Lung cancer has been carefully examined by the American Cancer Society. Guidelines have been issued that target doctors as well as many other kinds of health care providers.
All patients need to be asked about smoking and how long they’ve been doing it. They also need to meet the following criteria to be screened for lung cancer –
- Ages 55 to 74.
- Fairly Good Health.
- Have a smoking history of at least 30 packs a year.
- Are smoking still or quit around 15 years ago.
Doctors will have to talk to you about the potentially harmful effects, limitations, and benefits of having a lung cancer screening. The screening must be done only at a facility with the proper kind of CT scan. The people in charge must be experienced in lung screening. That facility must have a team of qualified specialists who can provide the right kind of care and to follow up with patients who have abnormal results.
For The Patients
If you meet the criteria above for a lung cancer screening, you and your doctor/health care provider need to discuss the process. They will sit down and talk with you about the things you can expect to happen with your screening and the possible harm and/or benefits that go along with it. They will inform you of the limitations of screenings.
One of the main benefits of a screening is the lowering of your chances of dying from lung cancer. Lung cancer accounts for a large number of deaths among former and current smokers. It’s important that you’re aware that these screenings don’t benefit everybody. An LDCT screening won’t detect all lung cancers. Not all cancers that are detected are found in the early stages.
Even if lung cancer is detected through your screening, this does not ensure your survival. LDCT usually finds things that end up being cancer but need further analysis before they can pinpoint what it is. That means having more CT scans and even some more invasive tests like a lung biopsy. A biopsy means removing a piece of your lung tissue with a needle or via surgery. These tests themselves come with their own kind of risks.
Your screening needs to be done at a facility that has the proper kind of CT scanner. The screeners should have experience in performing LDCT scans for detecting lung cancer. The facility you use must have a team of qualified specialists who can deliver the proper care and follow-up necessary for the patients who have an abnormal scan result. You may not have access to one of these facility close by, which means some travel may be required.
If you agree with your doctor about being screened then you need to have an LDCT done every year, at least until you are 74 years old and still in good health.
Counseling should be sought if you are currently still smoking. You should be advised about your risks for lung cancer and be referred to a program for quitting smoking. Screening is never a good alternative for quitting. To get help quitting your smoking call the American Cancer Society – 1-800-227-2345.
What is Meant by “Fairly Good Health”?
Screening is intended to help find cancer in those who are not showing any signs or symptoms of having it. Those who already have the symptoms might need to undergo tests like CT scans to locate the underlying cause, which just might turn out to be cancer. Still, this type of testing is merely for diagnosis and analysis and is not equivalent to a screening. Some of the most common symptoms associated with lung cancer are coughing up blood as well as losing weight without trying to.
To get the most from a screening, patients have to be in fairly good health. They should be able to handle surgery as well as alternative treatments if they are found to have lung cancer. Patients who need home oxygen therapy probably couldn’t handle having a part of their lung removed, so they would not make good screening candidates. Patients that have other types of serious medical problems , which may shorten their life or keep them from being able to have surgery, may not benefit enough to make a screening viable and shouldn’t be screened.
Metal implants in a person’s chest (pacemakers, for example) or in the back (rods in your spine) have a tendency to interfere with the x-rays and produce a poor quality CT image of the lungs. Patients with that kind of an implant also need to stay away from a screening.
People who were already treated usually have to undergo follow-up tests. That includes CT scans for detecting whether or not the cancer has spread or come back. They call this ‘surveillance’, and it is different from lung cancer screening. If a person has a prior history of having lung cancer they would not be eligible for an NLST.
Screening, Costs, and Insurance Coverage
The price of a low-cost CT scan that is used as a screening for lung cancer usually runs around $300 a test. That will vary from one center to another.
There are currently some private insurers who will cover the costs of lung cancer screenings, however, there are many whom won’t. Medicare has recently decided it will cover the costs of these screenings, and it looks like there might be more insurers jumping on board in the future.
Because of insurance coverage and the laws that regulate it which are always changing, it’s crucial that you check in with your insurance provider and the center doing the tests to see how much it is going to cost you. Even if you have insurance that doesn’t pay for lung cancer screening, it may still cover some of the other relevant tests for which you have something abnormal detected from your screening. It’s always a good idea to know just how much you’re going to have to pay in terms of deductibles and co-pays, etc.
If an Abnormality is Found During Your Screening
Around 1 out of every four screenings turn up something abnormal in the person’s lungs or in the surrounding areas that could be cancer. Most of the time these abnormalities turn out to be something other than cancer. However, additional screenings and tests may be called for to make sure. Some of the tests are defined in the section labeled ‘Exams & Tests for Locating Lung Cancer’.
CT scanning of the lungs will sometimes reveal problems in some of your other organs that were within the field of view of the scan. Any such findings will be discussed with you by your doctor when they are found.