Making strides against lung cancer
● By J. Chambless
Radiologist Laurence Spitzer (left) and director of imaging John Mikalajczyk are promoting a new type of screening exam for lung cancer.
By John Chambless
When it comes to lung cancer, by the
time symptoms show up, it's usually too late. That's why early
detection is a key to survival, and Jennersville Regional Hospital is
ready to help.
“Lung cancer is very prevalent. Almost 250,000 new cases will be diagnosed every year,” said radiologist Laurence Spitzer. “And there's a very high mortality rate. The five-year mortality rate has stayed at about 15 percent since the 1970s. If we catch it at an early stage, it has a very favorable prognosis.”
As part of a recent national trial, 53,000 patients across the country were studied. Some got an annual chest X-ray, and others got an annual low-dose CT scan that uses one-third the radiation dose of a normal CT chest scan. “The low-dose screen is just as thorough at picking up lung nodules,” Spitzer said. “The study found that, over two years, there was 20 percent reduction in mortality in those that were given the low-dose CT. That's very significant.”
The old practice of getting an annual chest X-ray is no longer applicable, said John Mikalajczyk, the hospital's director of imaging. “What most people don't know is that more people die from lung cancer than breast cancer and prostate cancer combined. It's a huge risk to the population that's really not discussed.”
Given the success of the low-dose CT scans, “the importance is stated by how quickly Medicare and Medicaid adopted payment for it,” Mikalajczyk said.
“Many insurance companies follow along with what Medicare does,” Spitzer said. “When the results of the study were published, many professional societies quickly jumped on the bandwagon and recommended this low-dose CT screening for lung cancer.”
The cost savings of early detection versus intensive treatment later makes financial sense for the insurance companies, and is a lifesaver for patients.
Since Jennersville began the low-dose scans in July, half a dozen tests have shown no nodules, Spitzer said. Patients who have gotten the initial scans commit to one more scan per year for three years, and all the data is sent to a national registry to help research into lung cancer.
“We are a member of the American College of Radiology,” Mikalajczyk said. “We submit information from every patient we have to their data repository. They will continue to study those who were scanned, and use that data to try and capture more people.”
Those most at risk are smokers, Spitzer said. To qualify for the low-dose CT screenings, patients must be 55 to 77 years old, show no signs of lung cancer, have a smoking history of at least 30 “pack years” (meaning one pack a day for 30 years), and be either a current smoker or one who has stopped smoking within the last 15 years.
The scan takes only seconds, it's painless and not invasive. The results are available the same day.
“After the first scan, about 14 percent of people stop smoking,” Spitzer said, because once under a doctor's supervision, smokers usually commit to a healthier lifestyle. The obstacle is getting wary smokers to come in for the quick and easy scans.
To accomplish that, Jennersville Hospital is reaching out to area physicians to let them know about the availability of the screenings. They distributed information at last weekend's Penn Township Picnic and Health and Wellness Fair as well, and have met with community groups.
Spitzer said 86 percent of the scans will typically be normal, and around 18 percent will require some degree of further follow-up. The hospital has a “Lung Navigator” staff member who guides patients through every step of the process.
Anyone interested in getting a low-dose CT scan must first get a prescription from a primary care physician. Screenings can then be scheduled by calling Jennersville Hospital at 610-869-1555.
To contact Staff Writer John Chambless, email firstname.lastname@example.org.