Lung Cancer Screening Consultation

HPA Magazine 9

Early detection of lung cancer with low-dose CT (Computerised Axial Tomography) scans lets doctors find lung cancers early, when they are small and still very curable. 

According to research published in the New England Journal of Medicine in October 2006, over 80% of patients who have a lung cancer detected by CT screening can be cured. When the lung cancer is found early, and the patient receives treatment right away, the cure rate rises to 92%. Without early detection screening, over 95% of lung cancer patients eventually die from their lung cancer, usually within a few years of the diagnosis.
Screening is an important and personal decision. Many articles about screening may be useful to help you and your doctor to familiarize with the results of our research. As always, your best bet is to discuss lung cancer screening with your doctor to decide whether it is right for you.
The type of cancer with the highest incidence is lung cancer (1.6 million cases per year, 12.7% of the total) and highest mortality rate (23% of total cancer deaths) worldwide. In Portugal, approximately 3500 people die from lung cancer each year, making it the leading cause of cancer death in men and the 4th largest in women. In the HPA Group there is a multidisciplinary team comprising Pulmonologists, Oncologists, Thoracic Surgeons, Radiotherapists, Radiologists, Clinical Pathologists, Geneticists, Nuclear Medicine Specialists, Psycho-oncologists, Nutritionists, Intensive Care and Palliative Specialists and Nurses who work together to provide patients with the most advanced diagnostic and therapeutic resources available. In addition to treatment, the diagnosis of this type of pathology is of the utmost importance.

HOW EARLY DETECTION SCREENING WORKS

STEP 1
Check for risk of lung cancer

• The very first step is to decide whether you should participate in a screening program. This depends on your age and smoking history. We are developing a program to allow you to check for your risk of lung cancer. A person’s risk of developing lung cancer is high enough to consider CT screening if they are over the age of 50 and have smoked 10 for more years. Other factors may increase your risk, including exposure to things like asbestos, gender (male), or race (Caucasian). You should talk to your doctor about your history to find out if you are at a high risk of developing lung cancer.

STEP 2
Baseline Screening

• Screening for the early detection of lung cancer starts with the first screening or baseline screening. This means that the patient has never had a CT scan of the chest before, or at least not in the last 3 years. If no nodules are found, you should repeat the CT scan the following year. 
• Annual repeat screenings are very important, because this is when the smallest, most curable nodules are detected. CT scans are so good that they show many small nodules in a lung. Most of these nodules are not malignant but less-serious abnormalities from some previous injury, a minor infection, or a non-cancerous tumour. When a nodule is found, the results of previous CT scans are compared in order to confirm if the nodule has grown. This is currently the best way to help decide if the nodule is actually malignant.

STEP 3
Biopsy

• If the follow-up CT scan shows that the nodule is growing at the same rate that lung cancers grow, the radiologist will order other tests, such as a biopsy, to get more information about the nodule. If the nodule is not growing like a lung cancer, it will only be necessary to repeat the CT scan the following year. 

STEP 4
Treatment

• When lung cancer has been found, it needs to be treated. If the lung cancer is in an early stage and is promptly removed by surgery resection, there is a very high chance of cure; according to our research, it is as high as 92%.
• Surgery is performed by minimally invasive techniques with the most advanced high-definition 3D video technology. The HPA Group is a pioneer in uniportal VATS, in which the surgery is performed by a small, single incision with less pain and fast recovery.