Woolcock Helps Doctors Solve Breathlessness Puzzle


Breathless patients often present a clinical challenge for doctors. Is it the heart or the lungs behind the complaint, or perhaps it’s the muscles, or even the brain?

To tackle this common and complex clinical problem, the Woolcock Institute of Medical Research in Sydney has launched a Breathlessness Clinic. Its mission is to make a doctor’s job easier by fast tracking a diagnosis for this worrying, anxiety-inducing complaint.

Woolcock respiratory physician Dr Tracy Smith said breathlessness, or dyspnoea, is one of the most common reasons Australians call an ambulance. Despite this, too few patients are able to get their breathlessness problem resolved quickly.

“Breathless patients are often referred to a respiratory physician or a cardiologist first, only to be sent to the other specialist later,” Dr Smith said. “This process can be time-consuming and frustrating for all involved. 

“On top of that, treatment recommendations for conditions which can lead to breathlessness are constantly changing, and there are few clinical guidelines to help specialists manage problems which affect more than one organ system, for instance patients with both heart and lung disease,” she explained.

The Woolcock Breathlessness Clinic seeks to solve this problem with a new and innovative model of care. Under this multispecialty approach, patients see a cardiologist and a respiratory physician at the same time to allow rapid, comprehensive assessment. 

“This is NSW’s first one-stop-shop for breathlessness, promising to investigate, diagnose and treat all patients under one roof and in a timely fashion,” Dr Smith said. “We’ll collaborate closely with GPs to ensure they are kept informed of the patient’s assessment and treatment recommendations.”

Dyspnoea has many potential causes. It can be triggered by long-standing lung disease like asthma, or it could be linked to heart conditions like coronary disease or arrhythmia, said the clinic’s chief cardiologist Professor Len Kritharides. “And for those with daily, long-term breathlessness, it may be caused by a range of lung, heart or muscle conditions, obesity, poor fitness or a combination of things,” Professor Kritharides said. “The fact there can be multiple inputs can make this a difficult clinical problem to solve in primary care.”

The Woolcock Breathlessness Clinic is for patients who present to their GP with breathlessness persisting for 4-8 weeks or longer. The GP is recommended to conduct baseline tests and treatments for any underlying asthma, COPD or heart disease. If no improvements are seen, they can be referred to the Clinic where patients will complete a screening questionnaire, full lung function testing and chest x-ray prior to seeing specialist doctors. “All our patients see a cardiologist and respiratory physician simultaneously,” Dr Smith said. “GPs will receive detailed correspondence regarding recommendations after each clinical assessment.” 

“Our ultimate goal is to help patients identify their treatment options as quickly as possible so they can get back to living a healthy, fulfilled life,” she said.

GPs can download referral forms online at www.woolcock.org.au/referral or email the Woolcock on info@woolcock.org.au to request a referral pad.

Centre Gives Lung Patients Hope for Brighter Future

  Ms Lillian Leigh at the Woolcock Centre for Lung Cancer Research launch on Wednesday, 18 April 2018.

Ms Lillian Leigh at the Woolcock Centre for Lung Cancer Research launch on Wednesday, 18 April 2018.

Lillian Leigh gives thanks for every extra day she gets.

The 37-year-old Sydney mother is living with lung cancer, a deadly disease for which there is no cure and few effective treatments. But thanks to drug trials, her tumours have shrunk, her energy has returned and she’s been given the chance to see her daughter start kindy.

“Every time I open my eyes in the morning, I'm so grateful,” says Lillian, a lawyer turned lung cancer advocate. “I'm so grateful for every breath I take, for every extra day I get with my family, every extra day I get to be a school mum. Every single day counts.”

Lillian has thrown her support behind NSW’s first lung cancer centre dedicated to finding new treatments and ultimately a cure for the disease with the highest mortality rate of any cancer. The Centre for Lung Cancer Research, run from the Woolcock Institute of Medical Research in Sydney, will shine a spotlight on the condition that is so often neglected by funders and hidden behind the banners of ‘no smoking’ campaigns.

Its opening ushers in a new era of lung cancer research to extend the lives of the 12,000 Australians – many young, fit and non-smoking - who are diagnosed with the condition every year.

Lillian, a beneficiary of a lung cancer drug trial launched in Melbourne, says the Centre launch can’t happen soon enough. “Think of breast cancer, prostate cancer, pretty much any other cancer and there’s a wealth of medical research underway into every aspect of the disease and how to beat it - but not so for lung cancer,” she says. “Lung cancer is the hidden cancer. We don’t have powerful lobby groups or celebrities backing our cause. Research funding opportunities are rare and the stigma, that victim-blaming mentality, is sadly alive and well in our community.”

The Centre, which opened on Wednesday, 18 April, will work to lift the profile of the disease, sending a clear message to funders, policy makers and the public that the lung cancer battle is a worthy cause, just like every other cancer.

The Centre for Lung Cancer Research will support large-scale research projects run from its high-tech purpose-built Glebe facilities, and act as a hub for a network of researchers, clinicians, respiratory physicians, oncologists, radiologists, thoracic surgeons and advocates for lung cancer. It’s high-tech laboratory, database and bio-bank will allow an unprecedented level of information sharing, ensuring patients get to benefit from new discoveries quicker than ever before. Several projects are already underway, including work to develop non-invasive diagnosis, innovative drug delivery and 3D-printed airway stents for patients with breathing difficulties.

Lillian, who is working with the Woolcock to establish the Network, says the centre gives her hope for future lung cancer patients. “It’s very exciting to see so much energy and expertise being poured into an area where it is so desperately needed,” she says. “It gives me hope that our voices, the voices of people with lung cancer, will finally be heard and that we can dare to wish for a better outcome than the status quo.”

“I want nothing more than to see my daughter start high school. Let’s make that dream a reality.”

John Cottam's Story

It wasn’t always easy for me. As a child, I was very shy and often not alert in class. I can’t tell you whether that had anything to do with a disorder or what, but had there been more awareness in terms of paediatric sleep disorder, I think, my parents would have done their best to address some of the difficulties I had during my childhood.

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