November is Lung Cancer Awareness Month, and Beatrice Community Hospital is hoping to prevent more deaths from lung cancer by catching it early.
Using a low-dose CT scan, the hospital can screen patients at higher risk for lung cancer and spot the disease while it is in the early stages.
“Lung cancer is the number one cancer killer, so it's the cancer that kills the most people, even though it's not the most common,” radiologist Dr. Kim Coleman said. “It kills more than breast, colon and prostate put together.”
One of the big reasons for that, she said, is that doctors have been able to screen for early signs of breast, colon and prostate cancers, while lung cancer typically required symptoms to be present before treatment.
Like mammograms, colonoscopies and routine physicals, Coleman said she hopes the low-dose CT scan will help to bring down lung cancer mortality rates in smokers.
With early diagnosis of lung cancer, survival rates are higher than 90 percent, Coleman said. If it’s diagnosed at an advanced stage, it’s almost reversed, with nearly 90 percent of people dying from the illness.
“It's a pretty deadly cancer if we find it advanced,” she said. “And it's a pretty painful deadly cancer. It doesn't kill you quick like a heart attack, it goes to your brain and it goes to your bones. It's painful.”
Jesse Young, the director of diagnostic imaging at BCH, said the low dose CT scan uses about one-sixth the amount of radiation produced by a typical CT scan, and it’s less invasive than many tests for cancer. In fact, patients are able to remain clothed during the procedure.
During the scan, the patient lies down on the table and he or she is positioned inside the big, doughnut-shaped CT machine. The X-ray tube inside spins around the patient, taking pictures of their lungs as it spins and, finally, reconstructs an image of the lungs.
The whole process takes about 15 seconds, Young said. The entire appointment will only take about 10 minutes.
“When they come for the test, the test takes no more than 10 minutes,” Young said. “There's no needles, there's no smashing, no tubes, no squeezing.”
“It's very easy,” Coleman added. “It's easier than going to the dentist.”
The test looks for nodules, or small masses of tissue in the lungs, Coleman said. With yearly visits, she said, they’ll measure nodule growth from year to year to check for changes.
“That's where it's really important that people stick with that annual screening,” she said. “Because that's where we get a little clue when it changes that it could be an early cancer.”
During trials of the low-dose CT scan, the people who were screened were found to be dying less often from other smoke-related diseases like heart disease and emphysema, she said.
The people most at risk are smokers between the ages of 55 and 80 who are either still smoking or have quit smoking within the last 15 years.
The scan is recommended for people who have smoked for 30 pack-years or more, or the equivalent of a pack each day for a year. If a person has smoked two packs a day for 15 years, Coleman said, that counts as 30 pack-years, as does three packs a day over 10 years.
The scan, which is available at most hospitals, is covered by Medicare and most insurance companies for the people who fall into that group.
Gage County has a higher than average rate of smokers than the rest of the state, Young said. The number of smokers who were 55 or older was somewhere in the neighborhood of 800 to 1,200 people, he said, and members of this group may want to consider getting screened.
While doctors are mandated by Medicare to discuss smoking cessation with patients, Young said that the screening doesn’t come with a lecture on not smoking.
“Once they're here for the test, we don't mention smoking, there's no pressure,” he said. “We're just here to do the scan.”
While, of course, smoking isn’t healthy, said Diane Vicars, director of public relations at BCH, the goal isn’t to force patients to stop smoking, it’s to scan people with risk factors for a deadly disease.
“This is not an anti-smoking campaign,” Vicars said. “This is a CT lung cancer screening awareness campaign.”
The screening offers peace of mind, Coleman said, but it’s only beneficial if it’s done year after year. It’s still a relatively new procedure, and it’s not for people who already show signs of lung cancer, like coughing up blood or having chest pains. It’s like a mammogram, she said, patients should come in before they find a lump in the breast tissue.
One of the biggest roadblocks to people having the scan, they’ve found, is denial, Young said. People who have smoked for years and have the mindset of “I don’t want to know.”
October was Breast Cancer Awareness Month, and it was hard to miss, Coleman said. Even football players wear pink to remind women of the importance of regular mammograms, she said, and she hopes the low-dose CT scan becomes a regular part of keeping people at risk healthy.
“Do it now,” she said. “Find it early.”
“If you develop cancer, you're going to find out at some point,” Young added. “So why not find out at a point when we have a high likelihood of treating the disease?”