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.

Following an X-ray he was told he had a spot on his lung but the doctor didn’t feel it was anything to worry about. Since he hated going to doctors, he didn’t do anything abut it. Five months later he was in the hospital, diagnosed with lung cancer.

His oncologist recommended chemotherapy and told him he might have about a year to live. My father-in-law went ahead with the chemo but after only two treatments he passed away, just two months after the diagnosis.

I want your readers to know that if a doctor says not to worry about a lung spot, they should worry. Don’t wait, do something about it NOW!

DEAR READER:
I agree with you. Any abnormal lung X-ray should be further investigated to determine what is wrong. In most instances it is not cancer but there is always a possibility, especially for individuals who are past or current smokers or work in heavily polluted areas.

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 to mention the title.

Because I did not understand why this was happening, I made an appointment with a hematologist (blood specialist). She took blood samples and did a genetic profile. Everything came back negative or normal. She concluded that I now have naturally “clotty” blood and I would have to live with it. There was no identifiable cause.

So now, Dr. Gott, my questions to you are: why, after 58 years of being a “normal blood clotter“, did the above happen to me? Will I really have to be on Coumadin for the rest of my life? Should the VA doctors be doing or have done more for me? Your opinions are appreciated.

DEAR READER:
I don’t know why your blood is now clotting in a dangerous fashion. Your hematologist appears to have run extensive tests and ruled out any genetic factors and disorders as the cause. Therefore, you will need to continue the Coumadin for the rest of life. If you were to discontinue it, you would run a very high risk of developing more pulmonary emboli (blood clots in the lungs). You would also be at higher risk for heart attack and stroke if the clots broke off and were carried to your heart or brain. Sticky blood is especially dangerous and your physicians have taken appropriate steps to normalize your blood and reduce your risk of serious consequences.

Another option to explore, albeit unlikely, is lung cancer. In my practice I have seen several cases where pulmonary emboli were the only symptoms of lung cancer. If you wish to explore this option, I recommend you see a pulmonologist (lung specialist). He or she will most likely take a medical history, do an examination and order some imaging studies of your lungs.

Let me know what happens.

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 to 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).