Lung cancer is the leading cause of cancer death in the United States. As with most types of cancer, lung cancer treatment is most successful when the cancer is discovered early.
While most lung cancer symptoms begin after the disease has reached an advanced stage, new technology can detect lung cancer in its earliest stages.
In this video, San Diego Health host Susan Taylor talks about screening for lung cancer with Samir Makani, MD, an interventional pulmonologist and director of the new lung cancer screening program for Scripps Cancer Center.
While some people who have never smoked do develop lung cancer, smoking is still the primary cause. In fact, 90% of lung cancers are related to smoking.
The longer or more often a person has smoked, the higher their risk of developing the disease. Once the disease has progressed, symptoms may include a lingering cough, shortness of breath, and even coughing up blood.
Early diagnosis is key to survival. When lung cancer is found in the late stages, survival after five years can be in the single digits. When it is found early, survival rates can be 80% or higher.
The Scripps Cancer Center has developed a fully comprehensive lung cancer screening program focused on detecting lung cancer in its earliest stages.
The multidisciplinary program includes lung doctors, cancer doctors, radiologists and other specialists. It is open to people between the ages of 50 and 80 who have smoked regularly for at least 20 years and have not quit within the last 15 years.
“If you qualify, the first step is a shared decision-making visit with our nurse practitioner, who will go over the risks and benefits of lung cancer screening, help you quit smoking if you're continuing to smoke, and talk about related conditions like emphysema and COPD,” says Dr. Makani.
“Once you’ve completed the visit, you would undergo a CAT scan, which has a very low radiation risk, and then meet again to go over the findings.”
The radiologist who reads the CAT scan looks for nodules, which appear as small white or hazy spots in the lungs. While nodules do not always indicate lung cancer and may be caused by scars from pneumonia or other infections, they require further evaluation.
If nodules are present, the next step is a procedure called a bronchoscopy, which removes a sample of the nodule to check for cancer. Recent advancements in robotic-assisted bronchoscopy have made it easier to access and obtain samples with greater accuracy.
“Back when bronchoscopy first started, we had limited access to the chest from the inside. Now with robotic bronchoscopy, we're able to reach the smaller lesions in very difficult portions of the lung that were previously unattainable,” explains Dr. Makani.
“We try to get close to these spots that are potentially the size of an eraser head on a pencil. Robotic bronchoscopy allows us to reach more areas and also provides stability, so when we get to where we want to go, we're able to maintain that position and take successful biopsies.”
Robotic bronchoscopy is done under general anesthesia, so patients are completely asleep and comfortable for the entire procedure, which takes about an hour.
Treatment for lung cancer may involve surgery, chemotherapy, radiation or a combination of these. Many early-stage lung cancers can be treated surgically by removing the affected portion of the lung. Scripps Cancer Center surgeons perform minimally invasive robotic lung cancer surgery in addition to robotic bronchoscopy.
If you have a cough that lasts weeks to months and you haven’t been sick, or you cough up blood or feel short of breath, see your primary care physician sooner rather than later. Your doctor will evaluate you and determine the cause of your symptoms and whether you need further evaluation.
“If you qualify for lung cancer screening, it’s very important to get screened. We know for sure that early diagnosis of lung cancer through screening provides a higher survival rate at five years,” says Dr. Makani.
“Here at Scripps Cancer Center, we’re actively looking at ways to improve our screening techniques. We’re looking at different blood tests to help identify high-risk patients as well, so there are a lot of innovative things happening in and around screening.”