Lung cancer is the third most common type of cancer in both men and women.
More men and women die every year from lung cancer than from any other form of cancer.
In 2011, the National Lung Screening Trial showed a 20 percent decrease in lung cancer deaths in heavy smokers who received a low-dose lung screening exam.
This screening helps to find lung cancer at an early stage so treatment options are more successful.
Learn more from Matthew Graczyk, MD, thoracic surgeon at the Virginia Piper Cancer Institute, about the importance of early lung screening.
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Lung Cancer Screening Can Help Catch Cancer Early
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Learn more about Matthew Graczyk, MD
Matthew Graczyk, MD - Thoracic Surgeon
Matthew Graczyk, MD, is a thoracic surgeon at the Virginia Piper Cancer Institute and Minnesota Oncology. His expertise includes all aspects of thoracic surgery, as well as diagnostic and therapeutic procedures for esophagus and stomach. He is also the co-medical director of the Lung Program at Abbott Northwestern Hospital.Learn more about Matthew Graczyk, MD
Transcription:
Melanie Cole (Host): Lung cancer is the third most common type of cancer in both men and women. More men and women die every year from lung cancer than from any other form of cancer. My guest today is Dr. Matthew Graczyk. He is a thoracic surgeon at the Virginia Piper Cancer Institute with Allina Health. Welcome to the show, Dr. Graczyk. Tell us about the known risks of lung cancer.
Dr. Mathew Graczyk (Guest): The biggest risk for lung cancer is tobacco or smoke exposure through smoking. Certainly, there are other ones that are lower down on the list that include radon exposure. You usually associate that with higher levels of radon exposure over a prolonged period of time. Lung disease is considered a risk for lung cancer. Things like emphysema or COPD, which is chronic obstructive pulmonary disease. A family history can contribute to a risk of lung cancer with previous close relatives that might have had lung cancer. Asbestos exposure is considered a risk factor for a special type of lung cancer in the lining of the lung.
Melanie: Tell us about this lung cancer screening we’re hearing about so much now. What do you need to get a prescription to have a lung cancer screening? Tell us about the screening itself.
Dr. Graczyk: You have to have a couple of things to meet what we consider qualifications and that is, first and foremost, having been a smoker for quite a long period of time. We use a 30-pack year history as a measure of that. That means that you had to have smoked at least one pack of cigarettes per day for 30 years or more or, for example, two packs per day for 15 years will qualify you as well. In addition, you have to be a current smoker or having had quit within the last 15 years and be between the ages of 55 and 80 and have no current signs or symptoms of a lung cancer.
Melanie: What is the screening test like and is it something you need a prescription for or can you just go to your doctor and say, “I’d like to get screened for lung cancer”?
Dr. Graczyk: The test is looking to detect a lung cancer early. It’s based on some research that came out over the last few years that showed that if we can screen this high risk population, we might be able to find cancers earlier than when we have been traditionally able to detect them. In order to obtain the test, it does require a prescription, if you will, or an order from a provider. Anybody can go in and inquire about the test but it requires, and should be, ordered through a provider that can meet with the patient to discuss the risks and the benefits of the testing and to make sure that they meet the qualifications so that it can be supported through insurance.
Melanie: Are there any risks to the screening?
Dr. Graczyk: There are. There are risks of finding things that we don’t know what to do with. For instance, the risk may be of overdiagnosis or of finding completely benign things in addition to looking for a cancer. We want to carefully make sure that patients are referred to places that know what to do with the results and worry about the things we need to worry about, but not worry about the ones that we don’t, but have appropriate follow up. The screening test is done with a CT scan, which is a special type of x-ray exam that uses a combination of x-rays and a computer. The CT stands for “computerized tomography.” That results in a small dose of radiation. That radiation dose is about the same as walking around outside that you would get from sunlight over a calendar year. It’s considered a small dose.
Melanie: How does a person find out the results of their screening test?
Dr. Graczyk: A board certified radiologist will look at and interpret all scans. In addition, a healthcare provider from, typically, a lung program will receive the exam results and he or she would call a patient about the results of a positive test and determine the next steps in a screening plan or in a follow up treatment plan. In addition, we certainly work closely--most screening programs do--with a lung nodule clinic where patients can be referred to for different findings on the results of the scan.
Melanie: Are there some symptoms of lung cancer or lung issues that people might notice that would send them to see you in the first place?
Dr. Graczyk: There are. The symptoms of lung cancer aren’t always specific to lung cancer but they certainly include things like coughing up blood, trouble breathing, shortness of breath that doesn’t go away, an unexplained weight loss, fatigue that is unexplainable by any other means, feverish chills and night sweats can all be associated with not only lung cancer but also other forms of cancer as well.
Melanie: Dr. Graczyk, people get chest pain and they worry that it’s heart disease and/or they hear lung cancer in the upper back, shoulders do any of those pains mean that there could be something going on?
