Lung cancer is a devastating disease that kills more Americans than breast, colon and prostate cancer combined. Unfortunately, lung cancer often does not produce symptoms until it is quite advanced. Seventy five percent of patients who are initially diagnosed have incurable disease, and the overall five-year survival rate is 16 percent.
The difference in five-year survival is dramatic depending on when the cancer is detected. Patients with early, or Stage 1 disease, have more than a 60 percent chance of surviving five years after undergoing surgery. In contrast, patients who present with late, or Stage 4 disease have less than a 5 percent chance of surviving five years and are far too advanced to benefit from a curative surgical procedure.
Until recently, there has not been an effective screening test to catch the disease at an earlier stage when it can still be cured with surgery. The National Lung Cancer Screening Trial, published in 2011 changed that. Investigators enrolled more than 50,000 patients and found that performing a yearly low-radiation dose CT scan of the chest reduced the risk of death from lung cancer by 20 percent.
To be eligible for screening, a person would have to be aged 55-80, have smoked for 30 pack years (calculated as number of years of smoking multiplied by the number of packs smoked per day), and not have other serious, life-limiting medical problems. Even if someone is a former smoker, there is still a benefit to screening until it has been 15 years since quitting.
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There are risks involved with screening, just like with any other medical test. For example, there may be incidental findings on the CT scan of the chest that lead to additional testing, or an invasive procedure may be required to biopsy an abnormal spot on the lung that turns out not to be cancer. The potential risks and benefits of screening must be discussed in detail with your physician before getting the initial CT scan.
Most importantly, if you are a current smoker, the single most important thing you can do for your health is quit smoking. The highest success rates occur in those who do a combination of nicotine replacement therapy, counseling and a medication to reduce cravings. The combination of a nicotine patch with either nicotine gum or lozenges is recommended for most patients. There are free resources, such as 1-800-784-8669, that provide counseling.
Schedule an appointment with your physician today to talk about smoking cessation and lung cancer screening.
Dr. Patton W. Thompson, a pulmonologist with Baptist Health Medical Group Pulmonary & Critical Care Medicine, practices at Baptist Health Lexington.