Posts Tagged ‘lung cancer screening’

Emory Saint Joseph’s Hospital and Winship Cancer Institute Launch Comprehensive Lung Cancer Screening Program

Emory Saint Joseph's Hospital and Winship Cancer Institute have launched a comprehensive lung cancer screening program for high risk patients.Emory Saint Joseph’s Hospital and Winship Cancer Institute have launched a comprehensive lung cancer screening program for Emory Healthcare that offers a low-dose CT (computed tomography) scan for patients most at risk for developing the disease.

According to the American Lung Association, lung cancer is the nation’s leading cancer killer and research shows that lung cancer screening with low-dose CT scans and appropriate follow-up care significantly reduce lung cancer deaths. The CT scan of the chest is used to screen for pulmonary nodules – collections of abnormal tissue within the lungs that may be early manifestations of lung cancer. These nodules are often detectable by lung screening before physical symptoms of lung cancer develop.

“Our goal is to detect lung cancer early,” says Stephen Szabo, MD, director of Winship’s community oncology at Emory Saint Joseph’s, “and our program is unique because we have a team of specialists in radiology, oncology, cardiothoracic surgery and pulmonology providing a continuum of care for each patient.” Participants also have access to the latest clinical trials and cutting edge new therapies within one academic medical system.

“Lung cancer remains the leading cause of cancer-related death for both men and for women. This comprehensive lung cancer screening program will increase the chances of detecting any lung cancers at an earlier, more curable stage” says Walter J. Curran, Jr., MD, Winship’s executive director.

The CT scan is recommended for current or former smokers ages 55-80 who have a 30 pack-year smoking history (packs per day x total years smoked = pack years) or for those who have quit within the past 15 years.

Patients meeting the criteria for the CT scan are required to have a provider referral. Emory Saint Joseph and Winship will assist those candidates without a referral by scheduling a shared decision making appointment with a provider on site in order to facilitate the screening.

Once the scan is completed and read by a radiologist within 48 hours, the multidisciplinary team will determine the best care plan for each patient based upon the results, whether it is immediate treatment or an annual follow up appointment. Patients that have nodules identified during the screening are provided an appointment within 48 hours for a lung nodule consultation with a physician who is a part of the multidisciplinary team.

For more information about lung cancer screening at Emory Healthcare, call 404-686-5864 (LUNG) or visit http://www.emoryhealthcare.org.

View the Emory New Center article here.

Lung Cancer Live Chat Takeaways

lung-chat-260x200According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the U.S.  At least 8.6 million Americans qualify as high risk for lung cancer and are recommended to receive annual screening with low-dose CT scans. Lung CT Screening for individuals at high risk has the potential to dramatically improve lung cancer survival rates by finding the disease at an earlier, more treatable stage.  At Winship Cancer Institute of Emory University, a highly coordinated multidisciplinary team provides advanced care and clinical trials option with cutting edge new therapies for lung cancer patients.

We hosted a live chat with Seth D. Force, MD and Suresh Ramalingam, MD of Winship Cancer Institute of Emory University’s lung cancer team on Wednesday, January 11 where we answered your questions about lung cancer risk factors, lung CT screening, symptoms and therapy. We received a lot of great questions that our physicians were able to answer. Below are some highlights from live chat, and you can read the full chat transcript here.

Lung Cancer Live Chat Highlights

Question: Is a chest x-ray the best place to start for screening?

Dr. Force and Dr. Ramalingam: Chest xrays have not been shown to be helpful for lung cancer screening as confirmed by several older clinical trials. For patients at high risk for lung cancer, a chest CT scan is the best screening test.

Question: At what point should a patient seek specialist if diagnosed with nodule

Dr. Force and Dr. Ramalingam:  Any person who is found to have a nodule should seek a specialist. These specialists can include a thoracic surgeon, pulmonologist, or an oncologist specializing in lung cancer. At Winship, our doctors sit down weekly to discuss the specifics cases and use specific guidelines to determine the next step for a patient found to have a lung nodule.

Question:  What are some of lung cancer symptoms that should worry us?

Dr. Force and Dr. Ramalingam: Good question! Most patients who present with early stage lung cancer are asymptomatic. Symptoms that should cause someone to seek medical consultation are persistent cough, chest pain, coughing up blood, difficulty breathing and unexplained weight loss.

