Low-dose CT scans detect lung cancer earlier, save lives

by: Lauren Sausser

Thoracic surgeon Dr. Elizabeth Kline at Roper Hospital discusses the importance of low-dose CT scans to diagnose lung cancer like the one that was used to discover the stage three lung cancer in Jane Lappe.

Jane Lappe is a retired English teacher and, until recently, a longtime smoker.
She always understood that lung cancer might be lurking in her future but only agreed to undergo a low-dose CT scan when her primary care doctor recommended it earlier this year.

The low-dose scans are similar to regular CT scans, except that they deliver a lower dose of radiation to capture an internal image.
Lappe said it helped that Medicare agreed to pay for the screening. “When you’re lying on that table and you realize what you’re being tested for, that should ring a bell,” she said. “It just hit me. What had I done to myself?”

That scan saved her life. Jane’s physicians at Roper St. Francis detected a spot on one of her lungs. They removed the mass and treated her with chemotherapy and radiation throughout the summer.

Now, Jane is cancer-free.

“That’s the part that’s just so unbelievable, that (the scans) are clear,” she said.

More than 158,000 Americans are expected to die from lung cancer this year, according to the American Lung Association, and most lung cancer patients are diagnosed during an advanced stage when doctors are left with few options.

Medicare announced earlier this year it would start covering the cost of low-dose CT scans for beneficiaries with a long smoking history. Evidence compiled during the National Lung Screening Trial, part of which was conducted at the Medical University of South Carolina, showed that the scans decrease lung cancer mortality.

Experts say this is the first time the U.S. health care system has targeted high-risk smokers with a life-saving screening option for lung cancer.

Dr. Elizabeth Kline is a thoracic surgeon for Roper St. Francis. She said the death rate for lung cancer is higher than the mortality rates for breast, colon and prostate cancer combined.

The low-dose CT scans are so effective, she said, because they allow physicians to detect the cancer earlier, when it’s easier to cure.
“We’re not decreasing the number of lung cancers, at least not now, but what we’re doing is causing this thing called ‘stage migration,’ ” Kline said. “We’re bringing (patients) out of the later stage and we’re pulling them up in the curable, early stage.”
Benjamin Toll, a clinical psychologist and co-director of the MUSC Hollings Cancer Center lung screening program, said some researchers worry that patients with clear scans will downplay their future cancer risk.

“I think there’s a lot of concern that this screening may be seen by some as a free pass to keep smoking,” Toll said. “We’re giving smoking cessation treatment to all patients.”

That includes a week of free nicotine replacement patches, he said.

Kline, at Roper St. Francis, said the number of low-dose scans the hospital system administers to smokers has quadrupled since Medicare announced it would cover the service.

“The low-dose scans save lives,” she said.

Jane Lappe, who lives in Mount Pleasant with her husband Mark, can attest to that. She’s not taking any more risks.
She stopped smoking the same day she received her low-dose CT scan.

“I never smoked another cigarette,” Lappe said.

Reach Lauren Sausser at 843-937-5598.