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Detecting lung cancer before symptoms with CT scan

September 2, 2015  |  Robin Lord

Courtesy of One Cape Health News

David Hirsch smoked for 35 years before giving up cigarettes for good in 2010.  Four years later, he saw an ad for a free computerized tomography (CT) scan and decided to sign up.

The results were not good. The scan showed a lesion in Hirsch’s right lung, and a follow-up PET scan and a biopsy confirmed that Hirsch had early-stage lung cancer.

In January 2012, Cape Cod Hospital thoracic surgeon Jeffrey Spillane, MD, performed a minimally invasive VATS lobectomy on Hirsch. He has been cancer free ever since.

Now 69, Hirsch, of Centerville, said his father and two sisters died from smoking-related cancers. He is certain that the CT scan saved his life.

“I was two years before having any symptoms (when the tumor was found), and by the time you develop symptoms, it can be stage 4,” he said.

Today, more people are getting low-dose CT scans to detect cancer in its earliest and treatable stage, thanks in part to Medicare’s recent decision to cover the annual scans for up to three years.  Medicare approval now means that all insurance providers will cover the screening.

The screenings also have been endorsed by the American Lung Association, which recommends using only low-dose CT units to reduce the amount of radiation exposure. In 2013, a prominent government panel, the U.S. Prevention Task Force, recommended using low-dose CT scans to screen current or former heavy smokers who are at high risk of lung cancer. The panel concluded the screenings will “prevent a substantial number of lung cancer-related deaths.”

Cape Cod Healthcare installed new low-dose CT units at its Cape Cod and Falmouth hospitals in 2014. Both hospital emergency centers and main imaging departments have the new units, which are manufactured by General Electric.

The Optima® CT660 allows radiologists to reduce the CT dose depending on the clinical task, patient size, anatomical location and clinical practice.

At Cape Cod Healthcare’s Regional Cancer Network, The team of medical and radiation oncologists, surgeons, pathologists and other medical professionals hold a weekly Thoracic Tumor Board meeting to discuss recently diagnosed cases and design personalized treatment plans for their patients.

The Lung Association recommends early, low-dose CT scans if you are:

  • A current smoker or one who has quit within the last 15 years,
  • and between 55 to 77,
  • and with a smoking history of at least 30 pack-years (one pack a day for 30 years, two packs a day for 15 years).

A 2013 study published in the New England Journal of Medicine found that a group of 1,871 people screened for lung cancer had 7,008 nodules, of which 102 were malignant.

“The majority of nodules that may be picked up (on a scan) are not cancerous, but it can create some anxiety in patients,” said Dr. Spillane, who has advocated for the increased screening for several years.  “So patients need to sit down with their doctor and talk about whether this is right for them.”