CT lung cancer screening

Posted by joelars @joelars, Sun, Jul 7 11:39pm

I listened to a discussion concerning cancer screening. It was the opinion of the oncologists that doctors continue screenings late into the patients life where the risks of radiation exposure outweigh any benefits because the patient doesn’t have enough years, statistically, to live. Does anyone know about what age is the right age to discontinue cancer screenings?

@joelars

@merpreb as a follow-up, I don't want to appear self-righteous or hypocritical when criticizing medical providers. I'm a lawyer. None of us, me included, can extricate ourselves from conflicts of interests inherent in professional relationships. In this case, that doesn't excuse the imaging company. They hurt their self-interest by not faxing the report and gained nothing.
But doctor's are used to not having to memorize the details of a patient's history and they rely on the specialists who provide them the reports they interpret for us. Without that report my doc wouldn't know that I had the x-ray.

Although, wouldn't it be nice if in addition to the numerous computer generated messages reminding you of your appointment they took a moment to think about why you are coming, and not just worry about a no-show, missed fee?

Jump to this post

@cwi thanks for your response.
I will lobby for 1x a year but I'll take the docs recommendation. Do you think I should use an oncologist to oversee the scans even though I have never had cancer or a pulmonologist (even though mine dismissed me years ago)?

REPLY
@joelars

@merpreb
Hi. my name is larry joel is my middle name.
Thanks for the empathy.
I conclude that many doctors don't know how common lung cancer is in former smokers and also the "business of medicine" subsumes much of their time.
In defense of my primary (I like him) he didn't remember why I was there because the imaging company didn't send him the new x-ray. His procedure is common practice: when he receives a new test (often they're blood tests) he reads the reports and only when they contain abnormalities he calls me in. But this time (the only time) I scheduled the appointment to take place after the results were in regardless of the results. The "lucky" part is if I didn't, since I wouldn't have gotten "the call" I would have concluded the test was negative, when it's maybe positive, and that positive test would have sat in the imaging office indefinitely. Worse, as I developed symptoms I would have ignored them reassuring myself I recently tested "clean." and it is "only" my COPD.

I just read (on the net) 60% of new lung cancer diagnosis" come from ex-smokers. Of those 60% about 30% are people (in my group) who quit between 10-20 years. Moreover, my group's chances of lung cancer is still 7 times higher than a never smoker. Even 30 years after quitting my odds are 3x higher(that's as low as it gets).
I'm not even considering not getting cancer as realistic. I (have to) put my hope in early detection. My primary can't help much there. I would need to see an oncologist to arrange yearly scans? They would take it seriously?

Jump to this post

@joelars– Hi Larry, it's finally nice to meet you! 🙂 I understand about liking your doctor and you have a valid point about his routine. I just got so mad.. Anyway it looks like you wont stay away form all of the statistics about lung cancer. Not everyone who has smoked will get lung cancer. This from the National Cancer Institute: Lung, larynx (voice box), mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, and cervix, as well as acute myeloid leukemia.
If you are a former smoker you will definitely have emphysema or COPD or COPD and emphysema, which I have.

https://www.cancer.org/latest-news/who-should-be-screened-for-lung-cancer.html
http://www.choosingwisely.org/patient-resources/ct-scans-to-find-lung-cancer-in-smokers/
I would suggest getting a pulmonologist and at least have breathing tests and if you don't already a rescue inhaler if you should need one. Can you get a referral?

REPLY
@cwm1

Larry, I would suggest scans every 6 mos. I am a breast cancer survivor. Mine was found because of scans every 6 mos. I had one nodule and a wedge resection. 6 mos. later, 2 more nodules were visible but too small to biopsy. I am now getting a scan every 3 mos. waiting for them to be large enough to biopsy. My next scans are next week. I too am a former smoker but only quit 8 yrs ago. Before I can have treatment, they need to determine if it is lung cancer or breast cancer since I have had both.

