Health Column - November 8, 2007

Detection of lung cancer: It pays to be proactive

By Dr. Mark Cooper

Blount Memorial Hospital

The goal of screening is to detect cancers when they are at an early stage, which when treated, will lead to a higher cure rate. Screening has been effective with breast cancer or through pap smears for cervical cancer.

Early detection of lung cancer is critical to improving survival. Testing people at high risk for developing lung cancer can help to find tumors that are small and more easily treated. Those at high risk include patients who may be older than 60 years old and smoke, patients who have smoked heavily in the past, those patients with previous lung tumors or those with a family history of cancer. These groups all may be suitable for a lung cancer screening program.

The stage of disease at discovery dictates a person’s outcome. Most data indicates that when diagnosed in an early stage, and surgery is possible, the five-year survival rates can reach 80 percent. Survival rates decline dramatically after the cancer has spread to other organs.

A detailed diagnostic tool for detecting lung cancer is the spiral, or helical, CT scan. The spiral CT scan can image the lungs in a single holding of the breath. Although spiral CT scans can detect tumors in the earliest stages of disease, there is a debate about how many lives this test may save and who should receive the test. It also is possible the screening will lead to false positives because the test can mistake scar tissues from an old infection, or a benign lump, as cancer. Patients with false positive results may then require follow-up.

A study published in The Lancet compared the use of spiral CT scans to chest X-rays for the early detection of lung cancer. Among the 1,000 patients tested, 27 cancers were found at baseline screening with the CT scan. Eighty-three percent of these were stage I, the earliest stage of disease, as opposed to seven cancers found with X-rays. An additional seven cancers were detected in annual repeat screening, 85 percent of which were stage one. The patients in the study were all 60 years or older with a smoking history of more than 10 pack-years.

Trials are underway to determine how screening affects the overall survival from lung cancer. A different trial looking at the benefits of the spiral CT scan is the National Lung Screening Trial (NLST). This randomized controlled trial, sponsored by the National Cancer Institute, will enroll 50,000 participants at high risk for lung cancer to determine any differences in lung cancer mortality between patients screened with low-dose spiral CT or chest X-ray. Further tests, such as bronchoscopy, will detect cancer inside the airways and are usually better for centrally placed cancer.

Lung cancer is the No. 1 type of cancer killer in the United States, however mortality rates are slowly declining. The development of newer surgical treatments such as cryosurgery, freezing of tumors, aims to keep patients alive in a stable condition. If patients are concerned about their risk of developing lung cancer, options are available for screening.

Cardiothoracic surgeon Dr. Mark Cooper is a diplomate in the American Board of Thoracic Surgery, and is affiliated with Roseman, Budayr and Cooper. He is a member of the active medical staff of Blount Memorial Hospital.

Stroke support group

The stroke support group meets on Monday, Nov. 12 from noon to 1 p.m. in the Blount Memorial Medical Fitness classroom, on the hospital’s 2-east floor. Safety director Carole Chambers discusses how to move with caution. This support group is for stroke victims and their families. For more information or to register, call 865-977-5636.

Suicide support group

The suicide support group meets on Monday, Nov. 12 at 7 p.m. in the Blount Memorial Hospital auditorium. The group meets the second Monday of each month and is for anyone who has lost a loved one to suicide. For more information, call 865-984-4223.

Alzheimer’s support group

The Alzheimer’s support group meets on Friday, Nov. 9 at 2 p.m. in the Sunflower Room at MorningView Village. The free support group meets the second Friday of each month and is open to community members who have a family member or care for someone who has the disease. For more information, call 865-980-4894.

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