November is Lung Cancer Awareness Month. Dr. Ashkan Shademan, a radiologist with ARA Diagnostic Imaging, shares critical screening advice with KEYE-TV’s Trevor Scott on CBS Austin’s ‘We Are Austin.’
(Trevor Scott) Welcome back to We Are Austin.
November is lung cancer awareness month, and early screenings could be important for your future health. Dr. Ashkan Shademan is joining us this morning from ARA Diagnostic Imaging to share who should be screened for lung cancer, and more information about low-dose CT lung screenings for early detection of the disease. Doctor, good morning to you. And, thanks for joining us today.
(Dr. Ashkan Shademan) Hi, good morning. Glad to be here.
(Trevor) Yeah, especially because this is really important information, especially because I understand that CT lung screenings can detect cancer in certain high-risk groups of people before they even have symptoms, which is probably so important – that early detection. So, tell us more about how to know – the folks at home – if they could be a candidate for an annual CT lung screening?
(Dr. Shademan) Yeah. So, you know, the main benefit of lung cancer screening is preventing death from lung cancer. Lung cancer screening finds 80% of lung cancer at an early stage when it is more curable. Without screening, 70% of lung cancers are found at a later stage when there is little chance for a cure. Lung cancer is the leading cause of cancer deaths in the United States. Since there are few early symptoms, people are often very sick by the time they are diagnosed.
(Trevor) All right.
(Dr. Shademan) CT lung screening is an exam done to detect lung cancer before there are symptoms. The US Preventive Services Task Force recommends that people at risk for lung cancer have an annual screening using low-dose computer tomography, or CT.
(Trevor) So, how does a patient know if they are in that group of a high-risk candidate to actually schedule a CT lung screening?
(Dr. Shademan) Yes. So, heavy smokers can benefit from this exam. 90% of all patients with lung cancer have a smoking history. The high-risk group includes people who have no symptoms of lung cancer, are between 50 and 77 years old, are currently smoking or who have to quit in the last 15 years, and have a 30-pack year history. This means that they have smoked a pack a day for 30 years, two packs a day for 15 years, et cetera.
(Trevor) Goodness. So, when we’re talking about scheduling the CT lung screening and they’re looking at their coverage, does insurance cover an exam like this?
(Dr. Shademan) Yes. Medicare covers it under those guidelines and other insurance may cover it up to the age of 80 and at a 20-pack year history level.
(Trevor) So, once you have the CT lung screening, how do doctors use this, and radiologists use the information, to actually identify the lung cancer?
(Dr. Shademan) Well, in conventional X-ray, cancerous nodules might be just a shadow. But on CT, the same nodule can stand out very clearly. Here is what a radiologist sees. You can see a cancerous lung nodule beside the white arrow.
(Trevor) And, people might be interested, are there risks with a CT lung screening?
(Dr. Shademan) Lung cancer screening uses a low-dose CT. We use less radiation, just enough to see what we need to see, which helps us to keep the dose low. It’s about the same as six months of natural background radiation that we get from our environment. In the case of people at high risk for lung cancer, we feel that the benefits of CT lung screening far outweigh the risks.
(Trevor) Interesting. So what happens? What are the next steps if a lung nodule like that is found on your screening?
(Dr. Shademan) It may indicate immediate biopsy or treatment is necessary. If the finding is not conclusive, you will be put on a carefully developed schedule of follow-up screenings to monitor your status. Sometimes nodules are caused by infection and clear up over time. Sometimes they stay the same or disappear on their own. Sometimes they grow and clearly become cancer.
(Trevor) So, you mentioned some age ranges and some elements for the high-risk categories, but what if you are a smoker or a former smoker, but you actually don’t fall into that high-risk group that you mentioned? Can you still benefit from a CT lung screening?
(Dr. Shademan) Generally, no. We don’t recommend that people outside the high-risk group have the exam. We find that we end up doing too many biopsies or further imaging on what turns out to be a non-cancerous abnormality, but, you should talk to your healthcare provider about your personal history, including smoking, family history, and other factors.
(Trevor) That is important information.
(Dr. Shademan) Yeah. If you have a cough that doesn’t go away, or you are coughing up blood, wheezing, or have shortness of breath, you need to see your medical provider right away. It is important for you to know there is a great benefit from stopping smoking today. As I mentioned, 90% of lung cancer is caused by smoking. There are smoking cessation programs available at the American Lung Association website and elsewhere, and your healthcare provider can also support you.
(Trevor) Sobering statistics there, regarding smoking and lung cancer. It’s important for people to know. So how do they get started? How can one go ahead and get that CT lung screening process started?
(Dr. Shademan) Well, talk to your healthcare provider. See if you qualify as a high-risk candidate and let your doctor know you would like to look into CT lung screening. Your provider can give you advice and a referral for the exam. It’s easy to call ARA for your appointment. You can also visit ausrad.com.
(Trevor) Really important information today, that early detection is key as it is with so many health issues. And thanks to ARA Diagnostic Imaging for shedding some light on this subject. Dr. Shademan, thanks so much for joining us today.
(Dr. Shademan) Thank you so much.