Jump to this post

@cwm1– I'm so sorry that you've been hit with cancer in two places. For years I had a scan once a year because my scans were clean after my first lobectomy. That lasted about 5 years. I am every 6 months now because I am stable enough. The number of CT scans and the time in between have to be carefully measured because you might have to return over and over again like I have needed to for 21 years and run out of options.
I wish you good luck with your scans next week so that you can get on with being treated and get rid of it all. How long do you wait to find out the results?

REPLY

Merry, fortunately I go to Mayo Clinic in Jacksonville. So I have my scan in the morning and get the results the same afternoon. I am beyond thankful that I had the sense to walk away from our local drs. after they totally missed the lump in my breast biopsy. I walked in the door and called Mayo before even sitting down. I haven’t regretted making that call for even one second. The longest I have ever waited is until the next morning and that was only because the scan was done late afternoon. When I read how long some people wait, I cringe. The stress is bad enough; having to wait longer would drive me over the edge.

REPLY

@cwm1– I go to MGH which is another state away. I am also fortunate but there are people who can't afford that or do not have out of state insurance. I'm not sure that it has anything to do with common sense or economics. I also have received my scan results right way but all of my doctors and I have decided that I have my CT scan and return a few days later for a full explanation with the radiologist's report because radiologist have special measurement equipment to measure nodules or lesions and that can make a difference, at least for me. I have a lot of lesions and if they grow and become a certain size they need to be either zapped or surgically removed. I have very little "curative" options left so I'm being triaged so that the safest and most prudent methods are used so that I do not run out of options.
Waiting for test results is extremely stressful. How do you get beyond that?
(I know that you are new to connect but would you mind using the @ and user's name to make it easier for me to follow?) Thank you

REPLY

@merpreb, I understand that everyone doesn’t have the options. I have 2 close friends among that group. We are on Medicare and have a supplement and we were extremely cautious about which supplement we got as my breast cancer appeared prior to that while still on group insurance from my husband’s employment. I am assuming that Mayo radiologists may have the same specialized equipment you spoke of as I get very precise measurements of my nodules. This time my scan is at 8:30 and I see the dr. at 2. I don’t get beyond the stress. However, I do go down and walk on the beach almost every day from 3-6 miles, depending on tides. It’s harder to walk at high tide so those days are shorter walks. That helps me tremendously I think. Of course, everyone doesn’t live near a beach.

REPLY

@merprep I just got the results of the x-ray. It is hard to understand with my docs accent but he said it looks like a recurrence of the pneumonia. They sent me for antibiotics and then I'll have a follow-up ct scan. I'm relieved they didn't use the word cancer or tumor but apparently I have had this pneumonia since March when I was hospitalized. I realize I left the hospital early because I was on vacation in florida and felt fine.and I further screwed up by not having the repeat x-ray for 2 months after the script was written. I'm actually relieved it doesn't appear to be lung cancer. But what do I make of this persistent infectious patch? Obviously if after the antibiotics and a clean ct I can put it behind me but what if the ct still shows the infection? I'm thinking thye may have given me the wrong antibiotic to take when I was released from the hospital in march or I didn't stay long enough as in-patient and take the iv antibiotics which were working well.

REPLY

@joelars– Great news abut it not being cancer. I'll take a pill to celebrate any day! Pneumonia can be very tricky to get rid of. Be patient and let your doctor guide you and listen to him! And no more what ifs! Ok? Relax and rest

Liked by joelars

REPLY

Now my concern is the connection between COPD and pneumonia. I googled it and I'm told COPD sufferers especially if 65 or older, are almost 8 times as likely to contract pneumonia. I never had it until 14 years after I quit smoking. That was in 2016. Then in 2019 I had it again. I get vaccines. I wonder are there people on this site with COPD that don't get it or rarely get pneumonia (I hope).

REPLY
@joelars

Now my concern is the connection between COPD and pneumonia. I googled it and I'm told COPD sufferers especially if 65 or older, are almost 8 times as likely to contract pneumonia. I never had it until 14 years after I quit smoking. That was in 2016. Then in 2019 I had it again. I get vaccines. I wonder are there people on this site with COPD that don't get it or rarely get pneumonia (I hope).

