Are there other benefits to lung cancer screening?
Yes.
People who receive negative reports after CT screening may have relief from lung cancer anxiety.
It is important to emphasize that cigarette smoking does not just cause death from lung cancer; it also kills by causing other cancers in the mouth, throat, voice-box, swallowing tube, kidney, bladder and colon (incomplete list).
Smokers also have strikingly increased risk of death from
-obstructive lung disease and respiratory failure
-heart attack, heart failure and sudden death
-stroke
-ruptured aortic aneurysm
-peripheral vascular disease
CT screening represents a “teachable moment”, a window of opportunity to quit smoking. All CT screening programs are supposed to offer advice and assistance in smoking cessation.
A person who quits smoking derives many benefits. Ongoing damage to lungs, blood vessels and other organs ceases. There may be some improvement in lung function, although damage is often permanent.
CT scans can also detect “incidental findings” that suggest the presence of other health problems.
Some have suggested that a low-dose spiral CT lung scan also serves as a more general “Health Check”. This is based upon the understanding that the chest CT scan can also detect many other diseases or early warning signs of disease.
These include the following. (The list is incomplete.)
-Nodules and other abnormalities in the thyroid gland, including thyroid cancer.
-Enlarged lymph nodes in the neck and mediastinum that can indicate a number of possibilities including various infections, leukemia and lymphoma.
-Tumors in the mediastinum (center of the chest), including lymphomas, thymoma and tumors arising from nerve tissues.
-Other diseases of the lungs including, emphysema and chronic obstructive lung disease (COPD), infections like pneumonia, tuberculosis and fungal disease, pulmonary fibrosis, pulmonary hypertension etc.
-Calcification of the coronary arteries; this finding suggests the presence of fatty deposits (atheromas) and raises the risk of heart attack and heart failure.
-Hiatus hernia and other esophageal disease.
-Abnormal fluid collections in the pleural, pericardial and peritoneal spaces.
-Liver disease
-Aortic aneurysm
-Spleen enlargement
-Pancreatic tumor
-Breast cancer
-Kidney cancer
-Gall stones and kidney stones
People in New Orleans are not shy about demanding lagniappe (pronounced lan-yap) when they shop. Lagniappe is something extra – the bakers dozen, the thirteenth donut.
Critics of screening suggest that discovery of other problems on CT scans is counter-productive; may result in anxiety or overtreatment.
Proponents of CT screening, myself included, believe that it is usually beneficial to a patient when medical problems are identified at an early stage – before they can cause serious complications or death.
For example, the discovery that you have emphysema changes in the lung might be the wake-up call that convinces you to stop smoking.
The discovery that you have calcification in the coronary arteries indicates strongly that you are developing fatty plaques (atheroma) that narrow the blood vessels. This is a strong indicator to your doctor and yourself that it is time to take a careful look at your need to lose weight, modify diet, control diabetes, stop smoking, control blood pressure and consider taking statin drugs – all to try to prevent progressive disease leading to heart attack.
In this scenario, the lagniappe of CT screening may be a longer healthier life.
What are the potential complications of lung cancer screening?