Transcription:
Lung Cancer Screening- Is It For You

Melanie: Screening is used to detect lung cancer early when it's more likely to be curable. If lung cancer is caught before it spreads, the likelihood of surviving increases.  

Welcome to Say Yes To Good Health with Memorial Hospital. I'm Melanie Cole, and I invite you to join in this very important discussion today, as we discuss low-dose CT lung cancer screening. Is this right for you? Joining me is Dawn Owren. She's the chief ancillary officer at Memorial Hospital.

Dawn, it's a pleasure to have you with us today. Before we get into the screening, what are you seeing in your area as far as incidence and awareness of lung cancer? Are more people getting the message? Have you seen smoking on the decline? Tell us what you're seeing.

Dawn Owren: Yes, we have seen an increase of some advertisements for decreasing of smoking. We have seen increase of our low-dose cancer screening for people coming in to get that screening. And awareness is out there. People realize that smoking is bad for you at this point.

Melanie: And have you seen in smoking cessation, are people joining these kinds of groups? Are they looking for other alternatives? Is there anything you can tell us about some of the support that's out there and what people really are looking for to help them? What kind of support works?

Dawn Owren: Yes. So the patches, things like that really help a person quit smoking. The health department offers some classes. Our physicians at Memorial Hospital are more than happy to do some counselling and offer solutions to help.

Melanie: So now, let's talk about low-dose CT lung cancer screening. Tell us a little bit about what this is, what the test is, when did this all start.

Dawn Owren: So, CT for low-dose cancer screening was approved probably five or six years ago. And we have been offering it since last January, so a little over a year. It is actually a CAT scan of your chest. The radiologist will read it, look at your lungs, look for any nodules or anything that could indicate lung cancer. The screen is done for people who are current smokers or who have quit within the past 15 years.

Melanie: So I'd like you to go over who is eligible because this is confusing to some people. They hear 30-pack years and 15-pack years. They don't know really what that means. Can you please define who should get screened? What are the eligibility criteria so that insurance pays?

Dawn Owren: Yes, it is confusing. The age is for persons age 55 to 77, who are current smokers or those who have quit within the past 15 years. And they must have a 30-year smoking history. So an example of that was if someone smoked a pack a day for 30 years, that's a 30-pack year. Another easy calculation would be two packs a day for 15 years, 30-pack-year. So you have to look at that. It gets confusing, but a lot of times people have smoked for 40, 45 years. So even a half a pack a day would do it and it's accumulative.

So one of the other things is you shouldn't have any symptoms of lung cancer, so no coughing, no night sweats, no loss of weight for no reason. And you have to be willing to listen to smoking cessation counselling and make a shared decision with your physician. Lastly, you have to have a doctor's order.

Melanie: So you do need a referral to do this?

Dawn Owren: Yes.

Melanie: And then how often after that first one, based on the results, of course, but how often after that first one? Is this like a yearly thing like we get our mammograms? Now, if someone was a previous smoker, they're going to go get this low-dose CT lung cancer screening every year. How often?

Dawn Owren: Yes, it's exactly like that. So if the radiologist reads your CT and it looks completely normal, you will get a letter in the mail close to a year, and we will schedule another CT for you one year, give or take, you know, a few weeks from your first one. And that will continue until you're not qualified anymore.

Melanie: Okay. So what about someone who's quit?

Dawn Owren: So if they've quit within the past 15 years, they've qualified. Let's say you got the CT done and you had quit 13 years ago, well then the next year you would be qualified and be able to have that. But once you hit you quit 16 years ago, then you would no longer qualify.

Melanie: And tell us a little bit about the benefits. I mean, we've already mentioned that it can catch it early, but really this kind of test some people aren't really sure whether they want to get this kind of test, but tell us about sort of what's going on in the lung cancer world, why this is such a huge test. I mean, it really does rival the colonoscopy, right? In the fact that this is able to do this and catch it early for, you know, treatments to be successful and have better outcomes.

Dawn Owren: Right. We can catch it much earlier. Usually by the time a person has symptoms, it's already spread to other parts in the body and, therefore, it's much harder to treat and the mortality rate is higher.

Melanie: Well, it certainly is. what's it like for the patient? Tell us about this test itself.

Dawn Owren: So the patient will come in, lay down on our table. It's like a big donut that the table moves them through, but it's not really thick. You can see out both sides of it. So claustrophobia is not usually an issue at all for anybody. And the test lasts about 15 minutes and you're up and gone, get results within a couple of days.

