Early screening detects lung cancer when cure is possible

The woman had gone to her primary care doctor for her annual checkup. Since she smoked and was between the ages of 55 and 77, she met the criteria for screening for lung cancer.

She didn't have any symptoms, but as with a mammogram or a colonoscopy, the screening would find lung cancer early when it could be cured.

The doctor sent her to the Lung Nodule Clinic at Cape Fear Valley Medical Center in Fayetteville for a low dose CT (computed tomography) scan. There, an area of concern was found on a lung.

It would need watching.

Three months later, another scan showed the area had changed, so a biopsy was performed and it was cancer.

"It was found at stage one, very tiny," said Carol Pyne, RN, the clinic's nurse navigator.

The patient underwent a CyberKnife non-invasive treatment with radiation to melt the tumor.

"She is doing great in her follow-up scans. She is living a normal life. Still smoking a little bit," Pyne said.

Lung cancer kills an average of 150,000 people every year in the United States, more than any other cancer, and 80 percent of them are smokers or ex-smokers.

Pyne sympathizes. She battles the stigma of smoking daily when new patients arrive.

"It's very hard to quit smoking," she said.

When cancer happens, there’s a lot of self-blame, so she believes it's this guilt that prevents many from getting screened in the first place.

"If you still smoke, get the screening," she said. "It's not a punishment."

It's your life at stake, Pyne said

As a nurse navigator, Pyne helps patients through the maze of appointments and procedures that come with a cancer diagnosis. She also helps those interested to find smoking cessation classes or get medication.

The Lung Nodule Clinic at Cape Fear Valley Medical Center uses Medicare criteria to recommend the low dose CT scan for lung cancer screening, whether or not a patient is on Medicare. Those conditions are:

If a person meets the criteria, then they will need a referral from their physician. Most health insurance policies cover the procedure.

A low dose CT scan doesn't require as much radiation as a regular CT scan. It’s a better screening tool than a chest X-ray, which -- being one dimensional -- doesn't show the three-dimensional "slices" of a CT scan.

The actual procedure takes 10 minutes, and the low-dose scan doesn't require an IV or dye as many full dose scans do.

The patient's primary care doctor will go over with each patent what to expect. As with any procedure, there are risks and benefits. The greatest risk is a false positive, which usually means repeated scans every few months.

Most people screened don’t have cancer. Nationally, the rate is one cancer for every 100 scans.

At the Lung Nodule Clinic, the rate is higher. Their past 156 low dose CT scans found five cancers.

Usually by the time lung cancer is diagnosed, it’s at a later stage. The low dose CT scans offer a chance to find cancer early when it’s more treatable with a longer survival rate.

Many times lung cancer is found accidentally, Pyne said, while a patient is being screened for other issues. Pyne knew of one patient with a history of heart disease, so when he had chest pain and shortness of breath, they assumed it was his heart.

After his cardiac work up was clear, a CT scan of the chest was ordered. Unfortunately, he was found to have stage IV lung cancer.

Providers and patients need to be vigilant about lung cancer screening. Early detection is the key to longer survival rates.