SMITH · Lung Cancer

Name

John / Jane Smith

Age

65 years

Opening statement

"I have come to see you because my partner booked the appointment as I have this cough, which won't go away"

Open questions — give freely:

• Irritating cough for 3–4 months; started out of the blue (thought it was a cold at first but no runny nose)
• Coughing every day, day and night; no particular pattern
• Not really bringing up much phlegm — occasionally a bit of clear stuff
• Sometimes embarrassing (e.g. in church when everyone is quiet)
• Not stopping you doing anything
• Partner bought cough linctus from chemist — hasn’t helped

If asked about other symptoms: Wonders if a bit more out of breath on exertion than usual (hills, hard work on allotment — has to stop for a rest sometimes). Thought it might just be “getting older.” Not stopping activities.

Only if asked directly:

• Lost about half a stone over 6 months — unintentional but pleased
• Streak of blood when coughed once a few weeks ago
• Ex-smoker — 40 pack-year history; gave up 10 years ago

• Appendicectomy 1980
• Essential hypertension 2015

• Amlodipine 5 mg daily
• Tried OTC cough linctus — didn’t help

No relevant family history.

• Ex-smoker — 40 pack-years; stopped 10 years ago
• Alcohol — a couple of glasses of wine with dinner twice a week
• Lives with partner and 1 dog; 2 grown-up children
• Retired bus driver; 1–2 hours on the allotment daily; enjoys walking the dog

• Not particularly worried about symptoms; laid back
• Infrequent attender — usually only comes when told to for annual BP check