Lung Cancer Screening Offers Hope to Those Most at Risk

Longtime smokers at increased risk of developing lung cancer now have access to an innovative screening using low-dose CT scans that could significantly increase five-year survival rates.

“Only an estimated five percent of those eligible nationwide are getting screened,” said Emily Kopas, APRN, coordinator of the Lung Cancer Screening Program at the Smilow Cancer Hospital Care Center in Greenwich. The team includes pulmonologists, chest radiologists, thoracic surgeons, thoracic oncologists, smoking cessation specialists and nurse practitioners.

Kopas cites statistics that only 16 percent of lung cancers are diagnosed early when the five-year survival rate is 56 percent. Survival drops to 6 percent among the 47 percent of cases caught at a later stage when the disease has spread.

“We can dramatically improve survival rates through early detection when lung cancer is most treatable,” Kopas said. “Screenings allow us to keep a close eye on the lungs and act on anything suspicious sooner rather than later.”

Lung cancer is the nation’s leading cause of cancer deaths for both men and women. Each year, more people die of lung cancer than of colon, breast and prostate cancers combined, according to the American Cancer Society. Symptoms include a persistent cough, hoarseness, wheezing, chest pain, shortness of breath, coughing up blood, weight loss and frequent respiratory infections.

In many instances, lung cancer is detected as an incidental finding on a routine chest X-ray, explained Justin Blasberg, MD, a Yale Medicine thoracic surgeon who specializes in lung cancer. “These findings often represent a missed opportunity for patients, as a delay in diagnosis could mean a more advanced problem in the future,” he said.

A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around the body to create cross-sectional images that provide more detailed information than a traditional X-ray. In one clinical trial, high-risk patients who had a low-dose CT scan saw a 20 percent reduction in mortality compared to those who had a chest X-ray.

The lung cancer screening program is open to individuals who are between 50 - 77 years old; smoked a pack of cigarettes a day for 20 or more years; and are currently smoking or have quit in the last 15 years. Eligible patients are screened yearly or more frequently if a scan reveals a suspicious nodule. Medicare, Medicaid and private insurance cover the low-dose CT scan.

Treatment options for lung cancer have evolved. “Surgery for early stage lung cancer has been the mainstay of treatment for several decades, and with robotic technology we can expedite a patient’s recovery and discharge,” said Dr. Blasberg. Patients with early stage lung cancer who want to avoid surgery or aren’t good candidates can be treated with radiation therapy. Medical oncology treatments, including targeted immunotherapy and other systemic therapies, are used when lung cancer has spread to other parts of the body.

Dr. Blasberg encourages patients to speak with their primary care doctor about lung cancer screening and resources to quit smoking. As Kopas put it, “It’s never too late to stop smoking.”