The Daily Item, Sunbury, PA

November 30, 2010

Scans key to find lung cancer

By Erin Thompson
The Daily Item

— DANVILLE — Lung cancer claims more lives than colon, breast, pancreatic and prostate cancers combined, but it remains the only one of which often is not routinely screened until it’s too late.

Dr. Matthew Facktor, M.D. and director of the Lung & Esophageal Cancer Clinic at Geisinger Medical Center, wants that to change.

He is taking part in a study led by The National Cancer Institute, which found that patients at risk for lung cancer who receive annual CAT scans, reduce the risk of death by 20 percent.

The study took active smokers who were otherwise healthy and between the ages of 55 and 75 and gave half of the participants a traditional chest X-ray once per year for three years and the other half a CT scan for three years.

Until now, no screening method had proven to be effective at reducing mortality from the disease.

“People don’t realize how many lung cancer kills. Then when we find it, it’s too late,” said Facktor.

Currently, when patients have problems with their lungs, such as coughing up blood, they receive an X-ray.

Otherwise, it is undetectable unless the cancer spreads to the liver and turns skin yellow, or to the brain and causes headaches.

“It’s a silent cancer,” he said. “It doesn’t usually cause problems until it starts to spread.”

But if it gets to that point, it’s already too late.

“No cancer can be cured in these late stages,” and more than 85 percent of patients who are diagnosed with lung cancer die from it.

Most cases of lung cancer are caused by smoking in people ages 50-80, said Facktor, but it is also caused by radon gas and asbestos exposure.

Currently, no insurance will pay for patients to have a CT scan like they would a mammogram or other cancer screening.

“Our hope is that getting a CT scan will become standard,” he said.

If it were to become standard, it would be specific to people at risk, such as heavy smokers.

“A mammogram is for women who are around 40, a prostate exam is for any man, a colonoskopy is for any person over 50...this wouldn’t be for a healthy 20-year-old person, it would be specifically for smokers” and at the discretion of the primary care physician.

CT scans are used to detect images that would not be visible in an X-ray.

“If in a car crash are worried might have deep injuries, you will get a CT scan to look for broken parts,” said Facktor. “We just don’t use it as a screening test specifically for lung cancer,” but how doctors first spot all lung cancers.

But no one said such screenings wouldn’t come with consequences.

“When we see a spot on the lung, it doesn’t mean it’s cancer,” said Facktor. “You would need a biopsy to prove it, which could cause further complications.”

Complications could include spasms of the bronchial tubes that can impair breathing, irregular heart rhythms, or infections such as pneumonia.

Some physicians are also worried that finding a spot on a lung during a CT scan could cause emotional stress, regardless of whether it turns out to be cancer.

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