Cancer in Your Corner
Aug 11, 2022
Clayton Hess MD MPH
Can you remember when smoking was stylish and popular? Are you a former or current smoker hoping to reduce your risk of lung cancer? There’s a way to beat the odds against lung cancer: a screening CT scan of the lungs once each year. Get yours today to keep cancer away.
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Ms. A. J. Patterson entered my office and sat across my desk to talk about treatment for lung cancer. Yet, she had gone to the Emergency Room a few weeks prior for an entirely different reason. A smoker much of her life, smoke inhalation had taken its toll – chronic obstructive pulmonary disease or COPD made it harder to breath. A chest x-ray was done to rule out pneumonia - it incidentally found a lung lesion. The lesion wasn’t causing her any symptoms - finding it was an accident.
“That’s exactly how we want to find them,” I told her, “The earlier the better.”
A CT scan confirmed the lesion to be colony of cells. A biopsy confirmed it as a clone army of rouge actors – cancer. She had smoked for 40 years but had quite 10 years prior at the convincing of her children and close family members.
“I wish I could turn back time to never start,” she said, “but I can’t.”
“We love you, Mom,” came the reply. “We are more likely to get you through this because they caught it early.”
Two family members had joined us in the room and others engaged by zoom. As they encouraged, we discussed treatment options. Either a surgery would be needed to remove a lobe of her lung and neighboring lymph nodes, or alternatively, 5 radiation treatments would be needed. The former was deemed too invasive for her, given her breathing and frailty. She decided to proceed with radiation.
“Radiation is invisible and painless as it enters your body,” I said, “You won’t even know you’re being treated.” For a cancer with such a deadly reputation, the family was surprised to hear of a treatment option with so few side effects and such high probability of cure.
“A short-course of high-dose radiation will create a small cloud of energy placed right over the cancer. This will translate into a ninety-plus percent chance of killing every cell,” I said. “The question remains, however, whether microscopic cells have already ventured beyond the original site of growth. If they have, the cancer isn’t as early stage as we thought and could regrow in the neighboring nodes. We won’t know that until future CT scans of the lungs – typically done once every 2 or 3 months after treatment.”
Ms. Patterson underwent treatment with me. She came in 2 or 3 times a week for about 30 minutes to receive a treatment that caused her no symptoms. Two months later, a new PET/CT scan of her chest showed a dramatic impact of our treatment – the cancer colony had been inactivated. There was no sign of growth or activity. It looked defeated.
Each quarter thereafter Ms. Patterson returned to my office for our new routine: review of a new CT scan of her lungs showing no change in the appearance of the cancer, followed by repeated denial of any symptoms, and ultimately a discussion that often went off topic. She loved to talk about favorite TV shows, her social life, and watching her grandkids get older. Cancer wasn’t a big concern to her - neither it nor its treatment had caused her any symptoms.
I never tire of moments like this, when medical discussions veer away from cancer, when patients tell me about the other life events – it means I have done my job well and cancer isn’t even on their radar. It’s always on mine.
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An annual CT scan to screen for rouge cancer cells growing in the lungs has been recommended by the U.S. Preventative Services Task Force for all Americans at high risk for lung cancer. This includes any smoker, age 50 to 80, with a history smoking of at least one pack of cigarettes daily for 30 years - or its equivalence (2 packs per day for 15 years, for example). To anyone with this amount of tobacco exposure, a yearly CT scan is recommended while actively smoking and for a full 15 years even after quitting.
If this applies to you or someone you love, call your doctor. One CT scan per year is all it takes to help keep lung cancer away.
Cancer in Your Corner aims to advance public health, bolster community trust, and enhance readership understanding through medical storytelling. Dr. Hess is the Director of Radiation Oncology at Sierra Nevada Memorial Hospital. His views do not reflect official positions of CommonSpirit Health, Dignity Health, or Sierra Nevada Memorial Hospital. Some aspects of this article are fictionalized history but are based on a true story. Names are fictitious to protect confidentiality.