Originally published in Chester County Life magazine
Many individuals who have attempted to quit smoking would probably agree it is often easier said than done. Diane Klause, 57, of Glen Mills knows this first-hand.
“I tried numerous times over twenty years to quit, but failed every time,” she said. Even an earlier diagnosis of chronic obstructive pulmonary disease or COPD, a progressive lung disease that makes it difficult to breathe, wasn’t enough incentive.
“As a health care professional, I know the risks associated with long-term smoking especially in someone with a history of lung disease,” said Diane, who is a practicing pharmacist in West Chester. “But, your mind tells you that ‘you are going to be okay’.”
Diane visited pulmonologist H. Todd Lustine, MD, at Paoli Hospital every six months to keep her COPD in check. On a recent visit, Dr. Lustine suggested Diane have a low-dose computed tomography (CT) scan of her lungs as part of a new lung cancer screening program at Paoli Hospital.
“My mother died of emphysema,” she said. “Having seen her suffer miserably, I saw this as an important opportunity for me to be proactive with my health and possibly prevent something similar from happening to me.”
According to the American Cancer Society, more than 224,000 people in the United States will be told they have lung cancer this year. As the number one cancer killer of both men and women, the disease will take more lives this year than colon, breast, pancreatic and prostate cancers combined. In fact, less than fifty percent of those diagnosed will be alive one year later.
For Diane, as well as anyone at high risk of developing lung cancer, low-dose CT screening offers new hope. In 2011, a national lung cancer screening study determined that low-dose CT was effective in detecting early-stage lung cancer, when it is most treatable, and reducing mortality from the disease by twenty percent. Since the release of these findings, a number of national organizations, including the American Cancer Society, the American Lung Association, the American Society of Clinical Oncologists, and most recently the United States Preventative Services Task Force, have embraced and recommended screening for patients deemed high risk.
“Lung cancer screening using computed tomography is one of the most effective prevention tools in health care today,” said Alicia McKelvey, MD, thoracic surgeon with Main Line Health Thoracic Surgery, at Paoli Hospital. “In the past, lung cancer had been undetectable until it had reached an advanced, often incurable stage. Now, this advancement has the potential to save many lives because it can detect the disease before any symptoms appear and when it has the greatest chance to be cured.”
In the wake of such promising outcomes, Paoli Hospital launched a lung cancer screening program in January 2014, complete with low-dose CT scans, education, and results tracking. Since then, more than 30 people have been screened at Paoli.
“It may not seem like a lot because the criteria required for screening narrows down the number of potential candidates,” explained Dr. McKelvey.
To confirm her eligibility for the scan, Diane contacted the lung health navigator at Paoli Hospital, respiratory therapist Rita Edwards.
According to Rita, national guidelines require a person to fall into one of two groups. The first group includes individuals who are 55 to 74 years old, have smoked a minimum of 30 “pack-years” (pack-years equals the number of packs per day multiplied by the number of years smoked), and/or be a current smoker or have quit within the past 15 years. People in group two are 50 to74 years of age, have a 20 pack-year smoking history and/or have either an immediate family history of lung cancer, a prior history of certain smoking-related cancers or long-term exposure to cancer–causing substances (carcinogens), such as asbestos or radon.
Diane met the criteria and scheduled a scan. The low-dose CT scan is described as quick, painless and easy because it doesn’t require fasting or any contrast material. The patient simply reclines on a table and briefly holds their breath while the CT scanner does the work. The whole process takes about 20 seconds.
“Although the radiation used during the screenings presents a small risk, the benefits far outweigh any potential consequences,” Dr. McKelvey added. “Patients can rest assured that we offer advanced CT imaging technology that reduces exposure to a minimum while maintaining the highest quality, safety, and accuracy of images.”
Soon after her appointment, Diane learned there was a small nodule in her right lung that required additional evaluation. She met with Dr. McKelvey who explained the findings and discussed the next steps, which included a surgical biopsy.
“I was scared to death before the surgery, but relieved to know afterward that the nodule was non-cancerous,” said Diane. Diane has been smoke-free since her surgery in June, yet she understands there is always a risk the disease could develop in the future.
“I never feared getting lung cancer until now,” she explained. “I plan to have another scan in a year. It’s a great opportunity, and I would recommend it to anyone who is concerned about their risk.”
Dr. McKelvey noted that screening is an individual decision that should be discussed with a health care provider who can detail the risks and benefits of participation and provide a referral for the procedure.
“As in Diane’s case, the scans can identify areas on the lungs that ultimately are not cancerous, but their presence can cause anxiety, fear and/or the need for additional procedures,” she continued. “On the other hand, the procedure may help to ease the anxiety that some may experience from not knowing if and when the disease could develop. “
Although the majority of lung cancer diagnoses are linked with cigarette smoking, people who do not smoke can get lung cancer, too, from other causes, such as exposure to secondhand smoke. Living in an area with higher air pollution and a genetic predisposition may play a role in lung cancer development as well.
In addition to the services offered at Paoli Hospital, Main Line Health also offers lung cancer screenings at Lankenau Medical Center, Bryn Mawr Hospital, and Riddle Hospital. For more information, please call 484.565.LUNG (484.565.5864) to speak to a lung health navigator or visit mainlinehealth.org/lungscreening.
Currently, a fee may apply based on your insurance coverage. However, all private insurers are required by law to cover the screening starting January 1, 2015. Medicare proposes to start covering them in February of 2015.