Dr. Graczyk: You know, they do and it’s certainly important to be aware of those symptoms and, most importantly, to contact your health care provider for anything that we’ve talked about and mentioned as far as symptoms go so that can be looked into further. It’s important to remember that the majority of those things are probably unlikely to be cancer related. But, the trouble that we have had with lung cancer in the past is that it hasn’t been able to be detected until a later stage. One of the benefits of a lung screening program is that we have found that we can really impact the changes of dying from a lung cancer by screening people early and looking for an earlier stage of disease rather than a more advanced stage and hopefully intervening and treating.
Melanie: You mentioned family history. Is there a genetic component to lung cancer?
Dr. Graczyk: There is, but the exact details of that genetic component have not yet been completely worked out in a detail level. In the laboratory, we are looking for different genes, but we certainly know that the highest risk people have had a first degree relative –so, a mother, father, sister or brother, typically, or a child--that has had a previous lung cancer, and that puts them at an increased risk. We don’t know yet how much of an increased risk but we certainly know it is a factor.
Melanie: Since lung cancer screening seems to be relatively new, does insurance cover this?
Dr. Graczyk: It does. Most insurance providers are covering the test. Medicare has approved coverage of the test and should be rolling out coverage for it for almost all providers in a timely fashion. That being said, it is certainly important for patients who meet the screening criteria and who are interested in looking into it further, to contact their healthcare provider and insurance provider to make sure that it’s covered and, if not, we do offer the screening test at discounted rates if people were interested in getting it uncovered and paying out of pocket.
Melanie: Dr. Graczyk, every once in a while you hear about someone who was never a smoker who gets lung cancer. What would make that person come in for a lung cancer screening?
Dr. Graczyk: Certainly, a higher percentage of lung cancers today than previously are associated with people who haven’t been smokers. It used to be about 10% of lung cancers that were found in non-smokers, but that number is increasing over the last few years – maybe approaching 20%. We don’t have a research study that shows that screening for that non-smoker population is coverable by insurance or has impacted the chances of dying from the disease. At the present time, we can’t recommend that for non-smokers. If they have other risk factors, I think we will be considering that going forward but we, certainly on a wide-scale patient population, haven’t done so yet.
Melanie: In just the last minute, please give your best advice to the listeners about low dose lung cancer screening, the benefits of it and prevention of lung cancer. Really, just your best advice.
Dr. Graczyk: Research shows that we can make a 20% increase in the chances of dying from a lung cancer for patients that fall into a high risk category for developing lung cancer based on history and smoking. We encourage all of those patients that fall into those categories between the ages of 55 and 80 and meet the criteria that we’ve talked about in our discussion to contact their healthcare provider if they think they are even close to meeting the criteria so that we can figure out if they do and get them in for a screen and, hopefully, identify and detect a cancer before it is more advanced stage and less treatable. In the early stages of lung cancer, the treatment can result in even a cure in a certain patient population and rid them of the disease.
Melanie: Thank you so much. That’s great information. You’re listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): Lung cancer is the third most common type of cancer in both men and women. More men and women die every year from lung cancer than from any other form of cancer. My guest today is Dr. Matthew Graczyk. He is a thoracic surgeon at the Virginia Piper Cancer Institute with Allina Health. Welcome to the show, Dr. Graczyk. Tell us about the known risks of lung cancer.
Dr. Mathew Graczyk (Guest): The biggest risk for lung cancer is tobacco or smoke exposure through smoking. Certainly, there are other ones that are lower down on the list that include radon exposure. You usually associate that with higher levels of radon exposure over a prolonged period of time. Lung disease is considered a risk for lung cancer. Things like emphysema or COPD, which is chronic obstructive pulmonary disease. A family history can contribute to a risk of lung cancer with previous close relatives that might have had lung cancer. Asbestos exposure is considered a risk factor for a special type of lung cancer in the lining of the lung.
Melanie: Tell us about this lung cancer screening we’re hearing about so much now. What do you need to get a prescription to have a lung cancer screening? Tell us about the screening itself.
Dr. Graczyk: You have to have a couple of things to meet what we consider qualifications and that is, first and foremost, having been a smoker for quite a long period of time. We use a 30-pack year history as a measure of that. That means that you had to have smoked at least one pack of cigarettes per day for 30 years or more or, for example, two packs per day for 15 years will qualify you as well. In addition, you have to be a current smoker or having had quit within the last 15 years and be between the ages of 55 and 80 and have no current signs or symptoms of a lung cancer.
Melanie: What is the screening test like and is it something you need a prescription for or can you just go to your doctor and say, “I’d like to get screened for lung cancer”?
Dr. Graczyk: The test is looking to detect a lung cancer early. It’s based on some research that came out over the last few years that showed that if we can screen this high risk population, we might be able to find cancers earlier than when we have been traditionally able to detect them. In order to obtain the test, it does require a prescription, if you will, or an order from a provider. Anybody can go in and inquire about the test but it requires, and should be, ordered through a provider that can meet with the patient to discuss the risks and the benefits of the testing and to make sure that they meet the qualifications so that it can be supported through insurance.
