculosis.

Many clinicians, research has revealed, put patients with these symptoms; coughing, weight loss and shortness of breath on TB medication at first observation.

This is even when tests later show the patient did not have the disease.

The findings were presented during the fifth Kenya International Cancer Conference held between November 15 and 17 in Nairobi.

Fredrick Chite, a medical oncologist and haematologist at the Moi Teaching and Referral Hospital (MTRH), said the observations were made from 154 patients who sought treatment at the facility.

“When we asked them (clinicians) what they do when the patients do not respond to the drugs, they said they simply switched to medication for drug resistant TB,” said Prof Chite.

Of the MTRH patients, 130 had masses in their lungs. Fifty-two had malignant growths with 42 confirmed as lung cancer, while 10 had metastatic diseases that are not related to lung cancer.

Patients died

Nineteen of the lung cancer patients later died.

Chite said the biggest challenge with such patients visiting health centres was that once they showed up with TB-like symptoms, they were put on tuberculosis medication.

This also happened even after an X-ray was done and it revealed a mass of any type.

“But they forget that it does not mean that everybody who has a lung mass has lung cancer,” the oncologist said.

Chite said 152 of the patients he saw at MTRH had lived with the symptoms for at least eight months. During that period, they had been examined by radiologists and other health professionals who concluded they had TB.

“Our patients come very late. We even have patients who have had up to 16 visits, but the cancer was never diagnosed. But this is not the problem of the patients; it is a problem with the referral system,” he said.

Chite said radiologists in rural health centres did not have the expertise to identity which abnormal mass could be cancerous because both TB and lung cancer presented the same symptoms

Killer cancers

“We are not looking for these patients; we sit and wait for them to come to the hospital. Our system of referral is also poor. It is no surprise that they walk to a health centre with a cough and they are put on TB drugs.”

Though lung cancer is not among the top five killer cancers in the country, smoking has been linked with exposing millions to the disease.

On the other hand, at least 29,000 Kenyans died from TB last year, according to a report by the World Health Organisation.