Lung cancer is the leading cause of cancer death in men and women in the United States, according to the American Lung Association. With Kentucky’s history as a tobacco state, where nearly one-third of adults are current or former smokers, it’s not surprising that the Bluegrass State ranks first in new cases of lung cancer each year.
Lung cancer is found in the tissues of the lung, usually in cells lining the airways. There are two main types of lung cancer: small-cell and non-small-cell. Small-cell lung cancer, also called oat cell, is usually found in active or former cigarette smokers. It’s more aggressive and is likely to spread to other parts of the body. Non-small-cell cancer progresses more slowly and is less likely to spread.
Risk factors for lung cancer can include age (older than 55), exposure to secondhand smoke, exposure to asbestos, and a history of lung disease, such as chronic obstructive pulmonary disease. Exposure to radon gas has been identified as the number one cause of lung cancer in nonsmokers. Family history and genetics also can increase risk.
Symptoms of lung cancer can be difficult to detect, or they might not appear at all until the disease has progressed to an advanced stage. Symptoms include coughing, chest or shoulder pain, shortness of breath, wheezing or hoarseness, coughing up blood, fatigue and weight loss.
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Traditional screenings such as chest X-rays and sputum cytology — when a sample of expelled mucus is examined under a microscope for abnormal cells — are limited in their ability to the early onset of lung cancer.
The latest technology in early detection, a low-dose computed tomography (CT) scan, uses a low-dose of radiation to take a series of detailed pictures of the lungs, scanning the body in a spiral path. This allows doctors to identify small cancer growths before symptoms develop.
A low-dose CT scan is four times more likely to find a malignant mass than a traditional chest X-ray, allowing for earlier detection and a higher chance of survival. This early detection has led to 20 percent fewer lung cancer deaths in participants screened by low-dose CT, compared with traditional screening methods.
Annual low-dose CT scans are now recommended for those at a higher risk of lung cancer. This procedure is typically covered by insurance. Medicare covers the annual screening for patients who are ages 55 to 77; are either current smokers or have quit smoking in the past 15 years; or have a written referral from a physician.
Although early detection gives patients more treatment options, the best prevention for lung cancer is to quit smoking or never start. Smokers who need help quitting might benefit from smoking-cessation programs, using nicotine replacement options, or taking prescription medicine.
If you are at risk for lung cancer, talk to your primary care provider about lung cancer screenings and smoking cessation resources available in your area.
Dr. Scott Pierce is with KentuckyOne Health Hematology and Oncology.