 

Thank you to everyone who participated in our lung cancer live chat with Dr. Force and Dr. Ramalingam. Learn more here.

Lung Cancer: Risk Factors, CT Lung Screening, Symptoms & Therapy Live Chat

lung-chat-260x200According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the U.S.  At least 8.6 million Americans qualify as high risk for lung cancer and are recommended to receive annual screening with low-dose CT scans. Lung CT Screening for individuals at high risk has the potential to dramatically improve lung cancer survival rates by finding the disease at an earlier, more treatable stage.  At Winship Cancer Institute of Emory University, a highly coordinated multidisciplinary team provides advanced care and clinical trials option with cutting edge new therapies for lung cancer patients.

Join Seth D. Force, MD and Suresh Ramalingam, MD, with Winship Cancer Institute of Emory University’s lung cancer team, on Wednesday, January 11 at 12 PM for a live chat where we’ll answer your questions about lung cancer risk factors, lung CT screening, symptoms and therapy. All are welcome to attend this online open-forum discussion.

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Minimally Invasive Surgery is Changing the Early Detection of Lung Cancer

Minimally invasive surgery is changing the early detection of lung cancer by innovating ways of tracking lung nodules when lung cancer is suspected.How is minimally invasive surgery changing the early detection of lung cancer?

The majority of lung cancer surgeries are now performed using minimally invasive approaches. Above 80 percent at Emory. This presents advantages to the patient: less muscle is cut and recovery is quicker. Traditionally surgeons would need to touch the nodule to find it, and accessing the lung via smaller incisions prevents that hands on touch.

When it comes to lung cancer early detection, we have to remember that the lung tissue is normally filled with air, sort of like a puffy sleeping bag. When someone gets a CT scan and a nodule is detected, the air is present. During surgery, the tissue collapses, causing the nodule to shift away from where it was.

At Winship, cardiothoracic surgeons Manu Sancheti, Seth Force and colleagues have been developing a technique of using gold markers. It’s called fiducials and it keeps track of small nodules when lung cancer is suspected. The minimally invasive surgeons published their findings in 2014 in the Annals of Thoracic Surgery.

During a CT scan the radiologist will mark a nodule by inserting a fiducial, which is then visible during the operation via fluoroscopy. This allows the surgeon to precisely cut out the appropriate lung tissue containing the nodule.

“Some nodules are small enough that it’s difficult to feel them at all,” Force says. “Rather than take as many as 45 minutes to hunt around for a nodule during surgery, gold markers are an attractive and accurate alternative.”

Sometimes, cancer can be diagnosed and removed in one day. Some nodules are located deeper, so that it’s harder to access them by needle biopsy first.

A sample from a nodule can be removed during minimally invasive surgery, sent to the pathology lab, and within 30 minutes, the surgeon can have an answer to the question: is it cancer?

Lung cancer remains the number one cancer killer in the U.S. It takes the lives of more people than breast, prostate and colon cancers combined. Lung screenings help lung cancer patients with early diagnosis and increased survival rates through options such as gold markers and minimally invasive surgery. Emory Healthcare’s low-radiation-dose lung screening is available for patients with a significant smoking history. Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

Lung Cancer Screening Guidelines You Need To Know

Current guidelines state that screening for lung cancer is recommended when all of the following lung cancer screening guidelines are met. Learn more.Did you know that not everyone can actually qualify for lung cancer screening? Current guidelines state that screening for lung cancer is recommended when all of the following lung cancer screening guidelines are met:

  • Age 55-77 years
  • Asymptomatic (no signs or symptoms of lung cancer) no lung infection (pneumonia, bronchitis) within the past 12 weeks
  • Current or former smoker (if former smoker, it is recommended that it has been less than 15 years since quitting)
  • History of cigarette smoking with pack-years greater than or equal to 30
  • You have not had a CT of the chest within the last 12 months

How to Calculate “Pack-years”

VIEW ONLINE CALCULATOR

20 cigarettes = 1 Pack

To translate smoking history into ‘pack years,’ simply multiply the number of cigarette packs smoked per day by the number of years smoked.

(# packs per day x # total years smoked = pack-years)
For example: 1½ packs a day smoked over a 30-year period = 45 pack years. If an individual has less than a pack per day smoking history calculate pack-years using the formula below.