Jump to this post

I never get pneumonia. It is just harder on copd patients. I don't think we are more susceptible to getting pneumonia,,,just harder on us to heal from it.

REPLY

@joelars You don't need an oncologist to order the annual low dose CT scans that are now on the same list of routine screening for people between 55-80 who currently smoke or quit within the last 15 years as colonoscopies are for people over age 50. And, when mine starting abnormal my doc ordered them more frequently and then turned me over to a specialist when it got to that point. One thing that I've concluded is that the more incompetent the practice the more skeptical the recipient becomes. I second what Merry says about looking elsewhere. You should be able to look through American Cancer Society's recommendations . Or, I've found that US New seems to publish good reports. Until it affected me I never realized how poor most of the hospitals in my area were. A neighbor with breast cancer went from one very local hospital who I wouldn't trust with most things to a place in a nearby state who always advertises in our area and passed away not long after. When I was diagnosed and saw in that report how poorly that place was rated compared to one very good one not far away it infuriated me that their advertising would so easily mislead that woman and her family. In our case, we decided that since we had the ability to drive 7 1/2 to Mayo we chose it. And, I have found that no one has the doom and gloom you are experiencing because the doctors do keep track of why you're there and spend quality time going through things together. Of course, wherever you go people are human but in my opinion, yours is a repeating pattern in people's comments when they'd been to places not specializing in lung cancer.

REPLY
@joelars

Now my concern is the connection between COPD and pneumonia. I googled it and I'm told COPD sufferers especially if 65 or older, are almost 8 times as likely to contract pneumonia. I never had it until 14 years after I quit smoking. That was in 2016. Then in 2019 I had it again. I get vaccines. I wonder are there people on this site with COPD that don't get it or rarely get pneumonia (I hope).

Jump to this post

@joelars– I was hospitalized with Pneumonia last year but my Pulmonologist said it really was just bad bronchitis, which I have had before. SO I've never had it, which is very surprising to me. Did your doctor change your meds?

REPLY
@bluelagoon

@joelars You don't need an oncologist to order the annual low dose CT scans that are now on the same list of routine screening for people between 55-80 who currently smoke or quit within the last 15 years as colonoscopies are for people over age 50. And, when mine starting abnormal my doc ordered them more frequently and then turned me over to a specialist when it got to that point. One thing that I've concluded is that the more incompetent the practice the more skeptical the recipient becomes. I second what Merry says about looking elsewhere. You should be able to look through American Cancer Society's recommendations . Or, I've found that US New seems to publish good reports. Until it affected me I never realized how poor most of the hospitals in my area were. A neighbor with breast cancer went from one very local hospital who I wouldn't trust with most things to a place in a nearby state who always advertises in our area and passed away not long after. When I was diagnosed and saw in that report how poorly that place was rated compared to one very good one not far away it infuriated me that their advertising would so easily mislead that woman and her family. In our case, we decided that since we had the ability to drive 7 1/2 to Mayo we chose it. And, I have found that no one has the doom and gloom you are experiencing because the doctors do keep track of why you're there and spend quality time going through things together. Of course, wherever you go people are human but in my opinion, yours is a repeating pattern in people's comments when they'd been to places not specializing in lung cancer.

Jump to this post

thanks for your response.
you mention 15 years as a cut-off. I'll hit 15 years next year.

REPLY
@merpreb

@joelars– I was hospitalized with Pneumonia last year but my Pulmonologist said it really was just bad bronchitis, which I have had before. SO I've never had it, which is very surprising to me. Did your doctor change your meds?

Jump to this post

@merprep the only meds I got were the antibiotics I picked up yesterday following his reading of the x-ray.

REPLY
@joelars

thanks for your response.
you mention 15 years as a cut-off. I'll hit 15 years next year.

Jump to this post

wait, I was 15 years in 2017. That was my last chest x-ray for cancer screening. I had this recent one because of pneumonia I contracted in March.

REPLY
Please login or register to post a reply.