Lung Cancer Screening - Mayo Clinic
How to Screen for Lung Cancer
Lung cancer is the leading cause of cancer deaths among both genders in the U.S., claiming more lives than colon, prostate, ovarian and breast cancer combined.People at the greatest risk for lung cancer include smokers and those who work with or around toxic chemicals, gases and irritating particles. Screening for lung cancer is important because it's much easier to treat in the early stages before spreading or metastasizing to other parts of the body. You can sort of screen / monitor yourself by understanding common symptoms, but periodically seeing your doctor for chest x-rays, sputum samples and/or CT scans is the best strategy.
Identifying the Symptoms of Lung Cancer
Remember that early symptoms can be mild and vague.One of the reasons that lung cancer is so deadly is that the disease doesn't often cause noticeable symptoms during the early stages.Furthermore, the mild symptoms of early stage lung cancer are often mistaken for a cold, bout of the flu, bronchitis or asthma.
- Common early signs of lung cancer (and most upper respiratory infections) include a mild, persistent cough, shortness of breath, fatigue, and weight loss.
- Signs and symptoms of lung cancer usually become noticeable once the disease is advanced, which is why it's such as deadly disease.
- The common cold, flu and bronchitis are viral infections that typically fade away two to three weeks, so if your symptoms persist, schedule an appointment with your doctor.
Be suspicious of a new cough that doesn't go away.One of the telltale symptoms of lung cancer is the development of a persistent cough that's either completely new or noticeably different than the typical dry, hacking smoker's cough.In contrast to the dry and unproductive cough common with smokers, coughing up foul-smelling phlegm and even blood on occasion is not unusual with the mid-stages of lung cancer.
- Due to the constant coughing and slow destruction of tissue in the lungs from lung cancer, chest pain invariably develops also.
- Along with the coughing, wheezing and hoarseness are common with lung cancer too — but it's often misinterpreted as being either emphysema or asthma.
- If you have a cold or flu and are full of phlegm you may need a chest x-ray. If you have a severe cold with purulent sputum, then the doctor will do a chest examination, such as an x-ray.
Look out for unexplained weight loss and fatigue.Another telltale sign of later-stage lung cancer (and many other cancer types) is unexplained / unintended weight loss, which is known medically as cachexia.Cachexia is best described as wasting away and it occurs because the growth and spread of the cancer burns a lot of energy, so your muscles and fat stores waste away.
- Unlike weight loss from dieting and exercising, cachexia leads to loss of muscle mass and a gaunt-like appearance — sunken eye sockets and cheeks, for examples.
- Along with weight loss, chronic fatigue develops rather quickly with lung cancer because the lungs lose their ability to absorb oxygen and transfer it to the blood efficiently.
Watch out for unexplained bone pain.A late-stage and very serious symptom of lung cancer is deep, achy bone pain, which usually indicates the cancer cells have spread (metastasized) to the skeletal system.The spine, ribs and skull are common sites of metastasis for lung cancer, which is often described as a constant, deep boring pain that can get worse at night while in bed.
- If lung cancer spreads to the skull / brain, headaches, dizziness and nausea quickly follow.
- Once lung cancer has spread to the bones and/or other organs, the chances of survival tend to plummet, even with intensive medical treatment.
Getting Screened for Lung Cancer
Talk to your doctor about getting screened if you're at risk for lung cancer.If you're a heavy smoker (or have a recent history of smoking), work with toxic / noxious material and are older than 55 years old, ask your doctor about yearly (annual) screenings for lung cancer.Getting screened typically means testing for the disease when there are no symptoms or history of lung cancer.
- Heavy smoking means smoking at least a pack of cigarettes a day for more than a few years consecutively.
- The goal of screening is to catch lung cancer early when it's most treatable and poses the least threat to life.
- Lung cancer screening tests can suggest cancer when no cancer cells or tumor is present, which is called a false-positive result. False-positives lead to additional diagnostic tests and surgeries that are not needed and carry additional risks.
Don't rely only on chest x-rays.Many decades ago, chest x-rays were considered the most hi-tech and best way to diagnose lung cancer, but in modern times it's recognized as being unreliable for screening purposes.Chest x-rays are pretty good at detecting larger tumors and masses in the lungs, but that's when the condition is already quite advanced, which defeats the purpose of screening. As such, x-rays should only be used to help confirm a diagnosis of lung cancer, not screen for it on a yearly basis.
- Chest x-rays involve relatively high doses of radiation, which can increase the risk of lung cancer (and other cancers) developing over the course of many years.
