Dear Dr. Garner,
First, I want to wish you a Happy New Year! Now I have a question that I hope you can help resolve. My husband has been a heavy smoker all of his life. His doctor orders chest X-rays each year to see if he has any early sign of cancer. Fortunately, everything has been OK so far.
I heard about a new test on TV that is like a CT scan. Apparently, it is able to find cancers at an early stage. Should my husband continue to go for a chest X-ray each year, or should he switch to the new method?
Lung cancer concerns in Canarsie
I hope that you and all of our readers had a happy and healthful New Year. May all your New Year’s resolutions be realized.
While New Year’s resolutions often include quitting smoking, this is usually not successful. For those who do smoke, the screening you heard about on TV – a computerized tomography (CT) scan – can help detect lung cancer when it is still at a curable stage.
What makes lung cancer so deadly is that 75 percent of patients go to the doctor after the cancer has spread and cannot be cured. Unfortunately, at the end of five years, most of these patients will be dead.
What can a smoker do? The idea of getting a chest X-ray each year to find early curable cancer has been used in the past but has now been shown to be ineffective. There is no study that has shown any benefit as far as prolonging life or improving quality of life by getting a chest X-ray each year. The CT scan test that you mention, however, is a very important way to prevent deaths from lung cancer.
Until recently this test was not practical to use because the CT scan itself gave off a large amount of radiation, which over time could be harmful and actually cause cancer. Through new technology, a low-radiation dose CT scan test can be used to detect early lung cancer. This may be at a stage when it can be cured. No test is perfect, however I believe the benefits far outweigh the risks.
Government panels have reviewed the test, and these experts have concluded that heavy smokers should have a yearly CT scan screening. This recommendation will help to make the test available and covered by Medicare, Medicaid and most private insurance. New York Methodist Hospital, Park Slope, with which I am affiliated, is one of many hospitals that offer free or low cost low-dose CT scan tests.
Anybody who has been a heavy smoker should see his or her doctor to determine if low-dose CT scanning should be performed. I could present a lot of other data, both economic and medical, however the bottom line is that a low-dose CT scan lung cancer screening saves a significant number of lives and is highly underutilized.
I hope that this discussion spurs others who are most at risk to take this 25-second test. Of course, the most effective thing you can do to reduce the risk of lung cancer is to stop smoking.
The patients identified by the panel to benefit the most from lung cancer screening are:
• ages 55 and over
• have a history of heavy smoking (at least 30 pack-years)
• a former smoker who has quit within the last 15 years
Tell your husband that a low-dose CT scan screening is the way to go and could save his life. I hope that your husband and other smokers take advantage of this life-saving opportunity in the new year.