Lung cancer is the leading cause of cancer deaths in the U.S. It has poorer survival rates than breast, colon and prostate cancer combined.
The statistics are frightening, primarily because lung cancer is often detected in its later stages, when treatment is more difficult. Successful treatment of lung cancer relies especially on early diagnosis and quick treatment.
“This year it is estimated that more than 235,000 people will be diagnosed with lung cancer in the US and over half of those folks will die from their disease,” noted Dr. Christopher Willms, Thoracic Surgeon at Sentara Martha Jefferson Hospital. “Most lung cancers are diagnosed at advanced stages with estimated overall 5-year survival rate of 20 percent. However, we have seen significant improvement in these numbers through increases in screening and reduction in smoking rates.”
Since 2014, Sentara Martha Jefferson has offered a low dose lung cancer screening CT with the aim of catching these tumors as early as possible for people who are at a high risk of developing lung cancer. Patients may be referred to the Fast Track Thoracic Clinic for expeditious evaluation if abnormalities are found on their scan. Lung cancer screening with low dose CT scanning is underutilized but hopefully with increased awareness, more people with high risk of lung cancer can be screened.
Risk Factors for Lung Cancer
“By far the most common risk factor for lung cancer is smoking,” said Dr. Willms. “Over 80 percent of lung cancer deaths are thought to be related to smoking.”
Tobacco smoke has been a known risk factor for lung cancer for many decades. In fact, Dr. Willms noted that accumulated evidence of smoking as a risk factor during the first half of the 20th century eventually led to the 1964 Surgeon General’s report that smoking causes lung cancer.
Smoking is not the only risk factor, however. Other risk factors that may be found in the home, environment or workplace include:
- Radon exposure
- Asbestos exposure
- Certain chemicals, such as arsenic, beryllium, cadmium, silica, vinyl chloride, nickel, chromium, coal, mustard gas and chloromethyl ethers
- Radioactive ores such as uranium
There are types of lung cancer that are not related to any of these risk factors, and there certainly can be other risk factors such as genetic. But it is important to note that smoking is by far the greatest factor in the development of lung cancer.
Symptoms of Lung Cancer
“Unfortunately, once a person develops symptoms of lung cancer it usually indicates that it has progressed to a more advanced stage,” explained Dr. Willms. “Once this happens the chance for cure decreases dramatically, which is why we want to catch it before symptoms develop.”
Symptoms of lung cancer may include:
- Change in cough
- Coughing up blood
- Chest pain, particularly with coughing or deep breathing
- Hoarseness that is new
- Decreased appetite
- Weight loss
- Feeling tired or weak
- Shortness of breath
- Recurring chest infections
Early Detection
Fortunately, the prognosis for patients who are diagnosed in the early stages is good.
“Recently we have seen an improvement in lung cancer mortality resulting from lung cancer screening and decreased incidence of smoking,” said Dr. Willms. “When diagnosed early and removed with surgery, survival for lung cancer is significantly improved. Five year survival for more advanced lung cancer is only 20 percent as opposed to over 90 percent for surgically treated stage I lung cancer.”
To ensure detection at the earlier stages, lung cancer screenings are now available to current smokers between the ages of 55 and 74 years old—or former smokers who quit less than 15 years ago—and former smokers who have smoked 30 pack years (meaning one pack a day for 30 years, or two packs a day for 15 years, etc.). People who are concerned but don’t fit the screening guidelines should consult with their primary care physicians.
Earlier this year the US Preventive Services Task Force updated their recommendation to consider individuals aged 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years to be at high risk of lung cancer and recommend screening with annual LDCT in this group.
The screening is quick and painless. Patients undergo a low-radiation dose, non-contrast (without dye injected through the veins) CT scan that takes about five to 10 seconds. All told, the appointment takes about 15 minutes.
It is important to speak with your primary care provider about the screenings you may need and whether a lung cancer screening would be appropriate for you.
If you are 55 or older with 30-pack year smoking history and are a current smoker or have quit within the last 15 years, you may be eligible for a low-dose CT lung screening. Learn more at www.sentara.com/ScreenMyLung.
