Dr. Sunil Gandhi, Cancer & Blood Disease, 03/12/13

Lung cancer is the deadliest cancer in the United States. Lung cancer causes more deaths than the next three most common cancers combined (colon, breast and prostate).

This is a major disaster. As a country, we must do something to improve this situation. As in many other cancers, early diagnosis is the key in improving odds for cure.

The five-year survival rate for lung cancer is 52.6 percent for cases detected when the disease is still localized (within the lungs). However, only 15 percent of lung cancer cases are diagnosed at an early stage. For distant tumors (spread to other organs) the five-year survival rate is only 3.5 percent.

Obviously, if we want to improve the cure rate, we need to diagnose more patients when the cancer is localized. Unfortunately, at this stage either the patient has no symptoms or only vague symptoms. Many patients do not seek a doctor’s help until it has spread beyond the lung, which makes it practically incurable.

What can we do to detect early lung cancer? The only proven way is screening. Lung cancer screening of all eligible heavy smokers has the potential to avert about 12,000 deaths from the disease each year in the United States.

That reduction would represent 7.6 percent of total lung cancer deaths eliminated nationwide, via early detection with the low-dose CT regimen used in the National Lung Screening Trial (NLST). This was as per a study reported online in Cancer. The ACS, or American Cancer Society, supported this study.

Patients who meet all of the following criteria may be candidates for lung cancer screening:

+ 55 to 74 years old

+ In fairly good health

+ Have at least a 30 pack-year smoking history

+ And are either still smoking or have quit smoking within the past 15 years.

It is estimated 8.6 million Americans fit this criteria. Each CT scan costs several hundred dollars. This is costly.

Also, many times, a spot seen on a CT scan looks like lung cancer and further investigation, which can amount to a biopsy or surgery, may find the lesion to be benign. This is called a false positive. This drives up the cost.

The jury is still out on whether this should be fully implemented in the country. At this time, the National Comprehensive Cancer Network, the American Lung Association, and some other groups now recommend annual CT scans for high-risk patients.

While the ACS, or American Cancer Society, has not yet made the same recommendation, I personally feel it is a good idea in appropriate patients.

Dr. Sunil Gandhi is a hematologist and oncologist. He is the volunteer medical adviser of the Citrus Unit of American Cancer Society. Write to 521 N. Lecanto Highway, Lecanto, FL 34461, email sgandhi@tampabay.rr.com or call 352-746-0707.