- X-rays visualize bone much better than soft tissue, so chest x-rays are more valuable for seeing if lung cancer has spread to the surrounding bones.
Get a CT (computed tomography) scan for best results.According to medical authorities, the only recommended effective screening test for lung cancer is low-dose CT scans or LDCT.With an LDCT, a special x-ray machine controlled by a computer scans the chest area and uses relatively low doses of radiation to take detailed pictures of the lungs — both of the soft tissues and surrounding bones.
- Annual screening with LDCT reduces the number of people who die from lung cancer, but only in very high-risk smokers and ex-smokers.
- LDCT screening is associated with a high number of false-positive results, which leads to unnecessary further testing and procedures.
- LDCT takes place on a table that slides in and out of a large scanning machine. The detailed pictures are actually many "slices" of the chest area.
Augment CT scans with a sputum test.Another type of test that can be used along with LDCT scanning (but not relied upon solely) is sputum cytology, which involves looking at a sample of your lung mucus (called sputum or phlegm) under a microscope for cancer cells.Collecting sputum is not difficult with chronic smokers and people with lung cancer, so no invasive procedures are needed.
- Sputum cytology is used to check for signs of lung cancer, but it doesn't decrease the risk of dying from lung cancer when used solely as a screening tool.
- Unlike chest x-rays and CT scans (even lose dose), sputum cytology doesn't expose the patient to any radiation. Furthermore, false positives are much more uncommon.
- If the sputum does not uncover the etiology, then you may need bronchoscopy with bronchoalveolar washings. This is when they put a tube in your trachea to get a specimen from the inner lung tissue for diagnosis.
Reducing Risk Factors
Quit Smoking.Your risk of lung cancer significantly increases with the number of cigarettes and cigars you smoke daily, as well as the number of years you smoke for.Quitting at any age can dramatically lower your risk of developing lung cancer — it's never a bad time to quit. Tobacco smoke contains cancer-causing compounds (carcinogens) that mutate lung cells into cancerous cells.
- Quitting "cold turkey" is difficult for most people, so consider using nicotine patches or gum to wean yourself off the addiction.
- Hypnotherapy can be very effective for quitting smoking, but it doesn't seem to work for everyone. Make sure to use a reputable hypnotherapist.
- Try using the START acronym to help you on your way. START stands for “Set” a start date to quit smoking, “Tell” your friends and family for support, “Anticipate” difficulties and plan ahead, “Remove” all tobacco products from your car, house, and place of work, and “Talk” to your doctor about available treatment methods and support.
Avoid secondhand smoke.Even if you're not a chronic smoker, your risk of lung cancer increases measurably if you're exposed to secondhand smoke on a regular basis.It's not as intense as smoking, but some of the carcinogens float in the air and can cause lung damage once you breathe them in.
- Most restaurants in developed countries are non-smoking now, but avoid bars / nightclubs where smoking is still permitted.
- Ask your friends and family member who are smokers to smoke well away from you and other non-smokers (especially children) — preferably outdoors in a well ventilated room or area.
Reduce your exposure to radon gas.Radon gas is produced by the natural breakdown of uranium in soil, rock and water in the environment, which invariably becomes part of the air you breathe.However, unsafe levels of radon can accumulate in buildings and homes if they are near or built on uranium-rich soil — it can damage lung tissue. Radon gas cannot be seen or smelled by people, so it must be tested for by special (albeit affordable) equipment.
- Buy a radon testing kit from a home improvement store and test your home and workplace — it can take a few weeks.
- If unsafe levels of radon are discovered, remedies are available, such as insulating and ventilating the space that's affected.
Stay away from asbestos.Exposure to asbestos is a known cause of cancer because it's a strong lung irritant that triggers a constant inflammatory reaction, and also leads to cellular mutation.Asbestos used to be used in insulation products and brake pads many years ago, although it's still used in some industrial applications. Be cautious if you live or work in an older building — made in the 1970s or earlier.
- Asbestos lodged in lung tissue causes lung cancer, although when it gets lodged in the pleural lining it leads to a condition called mesothelioma.
- In addition to asbestos, workplace exposure to arsenic, chromium and nickel also increase your risk of lung cancer, especially if you're a smoker.
- There are two general types of lung cancer: small cell (occurs almost exclusively in heavy smokers) and non-small cell, which includes squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
- People with a parent, sibling or child with lung cancer have a greater risk of developing the disease.
- There are four stages of lung cancer, with Stage IV being the most serious because it involves metastasis to other areas of the body.
- Treatment for lung cancer focuses on radiation, chemotherapy and surgery.
Video: Lung Cancer Screening: The Life-saving CT Scan
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