Melanie: Are there any risks to the screening?
Dr. Graczyk: There are. There are risks of finding things that we don’t know what to do with. For instance, the risk may be of overdiagnosis or of finding completely benign things in addition to looking for a cancer. We want to carefully make sure that patients are referred to places that know what to do with the results and worry about the things we need to worry about, but not worry about the ones that we don’t, but have appropriate follow up. The screening test is done with a CT scan, which is a special type of x-ray exam that uses a combination of x-rays and a computer. The CT stands for “computerized tomography.” That results in a small dose of radiation. That radiation dose is about the same as walking around outside that you would get from sunlight over a calendar year. It’s considered a small dose.
Melanie: How does a person find out the results of their screening test?
Dr. Graczyk: A board certified radiologist will look at and interpret all scans. In addition, a healthcare provider from, typically, a lung program will receive the exam results and he or she would call a patient about the results of a positive test and determine the next steps in a screening plan or in a follow up treatment plan. In addition, we certainly work closely--most screening programs do--with a lung nodule clinic where patients can be referred to for different findings on the results of the scan.
Melanie: Are there some symptoms of lung cancer or lung issues that people might notice that would send them to see you in the first place?
Dr. Graczyk: There are. The symptoms of lung cancer aren’t always specific to lung cancer but they certainly include things like coughing up blood, trouble breathing, shortness of breath that doesn’t go away, an unexplained weight loss, fatigue that is unexplainable by any other means, feverish chills and night sweats can all be associated with not only lung cancer but also other forms of cancer as well.
Melanie: Dr. Graczyk, people get chest pain and they worry that it’s heart disease and/or they hear lung cancer in the upper back, shoulders do any of those pains mean that there could be something going on?
Dr. Graczyk: You know, they do and it’s certainly important to be aware of those symptoms and, most importantly, to contact your health care provider for anything that we’ve talked about and mentioned as far as symptoms go so that can be looked into further. It’s important to remember that the majority of those things are probably unlikely to be cancer related. But, the trouble that we have had with lung cancer in the past is that it hasn’t been able to be detected until a later stage. One of the benefits of a lung screening program is that we have found that we can really impact the changes of dying from a lung cancer by screening people early and looking for an earlier stage of disease rather than a more advanced stage and hopefully intervening and treating.
Melanie: You mentioned family history. Is there a genetic component to lung cancer?
Dr. Graczyk: There is, but the exact details of that genetic component have not yet been completely worked out in a detail level. In the laboratory, we are looking for different genes, but we certainly know that the highest risk people have had a first degree relative –so, a mother, father, sister or brother, typically, or a child--that has had a previous lung cancer, and that puts them at an increased risk. We don’t know yet how much of an increased risk but we certainly know it is a factor.
Melanie: Since lung cancer screening seems to be relatively new, does insurance cover this?
Dr. Graczyk: It does. Most insurance providers are covering the test. Medicare has approved coverage of the test and should be rolling out coverage for it for almost all providers in a timely fashion. That being said, it is certainly important for patients who meet the screening criteria and who are interested in looking into it further, to contact their healthcare provider and insurance provider to make sure that it’s covered and, if not, we do offer the screening test at discounted rates if people were interested in getting it uncovered and paying out of pocket.
Melanie: Dr. Graczyk, every once in a while you hear about someone who was never a smoker who gets lung cancer. What would make that person come in for a lung cancer screening?
Dr. Graczyk: Certainly, a higher percentage of lung cancers today than previously are associated with people who haven’t been smokers. It used to be about 10% of lung cancers that were found in non-smokers, but that number is increasing over the last few years – maybe approaching 20%. We don’t have a research study that shows that screening for that non-smoker population is coverable by insurance or has impacted the chances of dying from the disease. At the present time, we can’t recommend that for non-smokers. If they have other risk factors, I think we will be considering that going forward but we, certainly on a wide-scale patient population, haven’t done so yet.
Melanie: In just the last minute, please give your best advice to the listeners about low dose lung cancer screening, the benefits of it and prevention of lung cancer. Really, just your best advice.
Dr. Graczyk: Research shows that we can make a 20% increase in the chances of dying from a lung cancer for patients that fall into a high risk category for developing lung cancer based on history and smoking. We encourage all of those patients that fall into those categories between the ages of 55 and 80 and meet the criteria that we’ve talked about in our discussion to contact their healthcare provider if they think they are even close to meeting the criteria so that we can figure out if they do and get them in for a screen and, hopefully, identify and detect a cancer before it is more advanced stage and less treatable. In the early stages of lung cancer, the treatment can result in even a cure in a certain patient population and rid them of the disease.
Melanie: Thank you so much. That’s great information. You’re listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.