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.

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.

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).