Routine lung cancer screening recommended for more current former smokers – Bemidji Pioneer

DULUTH — What started as a routine medical checkup in early January turned into a life-changing day for Tom Collier.

The Duluth man’s doctor, Kelly McKinnon, questioned him about his medical history, including smoking. Even though Collier, 73, had quit smoking more than a decade ago, McKinnon suggested he get a chest X-ray. Sure enough, the scan came back with a smudge that caused concern due to its star-shaped edges, called spiculation.

After an additional PET scan and biopsy, it was determined that Collier had stage 1-A non-small cell carcinoma in the lower left lobe of her lung.

An image from the low-dose CT scan that detected Tom Collier’s cancer, visible as a small, irregularly shaped spot on the right side of the image on the right. Screening with low-dose CT scans is effective in finding cancer at an early stage when it is easier to treat. Two sections of this image have been edited to hide personal information.

Steve Kuchera/Duluth News Tribune

“I had no way of knowing,” Collier said of her cancer. “I didn’t feel any different at that early stage. It’s one of the insidious things about cancers is that in their early stages you don’t have a lot of obvious symptoms so the way you find out about them early is through screening and testing.

His doctors and specialists are optimistic that stereotactic body radiation therapy, which finely focuses radiation on the tumor, will be an effective treatment for Collier.

Collier is just one of approximately 15 million Americans who are recommended to get regular lung cancer screenings. Last year, the US Task Force on Preventive Services expanded its guidelines for screenings to include people between the ages of 50 and 80 who have a 20-pack-year history of smoking. Earlier this year, the Centers for Medicare & Medicaid Services announced that it was also expanding its screening eligibility for Medicare beneficiaries to include people ages 50 to 77 with a 20-pack-year smoking history. .

A “pack-year” is defined as one year of smoking one pack of cigarettes a day, or its equivalent – such as half a pack a day for two years, or two packs a day for six months. The expanded guidelines, which lowered the required number of pack-years and minimum age, nearly doubled the number of eligible Americans.

The screening itself, a low-dose computed tomography (CT) scan, is non-invasive and only takes a few minutes. Scott Studden, director of diagnostic imaging at St. Luke’s Hospital in Duluth, said the scan itself only lasts a few seconds.

“It actually takes longer for you to walk into the facility and find a scanner than it does for the pictures to be taken,” he said.

Cancer screening.
St. Luke’s Director of Diagnostic Imaging Scott Studden talks about the process of receiving a CT scan March 28.

Steve Kuchera/Duluth News Tribune

However, Studden said St. Luke’s isn’t doing as many screenings as it could be, which he says is because many people don’t know they’re eligible. According to the American Lung Association, only 5.7% of eligible people have been screened.

“If we can get people to see their doctors and talk about smoking, talk about quitting smoking, and talk about getting tested, we’ll save more and more lives,” Studden said.

Collier said McKinnon hadn’t asked him, and if Collier hadn’t revealed that he was indeed a former smoker, his doctor wouldn’t have known he was overdue for testing.

“It hadn’t really crossed my mind. I have to give a lot of credit to Dr. McKinnon for being thorough on this,” Collier said. “We had to take a look, and thank God and thank (McKinnon) that we made it. Otherwise, I would have just trotted happily through life as this thing grew and maybe moved on.

Collier, who has worked as a graphic designer and photographer, started smoking at age 21 while in the Navy. His smoking habit worsened while at work, where he said he chain-smoked one or two packs a day.

“You have a bad day, you smoke a cigarette. You have a good day, you smoke two cigarettes,” he said. “You kind of start to link everything socially in your life to smoking.”

He resigned in 2010, the year his father died of chronic obstructive pulmonary disease.

Collier thinks if he hadn’t had his chest x-ray when he did, he probably wouldn’t have had the same optimistic diagnosis. The tumor, which measured 1.5 cm during his PET scan, grew to almost half a centimeter in diameter the following month. The cancer is still in an early stage and hasn’t spread to surrounding tissues or lymph nodes yet, but he could have it if Collier didn’t know it was there.

Cancer screening.
Dr Kelly McKinnon

Steve Kuchera/Duluth News Tribune

“It’s a good time to catch it before it spreads elsewhere,” McKinnon said. “I think if he hadn’t accepted this analysis and it would have been later and had the opportunity to spread, this specific treatment that he is likely to tolerate would not have been such a safe option. for him.”

McKinnon said, on the bright side, patients are scheduling more routine checkups after a sharp drop early in the coronavirus pandemic. However, many people who come for screenings now find health issues at later stages due to the postponement.

Lung cancer is the leading cause of cancer death, accounting for 25% of all cancer deaths, more than colon, breast and prostate cancers combined. According to the American Cancer Society, approximately 236,740 new cases of lung cancer and 130,180 lung cancer deaths will occur in 2022.

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