Lung cancer screening

Jodi Nielsen, supervisor of CT Scan and MRI, sits near the entranceway of a low-dose lung cancer screening LightSpeed VCT in the CHI St. Francis Radiology Dept. (Independent/Andrew Carpenean)

Over the years, little progress has been made in treating lung cancer, which is the leading cause of cancer-related death in both men and women.

Typically, lung cancer is discovered only after a person develops symptoms, such as pain, a chronic cough or coughing up blood. Most of those people will be dead within a year.

But a new lung cancer screening method is a game changer, according to Dr. M. Sitki Copur, medical director of oncology at the St. Francis Cancer Treatment Center.

The innovation is called low-dose computed tomography. The abbreviation for computed tomography is CT.

It has been available since November at CHI Health St. Francis.

Not only does the screening method reduce lung cancer mortality, but it is quick and reasonably priced. The scan itself takes less than a minute, with the entire appointment lasting about 30 minutes.

If you meet the criteria, the low-dose CT screening is covered by Medicare and most private health insurance.

The benefits of lung cancer screening, Copur said, make it comparable to other screening tests such as mammograms, colonoscopy and pap smears.

Traditionally, lung cancer is diagnosed when the patient is at Stage 3 or 4. After five years, only 15 percent of those people are still alive.

The new screening method allows doctors to catch lung cancer when it’s at stage 1 or 2. At that point, “you can cure them,” Copur said.

Copur believes the new lung cancer screening will save a lot of lives.

Dr. Nathan Murdoch, a radiologist, is also excited about low-dose CT screening. He said it’s “the most significant advance in increasing survival and decreasing mortality for lung cancer patients.”

When a tumor is still small, a surgeon can remove it. Oftentimes, that surgery removes the cancer entirely.

Of those diagnosed with early stage lung cancer, 50 percent are still alive in five years.

Lung cancer kills more people each year than colon, breast, prostate and pancreatic cancer combined.

Doctors might be able to keep an advanced lung cancer patient alive for two or three years, Copur said. But eventually the cancer will move to the brain, because it “is a sanctuary site,” Copur said. At that point, death is usually imminent.

To receive insurance coverage for lung cancer screening, patients have to meet strict eligibility criteria. Individuals must:

— Be between the ages of 55 and 77.

— Be asymptomatic, meaning they show no signs or symptoms of lung cancer.

— Have a tobacco smoking history of at least 30 pack-years. Two packs a day for 15 years equals 30 pack-years. One pack a day for 30 years equals 30 pack-years.

— Be a current smoker or someone who has quit smoking within the last 15 years.

CHI Health St. Francis didn’t have to obtain new equipment to do low-dose CT lung cancer screening. The screening is done on a CT scanner.

In order for the screening to be covered, though, the hospital has to comply with numerous requirements set down by the Centers for Medicare and Medicaid Services, which administers Medicare.

For people to receive the insurance coverage, primary care providers must refer their potentially eligible patients to St. Francis Cancer Treatment Center.

The referral must be made by a physician or qualified non-physician practitioner, such as a physician assistant, nurse practitioner or clinical nurse specialist.

Before the referral is made, rules require that the primary care provider and patient get together for lung cancer screening counseling and a “shared decision-making visit.”

During those sessions, the provider will talk about the risks, document harms and benefits and the importance of adhering to annual screening.

Facilities taking part in the program must offer a smoking cessation program, which CHI Health St. Francis does.

During the counseling session, that cessation program will be offered to the patient.

Just because lung cancer can now be caught early doesn’t mean it’s OK to keep smoking, Copur said.

The most important way to lower the chance of dying from lung cancer is to stop smoking.

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