As well as striking a devastating blow to his wife, Cathy, and their three children, the news of Brokenshire’s death has shone a spotlight on lung cancer, an illness that experts say is often misunderstood. It is among the most common forms of cancer in the UK; each year, about 47,000 people are diagnosed and 35,000 die. The over-75s are particularly at risk, but the fact that the disease can often be mild or mistaken for something else, and thus diagnosed at an advanced stage, means that it can also be a killer of younger adults.
For Brokenshire, a fit non-smoker, the early signs of his cancer were difficult to ignore. He was enjoying a weekend break with his family in Northern Ireland in September 2017 when he first noticed he’d started to cough up blood – a “slightly surreal” experience, he told the Telegraph in 2018. On the day he returned he booked an appointment with his GP and was eventually sent for a bronchoscopy. Within weeks, Brokenshire was told he had a cancerous lesion on his lung, requiring serious surgery.
But for other patients, early signs of lung cancer are not anywhere so dramatic and might be much harder to spot, says Karis Betts, health information manager at Cancer Research UK. A common early symptom is a cough that doesn’t go away after two or three weeks, or a pre-existing cough that gets noticeably worse. Unfortunately, there are lots of illnesses, infections and chronic health problems that can leave somebody with a persistent cough, which makes it extra difficult to spot lung cancer, says Betts – particularly now there an estimated 962,000 people in the UK suffering self-reported symptoms of long Covid (which also often leaves sufferers with a persistent cough).
Other signs include recurrent chest infections, coughing up blood, an ache when breathing, persistent tiredness, lack of appetite and unexplained weight loss.
Lung cancer is still considered by many to be a “smoker’s disease” and smoking is indeed responsible for about 70 per cent of cases, according to the NHS. But that means 30 per cent of cases are not linked to smoking, doctors stress. Brokenshire had never smoked.
Often, it’s difficult to tell what caused the disease. Paul Nicholson, 69, a construction worker from Newcastle, was diagnosed in 2015 after noticing pain in his lower stomach. He smoked regularly between the ages of 18 and 40, but he personally blames his diagnosis on the years he spent around chemicals like asbestos as part of his job.
“My wife and I were just totally devastated. It shocks you to the core,” he says. Nicholson didn’t like it if anyone used the word “cancer” around him. He and his wife were never able to have children and he hated the thought of leaving her alone after he died. “I know everybody’s got to go one day, but to leave somebody that you love and who looks after you… we’d been together for 40-odd years, it would have been a travesty if I had to leave her.”
He received a combined course of chemotherapy and radiotherapy and, in 2016, underwent a broadly successful operation in which the upper-right lobe of his lung was removed. The cancer has not fully gone away, but he was able to return to work six months after the operation and says he now lives a normal life. He attends an annual CT scan and has a chest X-ray every six months.