Melanie: well, you mentioned claustrophobia, but you know, because it's not like an MRI where you're in a little tiny tunnel, but what about the risks to the screening? People are worried about radiation.

Dawn Owren: So, this is why we call it low-dose CT, because we use a lower dose of radiation for these screening tests than others. Simply because it is a screening test and we want to limit people's radiation as much as we can.

Melanie: And what about preparation? Do they need to do anything? Do they have to get ready for this? Is there anything you want them to do before it?

Dawn Owren: No, there's really no prep. We probably will have them change into a patient gown just because of snaps and zippers, things like that.

Melanie: And what about insurance, Dawn? Is this covered by insurance?

Dawn Owren: So if you meet the criteria, Medicare covers it at 100% and most other commercial insurances do as well. If we have a worry about that, we call the insurance company and pre-certify it just to make sure that they'll pay for you.

Melanie: It's really quite a bit of technology that is advancing the world of cancer. It really is. Now, what if something is found on that CT? Tell us a little bit about the results. results What do they show?

Dawn Owren: So if the radiologist finds something, usually it's a nodule, a little round white spot. And if they are just a little bit worried about it, maybe it's just a granuloma, they'll have you come back in six months. If it's more worrisome to them, then we obviously call the results to your doctor and your physician hooks you up with the people that to treat it.

Melanie: And do you know what's going on? Anything exciting in treatments for lung cancer, especially if it's caught early?

Dawn Owren: Well, yeah, I mean, if we catch it early, there's a much better chance that you're going to come through it with much better results than if not. We've had, I think, three patients in the past year that have come in with no symptoms whatsoever and we found lung cancer. I just actually spoke with one of those patients and she is officially in remission. So, good outcomes if we can find them early.

Melanie: Good outcomes if we can find them early, for sure. And Dawn, as you and I were discussing off the air a little bit, you're in radiology and there's a lot that goes on in your department and we'll kind of touch back on CT lung cancer before we're done with his show today. But I'd like to touch on mammograms because this is something that women of a certain age, I'm 57, so I'm used to these things, been getting them for quite a while. But, you know, not a lot of women know if they're in their 30s, what to expect, they're afraid it hurts. You know, there's a lot of things going on with mammograms. So why don't you tell us what's exciting right now and who should be getting a mammogram?

Dawn Owren: So everybody should get their first mammogram at 40, as a screening, as a baseline. And then if that one's normal, 45 is when the next one should come. They should be yearly after that. What's exciting with us is we have our 3D mammography, which gives us more detail. Because of the fact we have more detail, you get less call backs. So, you know, a lot of times a woman will have her mammogram and then get a call back and say, "Hey, you need to come in for additional views. We're worried about something."

Melanie: That's the worst.

Dawn Owren: So with this 3D mammo, it cuts the breast into slices, just like a CT does or an MRI. And we can see those areas and those skin flaps much better and know that they're normal and not have to scare a woman by bringing her back for additional views.

Melanie: Getting that letter is literally the worst feeling, you know. And any women that I know that have experienced that, we all feel the same way, as is sitting there waiting for them to come and tell you that you're pictures came out good and you can go home. You don't have to go back and redo it.

So you've told us about 3D tomosynthesis, which is really exciting. What about for women with dense breasts, Dawn? Because we, and me included, you know, it doesn't always show everything. And the radiology department, you know, really needs to look close, but they also do whole breast ultrasounds. There are some other methods that can go along if you have dense breast tissue.

Dawn Owren: Yes. So besides the 3D, which certainly helps with dense breast, we also have ultrasound here at the hospital. The other test that a lot of times is done are MRI of the breast that we would have to refer you out to another facility to get done, but it is also a very comprehensive diagnostic test to evaluate any lumps or spots that we see.

Melanie: Do you need a referral for a mammogram?

Dawn Owren: We do request that you have a doctor's order, yes. Just because if you don't have a physician and you would have abnormal results, then we wouldn't have anybody to follow up with you. So we do ask that you ask your family doctor, they can call in the order and we can get you in.

Melanie: One of the things that, I mean, I've always wondered and really had to learn the difference of is the difference between screening and diagnostic mammograms because insurance covers one at like maybe 80% or depending on your insurance, and the other screening is usually covered at a 100% as a yearly screening. So tell us a little bit about why something is labeled routine screening or diagnostic.

Dawn Owren: So your screening is just the mammogram you go in for every year. You have no symptoms. You can't feel any lumps. It's just you're normal "I'm just checking to make sure that I'm okay." The diagnostic is the mammogram that you go in where you can feel a lump or you've had an issue in the past and they want to check up on it.

