Lung cancer is the leading cause of cancer death, accounting for about 25% of all cancers. More people die from lung cancer than colon, breast, and prostate cancers combined.
Experts now recommend a yearly low-dose CT scan of the chest for patients who are at high risk of the disease, but this potentially life-saving prescription has been slow to take hold.
In the fall of 2018, Lisa Barbaro developed a deep cough. An X-ray showed no sign of anything serious, still, her pulmonologist was concerned. Barbaro was a long-time smoker.
“Every doctor says you need to quit smoking. And I, I had smoked for 50 years, but I wasn’t quitting smoking,” Barbaro said.
Barbaro agreed to undergo a screening CT scan to give a more detailed view of the lungs. By early 2019, news no one wants to hear.
“She called me and she said, ‘You know, you’ve got two very small nodules on your lungs, one on each lung,’” Barbaro explained.
She had early-stage lung cancer.
“They were tiny, like just the end of a ballpoint pen, think of it. But we saw them change in size and therefore she was then recommended to have surgery,” said Dr. Claudia Henschke, Director of the Early Lung and Cardiac Program at Mount Sinai.
The lungs have few pain receptors, so lung cancer is often missed until it’s late stage. That’s why screening can be so important.
The US Preventive Services task force now recommends people who are over 50 and have a 20-year pack history get the CT screening. Pack history means you’ve smoked one pack a day for 20 years or two packs a day for 10 years.
Fewer than 10% of all smokers who are eligible for the CT lung screening actually get the test.
“We need to reach out to those, to smokers and former smokers, because we can really save their lives,” Henschke said.
“I had the X-ray. Lungs came back clean. I wasn’t having trouble breathing, nothing like that. I would have never known,” Barbaro said.
The CT scans for patients at higher risk for lung cancer are covered by private insurance, as well as Medicaid and Medicare. Because the scan also includes other organs in the chest and abdomen, Barbaro’s doctors detected a separate, early-stage breast cancer that her mammogram missed. She has also had successful treatment for that cancer.