(# total years smoked x # cigarettes per day) / 20 = pack-years
For example: 40 year smoking history 15 cigarettes per day = 30 pack years

Please note: a physician’s order is required for the Lung CT Scan. If you do not have this information, please make an appointment with your primary care doctor first. If you do not have a primary care doctor, please call 404-778-7777 and a representative will be happy to match you with an Emory provider.

Do you have any questions? Please comment below.

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What Is Lung CT Scan & How Does It Work?

Lung CT scan provides more detailed information than conventional X-rays making it possible to diagnose & manage lung cancer earlier & more effectively.A lung CT (computed tomography) scan creates detailed pictures of the structures in your chest, such as your lungs. A lung CT scan provides more detailed information than conventional X-rays making it possible to diagnose & manage lung cancer earlier & more effectively. This blog explains what lung CT is and answers some common questions you may be asking as well. If you have more questions, please post them in the comments below and we will respond gladly.

Computed Tomography, commonly known as CT or CAT scanning, is a non-invasive diagnostic tool. CT uses a specialized form of X-ray, coupled with computer technology, to produce cross-sectional images (slices) of soft tissue, organs, bone and blood vessels in any area of the body. CT lung cancer screening has revolutionized medical imaging by providing more detailed information than conventional X-rays and, ultimately, offering better care for patients.

Imaging methods to examine the lungs include chest X-ray, low-radiation-dose chest Computed Tomography (CT) and standard-radiation-dose chest CT. Low-radiation-dose CT is appropriate for cancer screening because it has been demonstrated to be more sensitive than X-ray in detecting cancer, with less radiation exposure than standard chest CT.

CT technology is used to detect pulmonary nodules, collections of abnormal tissue in the lungs that may be early manifestations of lung cancer. These nodules are often detectable by CT before physical symptoms of lung cancer develop. Early detection of pulmonary nodules through CT screenings has been shown to improve survival compared with patients not undergoing lung CT scan.

Many people have pulmonary nodules, but not all are cancerous. In fact, most nodules are caused by scar tissue from a prior lung infection and are not cancerous. Computed Tomography (CT) Screening frequently detects small nodules that are later determined to be non-cancerous. If you have benign nodules, you’ll be asked to return for a CT screening yearly for one or two years to make sure they don’t grow. If a nodule is concerning for cancer, further diagnostic testing will be recommended.

Common Lung CT Screening Questions

Why Is CT Used?

CT scans are used to check the size and structure of an organ or other soft tissue and determine if it’s infected, solid or filled with fluid. The scans are used to diagnose tumors, cancers, spinal injuries, heart disease, vascular conditions, brain disorders and various other abnormalities within the body. CT scans also are used to rapidly diagnose traumatic injuries and to guide a number of minimally invasive procedures such as needle biopsies, catheter placement, fluid drainage and duct and vessel stenting.

How Does CT Work?

CT uses X-rays to detect and record the amount of radiation absorbed by different tissues. During a CT scan, an X-ray tube focuses a precise beam of energy on a section of the body. A computer analyzes the readings from X-rays taken at thousands of different points and converts the information into images radiologists and other doctors use to analyze internal organs and tissue.

Is CT Safe?

Although there’s no conclusive evidence that radiation from diagnostic X-rays causes cancer, some studies of large populations exposed to radiation from other sources have demonstrated slight increases in cancer risk. However, smokers have a much greater risk of developing lung cancer. The chance of developing lung cancer in one’s lifetime is approximately one in 13 for males and one in 16 for females (combined smokers and non-smokers). The risk of developing lung cancer due to a single CT scan of the chest is estimated to be one in 10,000. Because the risk of developing lung cancer is much greater than the added risk from a CT scan, and smoking increases the risk of lung cancer, we feel the benefits of CT screening for lung cancer in patients with a significant history of smoking outweigh the risks of radiation exposure. The radiation dose for CT lung screening is considered “low-dose” because the radiation exposure is less than a CT scan of the chest that’s done for a diagnosed medical problem.

Please note: a physician’s order is required for the Lung CT Scan. If you do not have this information, please make an appointment with your primary care doctor first. If you do not have a primary care doctor, please call 404-778-7777 and a representative will be happy to match you with an Emory provider.

CT Lung Screening Real-life Patient Story

Read this real life patient story about Becky whose life was saved by an Emory doctor who performed a timely CT lung screening.This real-life story about an Emory CT lung screening patient is just one example of how ct screening for lung cancer can save a life.

