According to the American Cancer Society, lung cancer is the second most common cancer in both men and women (not counting skin cancer), and is by far the leading cause of cancer deaths among both men and women in the United States. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined1. Even more alarming, Illinois is expected to have an estimated 9,130 new cases of lung and bronchus cancer in 20192. Fortunately, the pulmonary medicine team at HSHS Medical Group Multispecialty Care - St. Elizabeth’s offers a low-dose computed tomography scan (LDCT), the “gold standard” test, to screen and diagnose for lung cancer.
“One of the challenges with lung cancer is that it typically will not present with any symptoms until it has spread,” said Laura Mahaffey, APRN, ACNP, an acute care nurse practitioner at HSHS Medical Group Multispecialty Care - St. Elizabeth’s. “On the other hand, some patients do experience symptoms such as a cough that does not go away or gets worse, hoarseness, weight loss and decreased appetite, or shortness of breath.”
Tobacco use is the leading risk factor for lung cancer. Smoking and secondhand smoke have both been shown to cause lung cancer. Other causes can include radon (a colorless and odorless gas), air pollution, and occupational hazards like exposure to asbestos, coal smoke, diesel fumes and silica. Risk factors can also include lung diseases like COPD, emphysema, fibrosis or a family history of cancer—especially with lymphoma, head or neck cancer. And if one of your first-degree relatives—like a parent, sibling, or child—has or had lung cancer, that puts you at a higher risk3.
“Shortness of breath will often bring patients to see us,” said Laura. “Many of the patients eligible for LDCT are patients already following with us because they have other problems associated with smoking, such as COPD, emphysema or chronic bronchitis. If the patient meets the criteria set forth by the USPSTF, then we talk with him or her about a lung cancer screening. We’ll discuss the benefits and risks of the screening. The main benefit is we may catch the cancer earlier, offering a better opportunity for a curative treatment option.”
One of the biggest misconceptions about some cancers is that if a nodule is revealed on an image, such as a CT scan, that it is automatically cancer. “This is not the case,” Laura stated. “Nodules can be anything from scar tissue to inflammation from an infection, or even a fungus. There are a lot of different guidelines and resources that are available for us to help with the monitoring and support the decision-making process.”
HSHS Medical Group’s pulmonary medicine team provides screening and diagnosis for those who are at high risk for lung cancer. “My role within the care team is screening,” said Laura. “I help identify those patients who are high risk and may be candidates for LDCT. I talk with them about a lung cancer screening and then order the test.”
The criteria for a screening are outlined by the U.S. Preventive Services Task Force (USPSTF), a volunteer panel of national experts in disease prevention and evidence-based medicine. The USPSTF recommends annual screenings for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who currently smoke or have quit within the last 15 years, and who have a 30-pack-per-year smoking history4, a way to measure the amount a person has smoked over a long period of time. It is calculated by multiplying the number of cigarette packs smoked per day by the number of years the person has smoked5.
LDCT is the only recommended screening tool for lung cancer. It’s a low-dose CT scan of the chest with minimal radiation, and little to no discomfort for the patient. It takes less than a minute to perform. During the procedure, the patient lies down on a table and briefly holds their breath to ensure the best possible visualization of the lungs. There is no contrast involved, no IVs needed, and no medication that needs to be taken pre- or post-procedure. The screening is Medicare-approved and considered the most accurate practice screening tool available. It is conveniently available in the same building as HSHS Medical Group’s office.
“Once the screening is complete, the results are shared with the patient,” Laura said. “This part of the process is often reassuring to the patient, and we give patients a big sigh of relief whenever we can give good news to them. If something is suspect in the image, we will discuss surveillance or treatment options and develop an individualized care plan appropriate for each patient. Another benefit is that the results can prompt patients to think about their smoking habits more critically, consider a cessation program, and finally stop smoking. Once the patient stops smoking, the risk of cancer goes down. The scan can give peace of mind for the patient and their family while at the same time encourage the patient to make healthy lifestyle changes.”
Laura concluded, “Lung cancer screening via LDCT is one more way we put the patient first at HSHS Medical Group. For patients at high risk for lung cancer, the screening is a state-of-the-art tool to help us catch cancer earlier and give the patient a better chance at curative therapy. Patients appreciate our team approach to their care, too. We are experienced and also up-to-date on current guidelines. Together, we exhibit compassion for our patients, especially when managing a serious diagnosis like cancer. My goal for every patient is for them to achieve the best life they can live. Our hope is to not find cancer in the patients we care for. But if we do find cancer … we want to find it sooner rather than later.”
Now patients can breathe easier knowing they have access to the “gold standard” for lung cancer screening, delivered by HSHS Medical Group’s patient-first care team, close to home. Talk to your health care provider if you meet the high-risk criteria for lung cancer.
HSHS Medical Group Multispecialty Care - St. Elizabeth’s is conveniently located at 3 St. Elizabeth’s Boulevard, Suite 5000, in O’Fallon, IL, 62269. Call (618) 641-5803. The pulmonary medicine team cares for adult patients ages 18 and over with pulmonary conditions including lung cancer, COPD, asthma, sleep apnea, chronic cough, and others. We are a specialist group that primary care doctors and hospital providers can refer to for further pulmonology follow-up for conditions and diseases of the lung.
1Lung Cancer Prevention and Early Detection-American Cancer Society-https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection.html
2Cancer Statistics Center-Illinois-American Cancer Society-https://cancerstatisticscenter.cancer.org/#!/state/Illinois)
3Lung Cancer Rates-Illinois-American Lung Association-https://www.lung.org/our-initiatives/research/monitoring-trends-in-lung-disease/state-of-lung-cancer/states/IL.html)
4Lung Cancer Screening-U.S. Preventive Services Task Force (USPSTF) https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening)
5NCI Dictionary of Cancer Terms-National Cancer Institute-https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pack-year
Signs and Symptoms of Lung Cancer
American Cancer Society = https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection/signs-and-symptoms.html
Most lung cancers do not cause any symptoms until they have spread, but some people with early lung cancer do have symptoms. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed at an earlier stage, when treatment is more likely to be effective. The most common symptoms of lung cancer are:
A cough that does not go away or gets worse
Coughing up blood or rust-colored sputum (spit or phlegm)
Chest pain that is often worse with deep breathing, coughing, or laughing
Weight loss and loss of appetite
Shortness of breath
Feeling tired or weak
Infections such as bronchitis and pneumonia that don’t go away or keep coming back
New onset of wheezing
If lung cancer spreads to distant organs, it may cause:
Bone pain (like pain in the back or hips)
Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain or spinal cord
Yellowing of the skin and eyes (jaundice), from cancer spread to the liver
Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collections of immune system cells), such as those in the neck or above the collarbone
Most of these symptoms are more likely to be caused by something other than lung cancer. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found.