Michael Spandorfer, MD
Pulmonologist and Critical Care Specialist
Roper St. Francis Healthcare
Who is at risk for lung cancer?
Smoking cigarettes, cigars and pipes puts people at risk for developing lung cancer. You are considered high risk if you are between 50 and 80 and (1) currently smoke and have a “20 pack-year” history of smoking, and (2) quit smoking in the past 15 years but had a 20 pack-year history. What is a “pack-year”? Any combination of packs of cigarettes and years that add up to 20. For example, one pack of cigarettes every day for 20 years OR two packs of cigarettes a day for 10 years would be 20 pack years.
Why is it important to be screened for lung cancer?
It’s very simple: We can save lives through the early detection of lung cancer. For every 1 cm that a stage 1 cancer grows, the five-year survival rate decreases by 10 percent. And now at Roper St. Francis Healthcare, we offer a new technology that helps us biopsy lung nodules even earlier and safer than before.
Should I have a lung cancer screening, even if I have no symptoms?
Yes, if you are in the high-risk category defined above, you should be screened using a low-dose CT scan, even if you have no symptoms. Screening is so important because there are generally no symptoms of early disease. However, the earlier we find lung nodules, or lumps, the more easily and effectively they can be treated.
How often should I be screened?
Generally, individuals at high-risk should be screened once per year.
Are there other risk factors for lung cancer besides smoking?
Yes, there are other risk factors, and you should discuss these with your physician and decide, together, if your risk indicates that you should be screened. These risk factors include:
- Radon exposure
- Occupational exposure
- Cancer history
- Family history of lung cancer in first-degree relatives
- Disease history (chronic obstructive pulmonary disease – COPD – or pulmonary fibrosis)
- Exposure to second-hand cigarette smoke
What happens if a lump or a nodule is found during the screening?
At Roper St. Francis Healthcare, every CT scan that reveals a lung nodule is reviewed at a weekly meeting of the experts with our Multidisciplinary Thoracic Oncology Program. This broad-based team includes specialists who review the size and location of the nodule or nodules and the patient’s medical history to make a recommendation to your physician about the next step.
Most nodules are not cancerous, and for many small nodules (under 8 mm or 1/3 of an inch in size), the recommendation will be to monitor it over time with additional CT scans. If the nodule does not grow, it is likely not cancerous. If it does grow, however, doctors may want to do a biopsy to take a sample of the tissue to determine whether it is benign (not cancerous) or malignant (cancerous).
An important new biopsy option is now available at Roper St. Francis Healthcare for patients with a Category 4 nodule (about 8 mm or larger). Previously, even patients with nodules of this size would be advised to “watch and wait,” because getting a biopsy required open surgery. This watching and waiting created patient anxiety. Now, a new robotic-assisted approach for biopsies is revolutionizing how we approach these lung nodules. It allows us to get answers earlier and save lives.
What is this new robotic technology, how does it work and why is it important?
The new Ion Endoluminal System® is a robot-assisted, minimally invasive navigational technique. Like a GPS guide, the technology allows us to easily reach all 18 lung sections with fewer complications than traditional procedures. No open surgery is needed. If the nodule is benign, the patient’s anxiety is relieved. If it is malignant, effective treatment can begin right away for a significantly improved survival rate.
How do I schedule a lung cancer screening?
Talk with your physician about your risk level, and if appropriate, ask for a referral for a lung cancer screening. The CT scan is low dose, so there is little exposure to radiation, and it is quick and painless.