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A Guide to Lung Cancer Screening

11-16-2017

Lung cancer is the second most common cancer and the leading cause of cancer death in both men and women, according to the American Cancer Society. Every year, more people die from lung cancer than of colon, breast, and prostate cancers combined.

The American Cancer Society estimates that in the United States this year, there will be approximately 222,500 new cases of lung cancer, and 155,870 deaths from the disease. This type of cancer mainly occurs in older people; approximately 2 out of 3 patients diagnosed with lung cancer are 65 or older. Less than 2% are younger than 45. The average age of diagnosis is 70. Men have a 1 in 14 chance of developing lung cancer, and women have a 1 in 17 chance, but the risk is much higher for smokers.

While these statistics may be scary, most lung cancers can be prevented since they are usually related to smoking or secondhand smoke. Less often, they are related to radon exposure or other environmental factors. However, some lung cancers occur in people without any known risk factors, and it isn’t clear whether these cancers can be prevented.

Commonly, lung cancers are at an advanced stage and have spread throughout the body when they are first found, which makes them difficult to cure. Thankfully, in recent years, doctors have found a test that can screen for lung cancer in high-risk patients. This test can find lung cancer much earlier and reduce the patient’s risk of dying from the disease.

According to the National Lung Cancer Screening Trial, studies show that lung cancer deaths can be reduced by 20% when at-risk patients participate in a lung CT screening program. Locally, Frederick Regional Health System offers this screening program.

What are the risks and symptoms of lung cancer?

You are at risk for lung cancer if you have family history or are exposed to:

  • Tobacco. Smoking is the leading risk factor for lung cancer, and about 80% of lung cancer deaths are attributed to smoking. Cigarette, cigar, and pipe smoking all increase lung cancer risk. Secondhand smoke can also increase your risk – it’s thought to cause more than 7,000 lung cancer deaths per year.
  • Radon. While radon is a naturally occurring gas, it is the second leading cause of lung cancer. Breathing in radon exposes your lungs to small amounts of radiation. There isn’t much radon outdoors, but homes and other buildings can have high radon levels, especially in basements and older homes.
  • Asbestos. Working in mines, mills, textile plants, shipyards, and places where insulation is used increases a person’s exposure to asbestos, which increases the risk of both lung cancer and mesothelioma.
  • Air pollution in cities is thought to increase the risk of lung cancer, although the risk is much lower than smoking.
  • Previous radiation therapy to the chest increases your risk for lung cancer, especially if you’re a smoker.

See your doctor if you experience any of these symptoms that might indicate lung cancer:

  • A cough that won’t go away or gets worse.
  • Coughing up blood or rust-colored phlegm.
  • Chest pain that gets worse with deep breaths, coughing, or laughing.
  • Hoarseness.
  • Weight loss and loss of appetite.
  • Shortness of breath.
  • Feeling tired or weak.
  • Infections like bronchitis or pneumonia that keep coming back or won’t go away.
  • New onset of wheezing.

If lung cancer spreads to other organs, it can cause:

  • Bone pain.
  • Nervous system changes, such as headaches, dizziness, problems with balance, or seizures if it has spread to the brain or spinal cord.
  • Yellowing of the skin and eyes if the cancer has spread to the liver.
  • Lumps near the surface of the body if the cancer has spread to the skin or lymph nodes.

Some lung cancers cause syndromes, which are groups of extremely specific symptoms.

  • Horner syndrome can be caused by cancers at the top part of the lungs and can affect certain nerves to the eye and face. Symptoms include drooping or weakness of an eyelid, a smaller pupil in the same eye, reduced sweating in the same side of the face, and severe shoulder pain.
  • The superior vena cava (SVC) is a large vein that carries blood from the head and arms back to the heart. Since it passes next to the upper part of the lung, tumors in this area can press on the SVC, causing blood to back up into the veins. This can cause swelling of the face, neck, arms, and upper chest. It can also cause headaches, dizziness, and a change in consciousness.
  • SIADH (Syndrome of inappropriate anti-diuretic hormone) is caused by cancer cells making a hormone that causes the kidneys to retain water, which lowers salt levels in the blood. Symptoms of SIADH include fatigue, loss of appetite, muscle weakness, nausea, and confusion.
  • Cancer cells may make a hormone that causes the adrenal glands to secrete cortisol. This is known as Cushing syndrome, and can cause symptoms like weight gain, easy bruising, weakness, high blood pressure, and fluid retention.
  • Lung cancer can cause the immune system to attack parts of the nervous system. With Lambert-Eaton syndrome, the muscles around the hips become weak and patients may have difficulty getting up from sitting. Another issue is paraneoplastic cerebellar degeneration, which causes loss of balance and unsteadiness in the arms and legs. It can also cause trouble with speaking and swallowing.

How can I prevent lung cancer?

While not all lung cancers can be prevented, there are things you can do to lower your risk of developing lung cancer.

  • Avoid tobacco. According to the American Cancer Society, if you stop smoking before cancer develops, your damaged lung tissue gradually starts to repair itself.
  • Avoid radon and limit exposure to cancer-causing chemicals.
  • Eat a healthy diet. Some evidence suggests that a diet high in fruits and vegetables can protect against lung cancers.

What is FRHS’ lung cancer screening program?

We offer a Low-Dose Lung CT Screening program to identify individuals who have an increased risk of developing lung cancer. This helps your healthcare team develop the best follow-up care based on your results. This test is free for eligible patients; the Affordable Care Act requires that all insurers cover approved screening programs at no cost to the patient. The U.S. Preventative Services Task Force approved Low-Dose Lung CT Screening in 2014.

You and your primary care physician will each receive a copy of the results and recommendations based on the screening. Our multidisciplinary team of radiologists and thoracic surgeons will review all positive CT lung scans.

The screening test is performed with a low-dose spiral CT. The scanner rotates around your body, while you lie still on a table that passes through the center of the scanner. This scan provides detailed images of the inside of your body. A computer that combines x-ray images taken from various angles makes the images. It can be performed with one short breath-hold and takes approximately 7-15 seconds.

If abnormal results are found, your primary care physician will discuss them with you and make additional referrals. If a doctor finds something suspicious, more tests and treatments may be recommended.

Am I eligible for the FRHS program?

You are eligible to participate in the FMH Lung Cancer Screening program if you are:

  • A current or former tobacco smoker who smoked at least 30 pack years. (To calculate pack years, multiply the number of packs you smoked per day by the number of years you smoked. For example, one pack a day x 30 years=30 pack years. Two packs a day x 15 years=30 pack years.)
  • A current or former smoker who has quit within the last 15 years.
  • Between 55-77 years old.
  • Asymptomatic – no symptoms of lung cancer.

You are not eligible to participate in the screening program if you’re experiencing any of these symptoms:

  • Hoarseness
  • Coughing up blood
  • Chest pain
  • Severe shortness of breath
  • Unintentional weight loss

To learn more about our Low Dose Lung CT Screening Program located at the James M Stockman Cancer Institute, you can review our FAQs or call 301-694-LUNG (5864). Call today to schedule your screening.



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