Becky Huff had been seeing radiologists just to follow up on findings of calcification after a mammogram. A CT scan of her breasts detected nodules in her lungs. Now 67, she quit smoking more than two decades ago. Becky was wondering whether working in a smoke-filled office also contributed to her cancer risk.

For the next two years Emory doctors monitored her lungs with CT lung screening every six months. Pulmonologist Gerald Staton led the group. Then, a change in the appearance of the nodules, along with an inconclusive biopsy, led her to consult an Emory thoracic surgeon Allan Pickens. He recommended a unique type of imaging — a PET scan — to gauge the possibility that cancer had spread.

“To me, that was another safeguard that they knew what they needed to do beforehand,” Becky says.

Using two small incisions on the side of Becky’s body, Dr. Pickens removed the upper lobe of her left lung. Two months later, in a similar procedure, he removed a segment from her right lung. When pathologists examined the removed tissue and samples from her lymph nodes, they detected no signs that the tumors had infiltrated the lymph nodes. That meant she could forgo chemotherapy and radiation.

“This is an example of when we were able to get there early, before the cancer has progressed,” Dr. Pickens said.

Becky’s recovery from the surgeries included some pain. She had trouble finding a comfortable sleeping position and needed to take pain medicine for a couple of weeks. Yet, she had avoided surgeries that would open the chest.

“I did get over the surgery a lot quicker than other people that I’ve seen,” Becky said.

Around the time of her surgeries in the spring of 2011, Becky had begun taking piano lessons. While raising five children, she had always wanted to learn to play. Now, five years after her surgeries and a reassuring PET scan this year, she continues to learn piano and stays active with frequent walks on her family’s wooded property in Talbot County, Georgia.

A physician’s order is required for CT lung screening. If you don’t currently have a care provider; you may meet with one of Emory team members to determine if CT lung screening is right for you.

Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

Lung Cancer Screening – How It Can Save Your Life

Early lung cancer screening detects cancer & helps catch a tumor before it spreads. Medicare & private insurance companies cover screening for lung cancer.Did you know that lung cancer screening can save your life or that of your loved one? Better screening and minimally invasive surgery are changing the prognosis for patients with early-stage lung cancer.

We breathe in and out, every minute of every day. Our lungs are critical for life. Yet if a group of cells in someone’s lungs starts growing into a tumor, that person usually can’t see it or feel it. Until it becomes large enough to be dangerous.

The lungs are encased in the ribs, with few nerve endings. So a tumor has to grow quite large. Only then it starts to take away enough lung capacity to cause discomfort or make someone cough. Even below that threshold, as a tumor becomes larger, it is more likely for some cells to separate off and metastasize.

Early detection of lung cancer by CT (computed tomography) lung cancer screening offers an opportunity to catch a tumor before it grows and spreads. In 2011, the National Lung Screening Trial with over 50,000 participants established the life-saving value of lung cancer screening by lowdose CT for people with a history of heavy smoking. In the last two years, both Medicare and private insurance began to cover the screening for lung cancer procedure.

“Better lung cancer screening is changing the outcomes for lung cancer patients by allowing us to find these tumors earlier,” says Allan Pickens, a Winship thoracic surgeon and director of minimally invasive thoracic surgery and thoracic oncology at Emory University Hospital Midtown. “When we find these tumors earlier, they are generally of a smaller size and have not had the chance to spread to other parts of the body, lymph nodes or other organs.”

Because of increased numbers of lung cancer screenings, doctors now discover lung cancer when it’s small. Often, less than two centimeters wide. Clinical studies show this is a point when it may be possible to treat the cancer by surgery alone. Surgeons also have been shifting to minimally invasive approaches known as video-assisted thoracic surgery.

Lung cancer remains the number one cancer killer in the U.S. It takes the lives of more people than breast, prostate and colon cancers combined. Lung screening may help with the early diagnosis and increased survival rates for lung cancer patients. Emory Healthcare’s low-radiation-dose lung screening is available for patients with a significant smoking history.
Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

Recap on Live Lung Cancer Chat with Dr. Suresh Ramalingam

Dr. Suresh Ramalingam, Professor/Chief of Medical Oncology from the Winship Cancer Insititute, recently conducted an chat pertaining to the leading cause of cancer deaths among both men and women, which is lung cancer.

