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Longtime smoker? Get screened Sunday Nov 5, 2017 at 2:00 AM Lung cancer is the leading cause of cancer deaths in both men and women, surpassing colon, breast and prostate cancers combined. According to recent statistics, 1 in 16 Americans will be diagnosed with lung cancer in 2017-2018. If detected at an early stage — that is, the cancer is limited to one area of the lung — the survival rate is higher than 50 percent. However, only 15 percent of lung cancer cases are diagnosed at an early stage. If the cancer has spread to other organs, the five-year survival rate drops to 4 percent. “The mortality rate is high because the disease does not manifest early and is not caught until the lesions are large,” says Dr. Berta Baldovino, a pulmonologist and critical care physician at Providence Medford Medical Center. Asante Physician Partners in Medford offers screenings for patients at high risk of developing lung cancer. By using low-dose CT imaging, clinicians can detect tiny spots on the lungs that might be missed by standard X-rays. Providence Medical Group also promotes lung cancer screenings for those who are current or former smokers. The risk of this population developing lung cancer is at least 25 times greater than someone who never smoked. Baldovino wants to get the message out to women, especially. Because publicity and marketing (of tobacco) has been targeted to females, they comprise the largest segment of smokers. “They’ve been told it’s in vogue, that it’s sexy,” she says. “They will be good about scheduling mammograms, but not think about getting their lungs screened.” A CT scan is the only proven effective way to screen for lung cancer. People who take part in screening can significantly lower their chances of dying from lung cancer. Smoking is the leading cause of lung cancer, accounting for up to 90 percent of all lung cancer. However, there are other underlying factors. Lung cancer also can be caused by exposure to radon, asbestos, hazardous chemicals, industrial toxins, particle pollution, secondhand smoke and genetics. Never picking up a cigarette or “quitting is the single best thing you can do for your health,” recommends Dr. George Giacoppe, a pulmonologist and critical care physician with Asante. “If it’s on fire, don’t put it in your mouth. “If you work around industrial toxins, such as solvents, hydrocarbons, paints and asbestos, wear a protective mask or gear,” he adds. Baldovino says that non-smokers who develop lung cancer likely have been exposed to radon. Radon is a naturally occurring radioactive gas that seeps into homes from the bedrock underneath and can build up to levels that are high enough to cause lung cancer. The U.S. Environmental Protection Agency estimates that this very common, colorless, odorless gas is responsible for as many as 22,000 lung cancer deaths each year. Baldovino advises Rogue Valley residents to test their homes for radon. Inexpensive kits can be found at most home improvement stores. Giacoppe recommends annual flu vaccinations to stave off infection and the risk of pneumonia as part of a healthy lung regimen. He also promotes regular rigorous exercise to help the lungs naturally release anti-inflammatory chemicals. And, while there may be concerns about the hazards of smoking marijuana, puffing on e-cigarettes or vaping, Giacoppe says, “there is not enough definitive data” to suggest a higher risk of developing lung cancer. “We might have a better idea in five to 10 years,” he says. Giacoppe admits that lung cancer research, the development of better diagnostic tools and the introduction of better treatments and drugs have been “in the back waters” of the medical research community due to the stigma associated with smoking. Breast, prostate and colon cancers, in the meantime, have received a flood of attention over the last 20 years. The protocols for early detection and treatment have improved significantly the survival rates for those diseases, while lung cancer remains “the largest killer among cancers,” says Giacoppe. The good news is that surgical techniques are improving, radiation therapy has become more focused, and chemotherapy is more effective. “The survival rate at each stage has improved,” he says. Genetic research is “the fastest growing piece in medicine,” as are clinical trials in immunotherapy, Giacoppe says. A better understanding of genetic mutations will help identify those who are predisposed to lung cancer as well as fine-tune and target potential treatment. Multiple clinical trials of new, targeted immunotherapy are currently underway at Providence Cancer Center. Lung cancer is a highly stigmatized disease among the general population as well as cancer patients. “It’s unfair, the ‘I told you so’ mentality,” says Giacoppe. “Patients believe they deserve the disease. “I have had patients who feel guilty or remorseful and will not pursue treatment as aggressively as they should. “Regardless of a person's smoking history, nobody deserves lung cancer,” he says. To be eligible for lung cancer screening, patients must be: • 55 to 77 years old with no symptoms. • Smoked the equivalent of a pack a day for 30 years or 2 packs a day for 15 years. • Be a current smoker or have quit within the past 15 years. • Have not had a chest CT scan in the past year. • Have no other major health conditions or declined function that would preclude standard therapies for lung cancer. Before scheduling a screening, both Asante and Providence physicians recommend patients receive counseling and participate in shared decision-making with their primary care provider. The pre-screening process is important, says Baldovino. “The patient must understand the benefits and the risks,” she says. If done responsibly, “lung cancer screenings can actually save lives.”