The numbers are pretty staggering. Every two and half minutes, someone in the United States is told that he or she has lung cancer.
The American Cancer Society projects that 159,000 Americans will die from lung cancer this year, more than will die from breast, prostate, and colon cancers combined. While the overall five-year survival rate for lung cancer is a stark 15 percent, when lung cancer is detected and treated in an early stage, the survival rate drastically increases.
Early identification and treatment are critical for achieving the best outcomes. Should you be screened for the condition? Your medical provider can help you determine whether lung cancer screening is right for you, but there are some basic guidelines, which have been recently revised.
Who Should Be Screened for Lung Cancer
The National Comprehensive Cancer Network, a professional organization that produces guidelines for the diagnosis and treatment of cancer, recommends that people with the following criteria be screened for lung cancer:
- Current smokers and people ages 55 to 74 who have quit within the last 15 years who have a 20-pack-year history
- Current and former smokers, ages 50 and up, who have a 20-pack-year history and at least one additional risk factor, including:
- a family history of lung cancer
- a personal history of any type of cancer
- COPD
- exposure to occupational agents such as silica, asbestos, arsenic, or diesel fumes
- exposure to radon
The U.S. Preventive Services Task Force, or USPSTF, also recently revised guidelines to call for screening at an earlier age and fewer pack years. USPSTF guidelines recommend annual lung cancer screening for adults ages 50 to 80 who currently smoked or have smoked in the last 15 years with a 20-pack-year history.
Wondering what a “pack year” is? A pack year means smoking an average of one pack of cigarettes per day for one year. A person may have a history of 20 pack years because he or she smoked one pack a day for 20 years, while another person may have a 20-pack-year history from smoking two packs a day for 10 years.
How Lung Cancer Is Detected
In lung cancer, studies have shown that the disease can be detected at an early stage using a spiral CT scan. Unlike a chest X-ray, which takes a flat 2-D image of the lung, a CT scanner captures the entire chest and reconstructs them in “slices” on a computer, giving very detailed information about the shape of spots in the lungs.
CT scanners can “see” spots on the lungs as small as a grain of rice. Not all spots are suspicious and not all spots are definitely cancer.
Many people, especially smokers or those who grew up or live in areas where lung infections are common, like west Tennessee, may have spots that could be caused by inflammation, scarring, or other lung diseases.
Most spots will simply be tracked over time, but some will need to be biopsied. A biopsy is a small sample of tissue that is examined under a microscope for cancer cells.
Tissue is collected through a tube inserted down the windpipe, which is a procedure called “bronchoscopy,” or by inserting a needle through the chest wall, which is called “percutaneous needle aspiration.” A minimally invasive operation called “video-assisted thoracoscopic surgery,” or VATS, is also an option.
Jackson-Madison County Hospital recently expanded its ability to accurately determine if a lung spot might be cancer with novel technology called “electromagnetic navigational bronchoscopy.” Using a GPS-like device synchronized with a CT scan, doctors can now navigate through the windpipe to reach spots deep in the lungs for biopsy, enhancing treatment options and avoiding riskier procedures.
How Lung Cancer Is Treated
If cancer is found, treatment options include surgery, chemotherapy, radiation therapy, and sometimes a combination of them. Surgery offers the best chance at survival for cancers found at a small size or early stage.
The traditional surgical treatment for lung cancer is to remove the lobe of the lung in which the cancer is growing, which is called a “lobectomy.”
This typically involves entering the chest by dividing the chest wall muscles and spreading the ribs in order to give the surgeon access to lung tissue. During this procedure, patients are asleep under general anesthesia with a special tube in the windpipe to allow only one lung to ventilate.
After removing the lobe of the lung, special tubes are left in the chest and the ribs and muscles are closed. These tubes are to drain fluid and air and are left in place from three to five days, with patients spending up to six days in the hospital.
Surgeons at Jackson-Madison County Hospital also offer VATS as a minimally invasive option for the removal of lung cancer. The goal with this surgery is to remove the cancer without spreading the ribs.
This is done by using a special small high-definition video camera, which allows for a magnified view of the lung structures, and specially designed long instruments to inside the chest. Often only two to four 2 ½ inch cuts are required, making the procedure less invasive.
Drainage tubes are still required, but they are often removed earlier and there is often less pain and discomfort. Many times, this results in a shorter hospital stay and earlier return to work.
While VATS is an option in many cases, it’s not appropriate in all situations, so your medical provider can advise on what’s best in your specific case.
West Tennessee Healthcare offers comprehensive surgical services, including treatment for lung cancer. Call (731) 541-5000 to learn more.
