Dr. Presser

More people die of lung cancer each year than breast, colorectal, prostate and ovarian cancers combined. Lung cancer kills, so why be a victim?

The current lung cancer screening guidelines are in response to the results of the National Cancer Institute’s sponsored national lung screening trial (NLST). NLST findings published in the New England Journal of Medicine in August 2011 reported evidence that low dose chest CT screening reduced lung cancer mortality by 20%.

According to the new guidelines, the recommendation is annual low-dose CT of the chest for people aged 55 to 74 with a history of smoking. In the US, the peak incidence of lung cancer is age 73. When lung cancers are found earlier, the five-year survival rate dramatically improves from 15% to over 90%. Right now only approximately 15% of all lung cancers are being diagnosed in an early stage amenable to surgery for cure.

What does this tell you? Don’t wait until you have symptoms, because by then it may be too late.

Who is a candidate for lung cancer screening?

If you are a current or former smoker and between the ages of 55 to 74 years with a smoking history of at least 30 pack-years (this means 1 pack a day for 30 years, 2 packs a day for 15 years, etc.), then you are in the group at highest risk for lung cancer and screening for lung cancer is recommended for you.

The risk for lung cancer is different for each person. If you do not share these factors, but have concerns, but sure to speak with your doctor. Anyone concerned about detecting lung cancer or other chest diseases early can be screened.

When caught early, very small masses can be identified and removed for diagnosis or cure through a minimally invasive VATS procedure

Should I get a CT scan to screen for lung cancer?

Only Low Dose CT scans are recommended for lung cancer screening. Chest X-rays are not recommended. However, it is important that you speak with your doctor about getting a CT scan. Be sure to discuss your complete health history and ask for a clear explanation about the possible benefits and risks of being screened. Although screening for lung cancer saves lives, there are some risks and not everyone is a viable candidate.

What do the results mean?

A CT scan of the chest can reveal anything from lung masses to calcified coronaries to emphysema.

Knowing what to do next is critical… Make sure you know your options.

A “suspicious” result means that the CT scan shows that something is abnormal. This could indicate a serious condition such as lung cancer, or a “false positive” which is no reason for concern. With a suspicious result, additional procedures to identify the abnormality may be recommended. If the abnormality is identified as lung cancer or some other serious condition, your doctor and team of experts will discuss treatment options with you.

A “negative” result means that there were no abnormal findings identified on the CT scan. However, this does not mean that you absolutely do not have lung cancer, nor does it mean that you will never get lung cancer. You will discuss your scan results with your doctor, and determine when and if you should be tested again based on your risk factors.

What is most important is finding a physician who understands all the many treatment options. If an abnormality is detected, formulating a well-thought out treatment plan is crucial. For example, if removing an identified tumor or nodule via surgery is the best course of action, you should know that minimally invasive procedures are now available resulting in smaller incisions, less pain, less stress on the body, faster recovery, and a shorter hospital stay. As a thoracic surgeon, I perform such procedures via this VATS (minimally invasive) approach whenever possible. This includes wedge resections, lobectomies, mediastinal tumor resections, decortications and single incision surgery for pleural effusions.

Lung cancer screening helps detect lesions earlier and save lives. Educate yourself early on in the process and remember there are no dumb questions. Speak with your doctor about your risk factors and whether lung cancer screening is a good idea for you.

The best way to prevent lung cancer is to never smoke or to stop smoking now. If you are still smoking, talk to your doctor about ways to help you quit.

Eric Presser, MD is a board-certified thoracic surgeon with Premier Surgical Associates in Palm Springs and an advocate for early lung cancer screenings. For more information, visit the American Lung Association at www.lung.org. Dr. Presser welcomes your questions and can be reached at 760.424.8224.