Healthy Living

Low-dose CT scans spot lung cancer early

New screenings helpful for longtime heavy smokers and ex-smokers

With all of the focus on lung health and COVID-19, people who smoke are being encouraged even more than ever to quit. In
With all of the focus on lung health and COVID-19, people who smoke are being encouraged even more than ever to quit. In addition, current and former smokers may want to talk to their doctor about an annual low-dose CT scan that can detect lung cancer long before any symptoms would surface. (Adobe Stock)

Lung cancer is the second most common cancer in both men and women in the U.S. according to the American Cancer Society. It’s also the leading cause of death from cancer because patients often don’t have symptoms until the cancer is big enough to cause compression on surrounding organs, said Dr. Hafiz Hashmi, a pulmonologist with UnityPoint Health, Cedar Rapids.

“The cancer that is diagnosed at later stages is usually not curable,” Hashmi said. “That’s why there is a need to detect it early.”

Physicians now know they can detect lung cancer in its early stages, thanks to a seven-year medical study, the National Lung Cancer Screening.

Half of the more than 53,000 current and former heavy smokers in that study got regular chest X-rays, the other half low-dose CT scans. The subjects who got the low-dose CT scans were 20 percent less likely to die of lung cancer. That’s because the scans revealed lung cancer in the early stages, when interventions such as surgery could remove a tumor.

Before the study, physicians would usually find lung cancer when they were looking for something else, said Dr. Eduardo Celis, a pulmonologist with Mercy Pulmonology Clinic in Cedar Rapids.

He remembers being at a medical conference when the findings of the National Lung Cancer Screening were published. The news, showing the promising results from annual low-dose CT scans, gave pulmonologists a weapon against lung cancer besides just encouraging their patients to quit smoking.

“If a patient meets the criteria for the years of smoking as well as their age, they should be getting a lung cancer screening,” Celis said.

WHO SHOULD GET A SCAN?

Nearly all lung cancers — 80 percent to 90 percent — are linked to cigarette smoking. Quitting smoking decreases the odds that a person will get lung cancer, but former smokers are still at risk.

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“Unfortunately, there is a misconception that only active smokers will get lung cancer,” Celis said.

The current American Cancer Society recommendation for annual lung cancer screenings focuses on older, long-term, heavy cigarette smokers:

• Age 55 to 74.

• Current smokers or ex-smokers who have quit within the last 15 years.

• Heavy smokers with a history of at least 30 pack-years.

The U.S. Preventative Services Task Force recommends the screenings through the age of 80, if a person is in good health.

Patients with another condition that significantly limits their life expectancy, or those who may refuse surgery, may not benefit from the scan, doctors say.

LUNG CANCER SYMPTOMS

Lung cancer can be a very aggressive disease, Celis said. A big problem with lung cancer is that it can remain asymptomatic for a long time. By the time most patients present with symptoms, their lung cancer will have reached an advanced stage.

Symptoms of lung disease, including lung cancer, include:

• Increased coughing, wheezing or shortness of breath

• Difficulty breathing.

• Fever or chills.

• Change in color of mucus.

• Feeling weak or tired.

• Hoarseness.

• Chest pain that gets worse with laughing, coughing or deep breathing.

• Unexplained weight loss.

LOW-DOSE CT SCAN

The low-dose CT scan uses 90 percent less ionizing radiation than a typical chest CT scan, according to radiologyinfo.org. In addition, it doesn’t involve the use of any contrast or dye, so there’s no risk of kidney damage, Celis said.

The non-invasive procedure is quick and painless — and covered by insurance for patients who meet the criteria. People can get a referral from their primary care physician or a pulmonologist.

“We’ve done a lot to improve the referral process,” Hashmi said.

In the same way that the public has become more aware of the need for other age-appropriate screenings, such as a colonoscopy beginning at age 50,

doctors are working to make lung cancer screenings more commonplace.

“I talk to everyone about their age-appropriate cancer screenings,” Hashmi said.

“This screening has to be incorporated into general health maintenance. I think that’s where we can make a significant impact on patients’ lives.”

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