DEAR DR. GOTT: My friend told me about a recent news program on television regarding early detection for lung cancer through X-ray. I missed it because I was visiting my father, who is in a nursing home, but I would love to know what this new testing is all about. Can you fill me in on the details?
DEAR READER: I believe the testing you are referring is spiral computed tomography (SCT). These scans are now being performed as a means of early detection for lung cancer in people who smoke or did in the past. Within 12 to 20 seconds, the machine rotates around the patient and creates images that are reconstructed into a three-dimensional model of the lungs.
The National Cancer Society is conducting a study that should answer questions as to whether a chest X-ray or spiral CT can lower death rates from lung cancer. Evidence from several studies indicates that the spiral CT can detect small cancers not detected on standard chest X-rays.
Of the people tested, up to 60 percent will have abnormalities that are not cancerous. They are simply benign nodules. Unfortunately, this can put the person on an emotional roller coaster, not to mention the radiation exposure. Beyond that, the disadvantage of the CT is that about 25 percent of those tested may produce false positive results, meaning that a person might be considered to have lung cancer when in fact he or she doesn’t. When a problem is suspected, the patient will likely be scheduled for a biopsy or treatment and perhaps even unnecessary invasive surgery, a procedure that can reduce pulmonary function. And that has nothing to do with the fact that many insurance companies will not recognize the cost of the CT, which will likely be close to $1,000. I can already imagine readers saying they will gladly pay this amount to avoid the tortuous medication and side effects they might face, and I can fully appreciate that view.
Lung cancer is the leading cause of cancer-related death in the United States. Perhaps that is why more and more hospitals across the country are using spiral CT for this very purpose, even before knowing study results.
If you are a smoker, the most effective means of prevention is to stop. This addiction, as with alcohol, drugs and countless other issues, is not an easy one to break. Tap into a local support group, and speak with your doctor about over-the-counter patches, gums, inhalers or prescription medications to get you through the initial stages of withdrawal. There is help, and the benefits are well worth it. If you are interested in joining a clinical trial, go to www.cancer.gov/clinicaltrials.
Then ask your doctor whether spiral CT is right for you. About 60 percent of the hospitals across the United States own this type of machine. It is said that early detection can reduce lung-cancer mortality by 20 percent. That’s impressive.
To provide related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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