Because lung cancer is usually found at an advanced stage that is not curable, it kills more people than breast, colon and prostate cancer combined. Part of the reason for the other cancers doing so much better are the screening programs that find an earlier stage, more curable cancers and that has led to much better survival rates for the other cancers over the last 20 years. Now it is time to screen for lung cancer and improve the survival rate for lung cancer. CT scan screening for lung cancer is now officially recommended by Medicare, American College of Chest Physicians, American Association of Thoracic Surgery, AMA, and American Cancer Society.
The final and most convincing proof that screening works comes from the National Lung Cancer Screening Trial where > 50,000 people were randomized to either a chest x-ray or a low dose chest CT scan once per year. Lung masses were found more often in the CT group than in the CXR group (27.3% vs. 9.2%) because the CT can see much smaller masses than the CXR. To be in the trial, all patients had to be > 55 years and smoked at least 1 pack per day for 30 years. The study showed a 20% reduction in death from lung cancer in the screened group.
What is the screening test?
A low dose chest CT scan is done.
Who should undergo screening?
– Age 55-80 years
– People who have smoked at least 1 pack per day for 30 years
– Current smokers or former smokers who quit smoking within the last 15 years
Does the CT scan diagnose cancer?
– Between 3% and 51% of the CT scans will show a mass in the lung.
– Of the people with a mass in the lung, between 1% and 5% have cancer.
Who should review the CT scan with you?
The CT scan should be reviewed by a radiologist with special expertise in evaluating lung masses or a specialist (e.g. a thoracic surgeon) who frequently evaluates screening CT scans with masses. Because <5% of masses found by screening are cancer, an expert is needed to determine which nodules to follow and which to diagnosis or treat.
What happens during a screening visit?
1. A lung cancer screening specialist will prepare you for what to expect from the screening.
2. You will undergo a low-dose chest CT scan.
3. After the scan, you will receive the results from your lung cancer screening specialist.
4. You may also want to discuss your results with your physician or qualified nurse practitioner.
5. Our team will let your doctor know your results, so he or she can recommend next steps if needed.
Who pays for the screening CT?
A screening CT for lung cancer is covered by Medicare and most insurance companies, such as Blue Cross, Blue Shield, Aetna, and United Health Care. You can call the phone number on the back of your health insurance card to make sure that your insurance carrier covers lung cancer screening. The scan can be scheduled by calling (310) 829-8686.
Lung Cancer Screening Fact Sheet
Low-Dose CT Scan Technology
This type of imaging scan is a newer form of CT known as a low-dose spiral or helical CT scan. The low-dose spiral CT scan continuously rotates in a spiral motion and takes several 3-dimensional X-rays of the lungs. These X-rays are very detailed and can show early-stage lung cancers that may be too small to be detected by traditional X-rays. Traditional X-rays can identify lung cancers the size of a dime, whereas low-dose spiral CT scans can reveal lung abnormalities the size of a grain of rice. This is a crucial difference – the smaller the tumor is when it is detected, the less likely the cancer cells have spread to other parts of the body. This means more treatment options and a higher chance of survival.
The CT Scan Experience
The low-dose CT scan is a quick, painless, and non-invasive approach to screen for lung cancer. This type of CT scan uses no dyes, no injections, and requires nothing to swallow by mouth. The actual scan itself takes less than a minute to complete and from start-to-finish; the entire appointment takes approximately 30 minutes.
Prior to getting the low-dose CT scan, you will change into an exam gown. Then you will be asked to lie on your back on the table of the CT machine with your arms raised above your head. The table will then slowly pass through the center of a large CT machine while detailed X-ray images are taken of your lungs. It is important to stay very still during the scan to prevent any possible blurring of the images; at times, you may be asked to hold your breath to decrease chance of blurring. While in the CT machine, you may hear a whirling sound as the scan rotates in a spiral rotation around the area of your body being scanned.
Though the scanner will cover your entire body for a short period of time, both ends of the machine are completely open for you to see and hear outside the machine. The physician or technician preforming the scan is able to see and hear you at all times.
After the Scan
You will receive a copy of your scan on a CD at the time of the exam. Your scan will then be reviewed by a special group of radiologist, and any findings will be discussed in a group conference by experts that specialize in the treatment of lung disease and cancer. It should be noted that abnormalities are common and that most are noncancerous and harmless.
Getting the Results
We will contact you with your results within a week of your exam, sometimes sooner. If additional follow-up is necessary, we will inform you of the next steps. If your scan has no positive findings, we will contact you in a year for continued monitoring.
Steps to Help You Quit
Decide to Quit
Congratulations! Deciding to quit smoking is the first step on your path to health and wellness. While success will require dedication and hard work, your determination will help you kick this habit once and for all. Stay on track by following these steps:
There are many things you can do now to help increase your chances of remaining smoke-free. Start with simple tasks like getting rid of your cigarettes, ashtrays and other items that may trigger the urge to smoke. List the reasons why you smoke as well as why you want to quit. This list will help you stay motivated.
Get Help from Family and Friends
Research shows that support from family and friends makes it easier to quit smoking. Let people know you are trying to quit and how important this process is for you. If you have an urge to smoke, call them. You can also work with your doctor to create a plan to help you along the way.
Learn New Behaviors
Humans are creatures of habit, so change may cause anxiety. Limit stress through physical activity, deep breaths or other activities to help distract you. Celebrate the little steps and reward yourself for not smoking.
Medications Are Available to Help You Quit
Cigarettes have many chemicals, including nicotine, which is very addictive. Withdrawal symptoms may include anxiety, restlessness and irritability. Using a nicotine replacement medication can increase your chances of success. Talk with your doctor to learn more.
Be Prepared for Temptation
It takes a lot of effort to quit smoking. To help you succeed, avoid stressful situations and walk away when people want to smoke around you. Create a plan in advance to prepare for possible urges and call a member of your support system when temptations arise.