By Dr. Wylie D. Hosmer
Time and again, studies have shown that screenings can make a significant difference in successfully treating cancer. Specifically, mammograms and colonoscopies have been shown to improve early detection and increase the possibility of cure for both breast and colon cancers. Now, research is showing that the same holds true for lung cancer — the most common cause of cancer-related mortality in the United States.
Lung cancer is more easily and effectively treated if diagnosed at an early stage, before the cancer has an opportunity to spread within or outside the lung.
Tobacco users are most at risk, and there is now a clinical trial available for high-risk patients. Over the past several years the National Lung Screening Trial randomly assigned more than 50,000 active or former smokers to receive either an annual CT (computerized tomography) scan of the chest for three years or an annual chest X-ray for three years. Participants in the trial were between 55 and 74 years old, had a history of smoking the equivalent of one pack of cigarettes a day for 30 years or more, and were still smoking or had quit within the last 15 years. The trial demonstrated a 20 percent reduction in the chance of dying from lung cancer for those patients who had the annual CT scans. The trial also clearly demonstrated that cancers were detected at a smaller size for patients who had annual CT scans as opposed to X-rays or no screening at all.
The positive results from the trial have led to broad recommendations from major medical organizations to provide an annual lung CT screening for any patient who meets the criteria established for the trial. The criteria has been broadened to some other situations so it is worth discussing with your physician if you have any history of smoking. Lung CT screenings are now covered by both Medicare and all commercial insurance companies. The CT used is a low dose designed to limit exposure to radiation.
Many cancer programs, including the Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, now offer CT lung screenings, as well as advances in the use of precision radiation techniques (radiosurgery) to provide an alternative to surgery for treatment of these patients.
In cases where the cancer has progressed to a more advanced stage, advances are being made in the use of medical therapies to harness the immune system to fight the cancers. It is indeed an exciting time to be in the field of oncology research and clinical treatment, as our understanding of this disease continues to make great strides and move us closer to breakthroughs.
Dr. Wylie D. Hosmer is the medical lead of the Thoracic Oncology Disease Management Team at the Hartford HealthCare Cancer Institute and director of the Thoracic Oncology Program at the Hartford HealthCare Cancer Institute at The Hospital of Central Connecticut in New Britain.