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Worried About Lung Cancer?

Posted 6/28/2017 by UHBlog

Are you a longtime smoker or former smoker who is concerned you may have lung cancer? Ask us if low-dose computed tomography screening is right for you.

Worried About Lung Cancer?

Whether you smoke cigarettes now or kicked the habit decades ago, you probably think about lung cancer from time to time – and you should. Up to 90 percent of the 230,000 people who develop the disease and the 160,000 people who die from it in the United States each year are smokers or former smokers. That’s more deaths than breast, colon and prostate cancers combined.

But lung cancer is highly treatable when caught early. A painless screening method called low-dose computed tomography (LDCT) can detect lung cancer even before symptoms develop – and just may save your life.

LDCT involves a simple, five-second CT scan that is taken while you hold your breath. Afterward, a radiologist interprets the scan and assigns a score signifying whether the findings are normal, a minor abnormality that needs follow-up or an abnormality that needs immediate referral to a specialist. Results are usually finalized within 24 hours.

“As far as the numbers of cancers caught without screening, about 55 percent are metastatic – or have spread to other parts of the body – at the time of diagnosis, and only about 25 percent are caught at an early stage when they are highly curable,” says thoracic and esophageal surgeon Philip Linden, MD. “But for those screened, about 75 percent are found at an early stage and only about 10 percent are found at the metastatic stage.”

Further, smokers or recent ex-smokers who undergo LDCT screening have a 20 percent lower chance of dying from lung cancer than those who just get a traditional chest X-ray.

There is no downside to getting scanned, Dr. Linden insists.

“Some people are concerned about radiation exposure from the CT scan, but it’s a very low dose,” he says. “The amount of radiation the patient gets from it is less than half the average radiation a person is exposed to throughout the year just from being outside.”

Occasionally, harmless findings are found on the scan, such as old scars or evidence of an earlier infection.

“That’s why, when it’s interpreted, it needs to be by a specialist in reading scans," Dr. Linden says. "If there’s a referral to a specialist, it has to be to one who is very familiar with lung cancer, so the correct tests are done and unnecessary additional testing is not done.”

Lung cancer is an abnormal cluster of cells that grows and multiplies to form a mass, known as a tumor, in the tissue of the lung or bronchi. Left untreated, it can spread to the other lung or nearby lymph nodes, or metastasize to other parts of the body. Early on, you may not notice symptoms, but as it progresses you may develop:

  • A persistent cough
  • Coughing with blood or bloody mucous
  • Shortness of breath or wheezing
  • Recurrent bronchitis, pneumonia or other lung-based infections
  • Loss of appetite or unintentional weight loss
  • Weakness and fatigue
  • Bone and joint pain
  • Hoarseness
  • Headaches and dizziness

With early detection and intervention, however, many symptoms may be avoided.

“Early lung cancer is best treated by surgical removal, and the cure rate from early cancer detected by (LDCT) and surgery is around 90 percent,” Dr. Linden says, explaining that cure rate refers to surviving five years or more after diagnosis. “If surgery is needed, it should be done by a thoracic surgeon dedicated to lung cancer as opposed to a thoracic surgeon who treats heart disease. If the patient has lung cancer but is too weak for surgery because of something like severe emphysema, we can use stereotactic body radiation therapy (SBRT), which is almost as good as surgery.”

Philip Linden, MD, is a thoracic and esophageal surgeon and Division Chief, Thoracic and Esophageal Surgery, at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Linden or any other doctor online.

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