As many of us are already aware, Dr. Ramalingam reminded participants that secondhand smoke is a known risk factor for the development of lung cancer. Given that exposure to secondhand smoke varies and is difficult to track, it’s also hard to quantify the exact risk second hand smoke has on a person. However, recent studies have shown that states in which laws are in place to restrict public smoking are beginning to report declines in lung cancer incidence.

During the live chat, Dr. Ramalingam also touched on lung cancer treatment options and noted that there is no one-fits-all approach to treating a disease like lung cancer. Ideal treatment methods vary based on the stage of the disease. For early stage lung cancer, surgery is considered the standard treatment, however Dr. Ramalingam noted that some researchers believe stereotactic radiation will one day replace the need for surgery. Dr. Ramalingam added that radiation can also be a very effective treatment option for patients who are not candidates for surgery due to medical reasons. Chemotherapy has shown effectiveness in nearly all stages of lung cancer.

There’s great news for former smokers and the concern of developing lung cancer. Once a smoker quits, the risk of lung cancer progressively decreases. (For a timetable on the benefits of quitting, check out our blog post here) Recently, lung CT scans have demonstrated the ability to save lives in patients who currently smoke, or who have a history of smoking. Dr. Ramalingam suggests that former smokers discuss their smoking history with their physician to see if a lung CT screening is appropriate.

If you would like more information about the causes, prevention and methods used to treat lung cancer you may review Dr. Suresh Ramalingam’s lung cancer chat transcript here.

For more information on lung cancer, check out the related resources below. To become a patient, you may visit the Winship Cancer Institute of Emory University online.

Related Resources

Lung Cancer MD Chat Follow-up Questions Answered

Dr. Taofeek Owonikoko

Dr. Taofeek Owonikoko

Dr. Kristin Higgins

Dr. Kristin Higgins

Doctors Kristin Higgins and Taofeek Owonikoko held a live web chat on the topic of lung cancer this month. From that chat, there were several unanswered questions that we wanted to circle back with the answers for. You’ll find them below in a Q&A format. If you’re interested in checking out the rest of the conversation from the chat, check out the lung cancer chat transcript.

Rhonda asked: Is there any lung cancer treatment program for people without health insurance?

Dr. Owonikoko: Depending on where this person resides, the state may have a program for indigent cancer patients. Also, the American Cancer Society has some patient support programs for indigent patients to support cancer care. Here is the webpage to the support options on the ACS website.

Marjorie asked: My sister has been treated this year for non-small cell lung cancer in the RUL, that was inoperable. she underwent 6 months of radiation and chemotherapy, and has been told that she is now in remission. what are the odds that she will remain in remission for 5 years or more?

Dr. Owonikoko: This is not a medical advice; best to discuss with the treating oncologist. However, depending on the exact stage of the cancer, 20-30% of patients treated with chemoradiation will survive past 5 years.

Marjorie asked: Also, can you comment on outcomes from radiation induced pneumonitis?

Dr. Higgins: Radiation pneumonitis arises in about 20-25% of patients that are treated with radiation and chemotherapy.  It typically resolves with a course of steroids but sometimes requires hospitilization for more intensive monitoring and supplemental oxygen.

Hank asked: There seems to be some controversy about the use of radiation therapy for lung cancer depending on the stege. What are the pro’s and con’s?

Dr. Owonikoko: There is not much controversy about the benefit of radiation for patient with locally advanced lung cancer. The discussion is more about the best way to give the radiation and how much. Radiation is generally not needed for patients with stage I lung cancer of the non small cell subtype but may be useful for symptom palliation in patients with stage IV non small lung cancer.

Dr. Higgins can provide additional insight on the radiation questions.

Dr. Higgins: A form of local therapy is needed to cure lung cancer that has not yet spread to distant sites, whether it be radiation or surgery.  Surgery is the best option for early stage lung cancer.  New techniques of radiation, particularly SBRT, have been used in patients with early stage lung cancer that are not medically fit for surgery. Outcomes have been very good with SBRT, however surgery and SBRT have not been directly compared and surgery remains the standard of care.  There are trials underway that are directly comparing SBRT vs. surgery.
Again I want to stress that surgery remains the standard of care for early stage lung cancer, but pros to SBRT include minimal recovery time and a less invasive procedure.

Do you have other questions for us related to lung cancer? Leave them in the comments below & we’ll be sure to post responses here.