Nationwide, lung cancer is the second most common new cancer diagnosis, as well as the leading cause of cancer-related deaths. According to the American Cancer Society, 222,500 new cases of lung cancer were found among American adults in 2017. Additionally, 155,870 will die from lung cancer this year.
In North Dakota, there were 480 cases of lung cancer diagnosed in 2016, making up about 13 percent of the 3,930 total cancer cases in the state that year. Of the 1,270 cancer deaths in 2016, 330 (about 26 percent) were from lung cancer.
According to Heidi Bender, FNP-C, pulmonology nurse practitioner and coordinator of the Lung Cancer Screening Program, smoking is the leading cause of lung cancer. But is it possible to be a non-smoker and still develop lung cancer?
“It can be,” she said, noting that exposure to radon and/or second hand smoke can contribute to the chances of developing lung cancer. (Additionally, cigar and pipe smoking, asbestos, and exposure to “some carcinogens – radioactive uranium or arsenic, for example,” in the environment can be culprits. Having a first degree relative who had lung cancer also slightly increases the risk.
One of the first steps in reducing your risk for lung cancer is to quit smoking. Cessation can lead to benefits almost right away. Within 20 minutes, your heart rate and blood pressure drops, Bender said.
“Within one to nine months, coughing and shortness of breath decreases, and lung function improves the ability to clear out mucus, clean the lungs, and reduce the risk of infection. Ten years after quitting, the lung cancer death rate is about half that of a person who is still smoking.”
Screening for lung cancer is important because some patients with lung cancer do not have symptoms, especially in the early stages, Bender said, adding that patients with advanced stages of lung cancer may present symptoms, such as shortness of breath, coughing, chest pain, coughing up blood, weight loss, or fatigue.
At Trinity Health, screening for lung cancer, using a low-dose CT scan, is now more likely to detect it in its earliest stages. The National Lung Screening Trial (NLST) demonstrated that low-dose CT scans reduce the death rate from lung cancer by 20 percent, by detecting lung cancers early.
Previous to this technology, lung cancer screening did not have formal screening and often the lung cancer wasn’t picked up early enough to make a difference in reducing the death rate, explained Scott Lewis, MD, medical director of Trinity Health’s Radiology department. “They would find cancers, but it was too late.”
Finding lung cancer early is critical because it does not often present symptoms until the cancer is in its later stages. To ensure that the screening makes a difference, Dr. Lewis said that “the right population” should be screened. If an individual meets the criteria, they would need to schedule a “shared decision-making” appointment with their primary care provider or the Pulmonology Clinic.
During the shared decision-making visit, the patient’s medical history is evaluated and a physical examination is done. The provider will discuss with the patient if they qualify for the low-dose CT and if this screening test is right for them. This meeting allows the patient and provider to make healthcare decisions together, based on clinical evidence, current medical condition, and patient values and preferences.
Jeffrey Verhey, MD, a pulmonologist with Trinity Health, explains that if a patient has no intention of evaluating an abnormal CT scan further, does not wish to undergo surgery or treatment, or has significant co-morbid conditions or health problems that would eliminate their opportunity to undergo surgery, the patient would not be screened.
Since the low-dose CT scan was introduced to screen for lung cancer at Trinity Health, 145 patients have been screened. The CT scans are done at Trinity Health’s Advanced Imaging Center, located at Health Center – Town & Country, 831 South Broadway, Minot.
If you meet the guidelines for the lung cancer screening, think you may qualify, or have questions about lung cancer screening, please contact Trinity Health’s Pulmonology Clinic at 857-5741. If symptoms of lung cancer are shown, contact your primary care provider. Please visit our website for more information: trinityhealth.org/lowdose.