Lung cancer is the leading cause of cancer death, killing more Americans than breast, prostate and colon cancer combined. Fortunately, there is a screening tool available for those at risk for lung cancer, but many people don’t take advantage of this option.

The screening, called low dose CT, helps detect lung cancer at its earliest, most treatable stages.  If lung cancer has grown into a larger tumor or spread beyond the lungs, the prognosis is very poor.

Low Dose CT—What it is & how does it work?
Lung cancer screening is performed with a low-dose CT scan (commonly referred to as a “cat scan”) which can identify abnormalities in the lungs called nodules that could be–or could turn into—lung cancer.  A low dose CT (LDCT) takes 3-D images of your lungs and can show nodules as small as a grain of rice.

The goal of any cancer screening test (for example: PAP smear, mammogram, colonoscopy) is to identify cancer in its earliest stages so that it can be treated effectively. With any cancer—especially lung cancer—the earlier it is found, the better chance there is for a cure.

Lung cancer is difficult to “cure,” except when the cancer is still very small and confined to a portion of the lung; in this case, the tumor may be surgically removed.

Who should be screened?
An annual screening for lung cancer (intended for long-term smokers) is now being recommended by major medical organizations, including the U.S. Preventive Services Task Force.
To be eligible for the screening, you must have the following risk factors:

• Be between the ages of 55-77*
• Have a 30 pack-year history or more**
• Be currently smoking or have smoked within the last 15 years
• No current symptoms of lung cancer (more on that below)

All criteria must be met for this testing. Because the test does involve some radiation, the risk for lung cancer must be higher than the overall lifetime radiation risk.

*If someone has a higher risk due to extensive smoking history, or a first degree relative (parent, sibling) who had lung cancer, screening may be recommended earlier.

**The “pack-year history” is determined by calculating how many packs of cigarettes per day have been smoked for what number of years. For example, if an individual started smoking at age 20, and smoked a pack a day until age 50, that would be 30 pack years. If that same person smoked 2 packs per day, 30 pack years would be reached by age 35.

As mentioned, lung cancer is the number one cancer killer in this country.  And while smoking is the leading risk factor for lung cancer, people who don’t smoke also develop lung cancer.  Exposures to chemicals (such as those that coal miners or veterans may have experienced), radon in the home and family history are also factors.

Does insurance cover this test?
Most insurance companies, including Medicare, currently pay for the screenings. If someone wants this test and is a good candidate, and their insurance doesn’t cover the test, we will work with patients on affordable payment options. We want this life-saving service to be available to as many people as possible.

If someone thinks they may be a good candidate for the test, getting started with the process is easy.  The first step is to contact your primary care doctor to discuss your lung cancer risk.  He or she will then assess if you are a good candidate for the screening, and then provide a referral.

The scan takes place at the Deaconess Midtown Hospital or at Deaconess Gateway Hospital. The testing appointment will last less than 30 minutes.

How often should someone at risk for lung cancer be screened?
It’s best to be screened once a year.  Set a reminder with your primary care doctor to order the test at each annual wellness check-up.   After you have completed your first LDCT screening, Jessica Waggoner, nurse navigator, will mail a reminder letter every year.

If the scan does show an abnormality, then additional tests or more frequent screenings may be needed. Even if your scan does not show any nodules, yearly scans are suggested because lung cancer can still develop over time.

Screening Results
The results are interpreted by a board certified radiologist,  and abnormal results are also presented to the Deaconess Multidisciplinary Lung Nodule Review Board, where each patient’s scan and history is individually reviewed. Results are sent to the primary care physician or physician who ordered the test.

If a patient is diagnosed with lung cancer, our Deaconess Cancer Services Nurse Navigator, Jessica Waggoner, steps in to help the patient begin the treatment process and various consultations.

Does lung cancer have symptoms?
Sadly, most lung cancers do not cause any symptoms until they have spread, which is why screening is so crucial.

Some people with early lung cancer do have symptoms. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed at an earlier stage, when treatment is more likely to be effective.

According to the American Cancer Society, the most common symptoms of lung cancer are:

• A cough that does not go away or gets worse
• Coughing up blood or rust-colored sputum (spit or phlegm)
• Chest pain that is often worse with deep breathing, coughing, or laughing
• Hoarseness
• Weight loss and loss of appetite
• Shortness of breath
• Feeling tired or weak
• Infections such as bronchitis and pneumonia that don’t go away or keep coming back
• New onset of wheezing

If you are at risk for lung cancer, we encourage you to be screened.  And if you know someone who should be screened, encourage them to do so.

For more information about the screening, or to schedule an appointment, call 812-450-LUNG.