Ask the Doctor at Saint John's: Lung Cancer Screening

Q. I am a former smoker, should I get a CAT scan screening for lung cancer?

By Robert Cameron, M.D., thoracic surgical oncologist at the John Wayne Cancer Institute at Saint John’s Health Center.

That’s a good question. Lung cancer is the leading cause of cancer deaths in the United States. And smokers -- even those who’ve quit -- are at high-risk. But screening for lung cancer is controversial and currently under heated debate in the medical community. Several national clinical trials are examining the issue.

Tumors in the lungs don’t produce many symptoms. We usually don’t discover lung cancer until it’s at an advanced stage and the prospects for recovery are poor. We’ll find it when someone comes in with a cough or cold that won’t go away, a cough that produces a bit of blood, or sometimes from a routine chest X-ray.

If you are a former long-term smoker over 50, I’d recommend talking to your doctor about a low-dose screening CAT scan, which can detect the disease at its earliest and most curable stage.

The drawbacks are that a CAT scan also detects small, benign nodules that commonly occur in the lungs. These nodules look like lung cancer and since only a biopsy can definitively tell the difference, people may go through needless pain, worry and the expense of unnecessary invasive tests or surgery.

A good idea if you’re a former smoker is to get a baseline CAT scan. If small nodules are detected, your doctor can follow them with regular screenings to see if they grow. If they remain stable, they’re assumed harmless.

For those people who do contract lung cancer, treatment most likely will involve a combination of surgery, chemotherapy and radiation therapy. In the case of surgery, which is my expertise, we’re able to do 80 percent of surgical cases with small incisions, allowing for quicker recovery and shorter hospital stays.

Although survival rates for lung cancer are improving, they remain much lower than other types of cancer. Cigarette smoking is the main cause of lung cancer. The good news is there has been a decline in lung cancer due to the decrease in people who smoke. California has one of the fewest smokers per capita of any state because people here are relatively health conscious.

Robert Cameron, M.D., is a thoracic surgical oncologist at the John Wayne Cancer Institute at Saint John’s Health Center. For more information about Dr. Cameron and other Saint John’s services, please call (310) 829-8990 or visit the website at www.stjohns.org. For a physician referral or a second opinion, please call 1-888-ASK-SJHC.

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