Bai Wei MD

Bai Wei MD

Question: What is new with lung cancer screenings?

Lung cancer screening is a process to detect the presence of lung cancer in an otherwise healthy adult who is at high risk of lung cancer. The goal is to detect lung cancer early when it is more likely to be cured. By the time symptoms of lung cancer develop, the cancer is usually too advanced for curative treatment.

Lung cancer screening is done by using low-dose computed tomography (also called low-dose CT scan, or LDCT). During the scan, a person lies still on a long table. The table slides through the center of a tunnel-like machine that uses low amounts of radiation to take detailed pictures of the lungs.

The process itself takes only a few minutes and is not painful. The pictures taken during the scan are reviewed by a radiologist. In the end, the result may show no abnormalities so the person may choose to continue annual low dose screening scans. Or the result may show one or more lung nodules.

Most small nodules will be monitored at the next annual scan. However, other more concerning nodules may need additional imaging studies sooner or even a procedure (such as biopsy) to remove a piece of the nodule for laboratory testing.

Lung cancer screening is generally recommended for older adults who are longtime smokers and who don't have any signs or symptoms of lung cancer, including those who: have a 20 pack-year or more smoking history, smoke now or have quit within the past 15 years, and are between 50 and 80 years old.

Pack-year is calculated by multiplying the number of packs of cigarettes smoked a day by the number of years that a person has smoked. For example, a person could have a 20 pack-year smoking history by smoking one pack a day for 20 years (1 times 20), two packs a day for 10 years (2 times 10), or half of a pack a day for 40 years (0.5 times 40).

In general, people continue annual lung cancer screening until they become less likely to benefit from screening itself. For example, people may choose to stop when they develop other serious health conditions so that they are more likely to experience complications from follow-up tests or are too frail to undergo lung cancer treatment.

Lung cancer screening is not without any risks. People may be concerned about being exposed to radiation. Roughly speaking, the amount of radiation exposure during a low-dose CT screening is equal to about half the radiation a person is exposed to naturally from the environment in a year.

Studies have shown that using low dose CT to screen for lung cancer in high-risk people reduces the risk of lung cancer deaths. Surviving lung cancer starts with a scan! Please discuss the benefits and risks of lung cancer screening with your doctor. Or you can call our oncology nurse navigator at 805-346-3463 for questions.

Dr. Wei Bai grew up in Beijing, China. In 1995, she graduated from Peking University Health Science Center (previously known as Beijing Medical University) with distinction. She then pursued graduate study in the United States. Upon receiving her master’s degree in molecular medicine from the University of Massachusetts Medical School in 1998, Bai joined a leading biotech company, Genentech Inc., in south San Francisco to pursue her passion in translational research. She participated in research and development of several cancer drugs, including trastuzumab (Herceptin), bevacizumab (Avastin), and erlotinib (Tarceva), among others in the company pipeline. Bai can be reached at 805-349-9393.

HAVE A QUESTION? This weekly column produced by Marian Cancer Care invites you to submit your questions to “Your Cancer Answers” at the following email address: mariancancercare@dignityhealth.org

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