Is spiral CT the answer?

December 9, 2010 By

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.
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Daily Column

April 25, 2008 By

DEAR DR. GOTT:
I am a 79-year-old male in reasonably good health for my age.

Many years ago I was diagnosed with mitral valve prolapse. It does not give me any trouble, unless it is somehow connected with my other problem. I have been diagnosed with air hunger.

Occasionally I have the sensation of a shortage of air in my lungs. This causes me to cough suddenly and take several deep breaths to relieve the feeling. I have never smoked and over the years have had several normal chest X-rays. A stress test also showed no abnormalities.

My doctor has prescribed Ativan and Buspirone daily. These seem to help somewhat but are not a cure. The problem intensifies when I have a cold and at other times for no apparent reason. This has been occurring for many years.

DEAR READER:
Air hunger is a respiratory distress condition. It is marked by labored breathing, difficulty breathing and/or the feeling of not getting enough air into the lungs. It can be very disturbing when it occurs. It is not related to mitral valve prolapse.

Your physician appears to have taken appropriate first steps in testing. I believe the next step should be a CT scan or MRI which shows more detail and may pick up an abnormality previously missed. Lung masses, cancer and other conditions need to be ruled out before you can be definitively diagnosed with a benign condition.

I would like to mention that since you appear to be responding favorably to Ativan (an anti-anxiety drug) and Buspirone (a tranquilizer), your air hunger may simply be a manifestation of a panic disorder. Perhaps a psychiatrist or therapist would be the appropriate next step to take.

To give you 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 number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure mention the title.

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Daily Column

April 7, 2008 By

DEAR DR. GOTT:
I’m 73 years old and have been told by two doctors (after having two lung X-rays one month apart) that I have a small spot on my lung. The last doctor said it is probably scar tissue. I have never smoked, had pneumonia or any other disease or illness that might have caused this. The doctors just attribute it to age. The latest advice was to wait six months and have another X-ray to see if the spot has enlarged.

Can you shed any light on this? Do you think it’s advisable to wait six months or should I go to a pulmonary doctor?

DEAR READER:
I advise you not to wait. Were I in your shoes, I would opt to discover what the “spot” is now, not later.

You need to have proof that the “small spot” is benign and not an early lung cancer. In my opinion, you should be referred to a pulmonary specialist who may choose to obtain a CT scan or MRI possibly followed by a biopsy of the lesion. Depending on the outcome of the tests, the specialist can then advise whether treatment is necessary, and if so, can provide you with appropriate options.

While I may be over-reacting, I would hate to miss diagnosing an early lung malignancy that could be cured if addressed early in the course of the disease. Let me know how this turns out.

To give you related information, I am sending you copies of my Health Reports “Pulmonary Disease” and “Medical Specialists”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

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