One of the main differences between the two is with screening, you may not get your results for a week or two. With the diagnostic, if you think that there's a problem or your physician thinks there's a problem, you will have the results the same day because the radiologist will read them and let you know. Also once we do a diagnostic mammogram, if they want to do more followup, we can do the additional views or the ultrasound the same day, the same time you're there.

Melanie: What's involved in scheduling a mammogram, Dawn? Tell the women out there how to go about scheduling this exam.

Dawn Owren: Super easy. You can get your order from your doctor. They put it into our system and you just need to call Radiology at. (217) 357-8660. And let them know you need to schedule a screening mammo and we should be able to get you in within a day or two.

Melanie: Oh, that's cool. So it's not a long wait because the anticipation is usually worse than the test itself. And any ladies listening that have not had their first one, please, it is not a big deal. It really doesn't hurt. It's about five seconds of a little bit of discomfort, but it is such a lifesaver and it's such a relief when you get that normal test back. I just got mine last week. So I know, and I also had the whole breast ultrasound at the same time. So I know that it is really a relief. And women, don't be afraid, don't put it off. Just call Memorial Hospital and schedule your mammogram today.

Now, Dawn, back to low-dose lung cancer for just a minute, the screening for this. How do people schedule that one as well?

Dawn Owren: Well, they'll probably have to have an appointment with their physician because of the smoking cessation counseling, which is very easy. They just go over, if you're smoking, what's available to help you stop to smoke. I mean, we would much rather you stop smoking, but you don't have to. We just have to show that you've had the counseling showing that smoking is bad for you and you really should stop. So once that's done, the doctor will send over the order and either the doctor will schedule the appointment or you can call in and schedule it at your convenience.

Melanie: Well, I'm glad you pointed that out because some people will say, "I'm not going quit so that I can get this test." So it is important, but the awareness, right? It's the support, the awareness, letting you know the education about how bad it is for you and that there are options available. To learn about those options, that's really the most important thing, isn't it?

Dawn Owren: Yes, it is. It's all about the education and being well-informed.

Melanie: Well-informed. And we have to be our own best health advocates. I mean, we really do, especially we women, Dawn. I don't know how old you are, but for myself, being caregiver, my dad who recently passed away, but was 97. I've got kids in their late teens, early 20s. It's this kind of middle sandwich generation. We take care of everybody. But we have to take care of ourselves, right?

Dawn Owren: Right.

Melanie: We certainly, as they say, have to put our own masks on before we can put the mask of our loved ones on. So just tell us again, because I'd like you to really reiterate this, who is eligible for lung cancer screening at Memorial Hospital.

Dawn Owren: A person who is eligible should be between 55 and 77, would have been either a current smoker or quit within the past 15 years, must have a 30-pack per year smoking history. And please, don't worry about that. Your doctor can calculate that easy enough for you, but basically it's one pack a day for 30 years is a 30 pack. And you can have no symptoms of lung cancer and, like we said, listen to smoking sensation education and also have an order from your doctor.

Melanie: And before we wrap up, because, you know, we covered a lot in this show today and that was so important. We covered mammograms and low-dose CT lung cancer screening, so kind of a two for one, listeners. We got both in. So you learned about both of these radiologic exams that are available at Memorial Hospital and also these exams could save your life. If we had more time, we'd talk about colonoscopy because that's another one that's so great and can really save your life. I'd like you to give some final thoughts. What would you like the listeners to take away from this and to know about low-dose CT lung cancer screening? Is it right for them?

Dawn Owren: Yeah, I just really want to express, don't let the radiation of the CT scare you. Don't let the test itself. Sometimes people think, "Well, if I don't know, I don't have to worry about it." It is so much better to know what's going on with your body and get it taken care of than letting things go until it's too late.

Melanie: One-hundred percent agree. It certainly is important. And as technology advances, we're learning so much more and we're developing so many more of these exams, these screenings that can save your life or the life of a loved one. So, you know, do your research, be your own best health advocate. Make sure you educate yourself because awareness is really the key to all of this. And talk to your doctor so you can schedule your low-dose CT lung cancer screening at Memorial Hospital right away. So important.

And for more health tips like this, you can always visit our website at mhtlc.org to get connected with one of our providers. Thank you so much, Dawn, for joining us today. And that concludes this episode of Say Yes To Good Health with Memorial Hospital. I'm Melanie Cole. And everybody, stay well, stay healthy and take care of each other.