Screening can help re­duce lung can­cer mor­tal­ity rate

The Ambler Gazette - - OPINION -

Cur­rent and for­mer heavy smok­ers — quit within the past 15 years — have a 20 per­cent less chance of dy­ing from lung can­cer by get­ting a low-dose screening CT scan that can show the early stages of the dis­ease, ac­cord­ing to a re­cent na­tional study.

The scans — rec­om­mended for those age 55 to 74 who smoke or pre­vi­ously smoked at least one pack a day for 30 years or two packs a day for 15 years and have no his­tory of lung can­cer — will be of­fered through a new Lung Can­cer Screening Pro­gram with fol­low-up pro­vided by a Com­pre­hen­sive Lung Nod­ule Man­age­ment Pro­gram, both be­ing launched Oct. 3 by Abing­ton Memo­rial Hospi­tal.

More peo­ple in the United States die from lung can­cer than any other type of can­cer, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion. About 200,000 in the United States are di­ag­nosed with lung can­cer ev­ery year, with more than 150,000 dy­ing from the dis- ease.

Re­sults from the Na­tional Lung Screening Trial show “clear, com­pelling ev­i­dence lung can­cer screening is cost­ef­fec­tive and has an over­all health ben­e­fit … a sur­vival ben­e­fit for those 55 to 74,” said Dr. Paul O’Moore, part of a team of ra­di­ol­o­gists, pul­mo­nolo­gists, tho­racic sur­geons, ra­di­a­tion on­col­o­gists, med­i­cal on­col­o­gists and pri­mary care physi­cians who de­vel­oped the AMH pro­grams.

The study, in which 53,000 cur­rent or for­mer heavy smok­ers re­ceived ei­ther low­dose CT or stan­dard chest X-rays ex­ams, con­cluded that those who had three low-dose chest CT scans over a three-year pe­riod had a 20 per­cent lower risk of dy­ing from lung can­cer than those who re­ceived the chest X-rays.

The screening and “one-stop­shop­ping” ap­proach lung nod­ule pro­grams in­clude the CT scan, speak­ing with a ra­di­ol­o­gist and work­ing with a nurse nav­i­ga­tor who will guide the pa­tient through the process of hav­ing any ab­nor­mal find­ings treated. Both will be of­fered at the PET scan fa­cil­ity at the hospi­tal’s Blair Mill Road com­plex, said O’Moore, an in­ter­ven­tional ra­di­ol­o­gist for 25 years who will be read­ing the scans and speak­ing with pa­tients at the Wil­low Grove fa­cil­ity.

“We were find­ing that a lot of peo­ple have scans for other rea­sons,” per­haps to rule out pneu­mo­nia for a cough, and some­times the scan picks up nod­ules in the lungs and the pa­tient doesn’t know what to do, O’Moore said. “This [pro­gram] is a com­pre­hen­sive and con­sis­tent so­lu­tion to manag­ing that.”

A CT scan “has a much greater sen­si­tiv­ity to small things,” he said. It can pick up a nod­ule 1 mm to 2 mm in size, while on a chest X-ray any­thing smaller than 5 or 6 mm is hard to see, he said.

“By the time you can see [some nod­ules] on a chest X-ray, there’s a chance of it be­ing a sig­nif­i­cant threat to health,” O’Moore said. “It [lung can­cer] may be past stage 1 or 2 … at stages 3 and 4 al­most none are cured.”

The spe­cific low-dose tech­nique be­ing used for the scan does not have a sig­nif­i­cant risk in caus­ing sec­ondary can­cers, he said; “the ben­e­fit clearly out­weighs any risk.”

The AMH pro­grams will con­form to the meth­ods used in the study, with pa­tients hav­ing the scan three years in a row, he said.

About one in 20 smok­ers in the 55 to 74 age group have nod­ules in their lungs, O’Moore said, but “it may be the re­sult of in­fec­tion or scar tis­sue.” Mon­i­tor­ing the nod­ules “be­comes a man­age­ment burden” for a pri­mary care physi­cian, he said.

“We tried to build a re­source within the Abing­ton hospi­tal sys­tem to prop­erly, re­li­ably and in a uni­form way pro­vide a thor­ough and con­sis­tent man­age­ment scheme,” O’Moore said.

Those whose scans show nod­ules would be ad­vised to have a fol­lowup scan. If, over a pe­riod of time there was no change in the nod­ule, it would prob­a­bly be noth­ing, he said.

A PET scan will show if some­thing is grow­ing, O’Moore said, and those with a nod­ule 4, 6, or 8 mm — the size of a pea — or one that is chang­ing would have a fol­low-up scan within three to 12 months.

“The point is to find can­cers when they can be cured,” he said. “If you wait for symp­toms, the show’s over.”

At stage 1 or 2, the size of a hazel­nut or smaller, “there is a high like­li­hood of be­ing com­pletely cured of can­cer,” O’Moore said. “By pecan size, you’re on the bad side of the sur­vival curve.”

Treat­ment can be surgery or a com­bi­na­tion of ra­di­a­tion, chemo­ther­apy and surgery, he said.

The goal of the new pro­grams is to have a co­or­di­nated team ef­fort to treat the can­cer as well as it can be treated, he said.

“We’re try­ing to pro­vide a cut­ting-edge com­pre­hen­sive so­lu­tion … and ben­e­fit peo­ple at risk of de­vel­op­ing lung can­cer,” O’Moore said.

“We want to catch it early,” he said. While the screening, which costs $350, is not yet cov­ered by in­sur­ance, he said, “What else can you spend $350 on to lower your risk of dy­ing by 20 per­cent?”

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.