Let's learn everything about lung cancer screening!

Are you a smoker ? Or are you a former smoker who has now quit? If so, this article will be very important for you. Today we are going to talk about a disease that many people fear, but which has a great chance of being cured if detected early. That is lung cancer . It can often be too late when it starts showing symptoms. So, today we are talking about a method that can detect cancer that has started to develop inside the body, even when there are no symptoms.

What is lung cancer screening?

Simply put, lung cancer screening is a test to find out if you have lung cancer before you have any symptoms . This is done with a special scan that is done once a year. This is called a low-dose CT scan (LDCT).

Think of it like taking a very clear set of photos of the lungs inside our bodies. From these images, we can identify even very small, invisible clumps of cancer cells (tumors).

You may think, "I don't have any problems, I don't have a cough, I don't have a fever, why would I be looking for cancer?" That's the problem. The worst thing about lung cancer is that it doesn't show any symptoms in the early stages . By the time symptoms like cough, fever , and chest pain start appearing, the cancer may have spread far and become difficult to treat. But what this `screening` does is catch the cancer before it reaches that dangerous stage, when it's still a small plant. Then the chances of a complete cure with treatment are much higher.

Who wants to take this test?

This is not a test that is recommended for everyone. It is specifically recommended only for people who are at high risk of developing lung cancer. According to medical experts, if you meet all three of the following criteria, it is wise to have this test once a year.

How is 'Pack-Year' calculated?

This may sound like a new term, but it's actually quite simple. A 'pack-year' is a measure of how many cigarettes you've smoked in your lifetime. Here's how to find it:

Multiply the number of years you have smoked by the number of packs of cigarettes you smoke per day (remember, there are 20 cigarettes in a pack).

Let's look at an example:

• Example 1: Sunil smoked 1 pack of cigarettes (20 cigarettes) per day for 20 years.
• His 'pack-years' = 20 years x 1 pack per day = 20 'pack-years' .
• Example 2: Kamal smoked for 10 years. But he smoked 2 packs of cigarettes (40 cigarettes) a day.
• His 'pack-years' = 10 years x 2 packs per day = 20 'pack-years' .
• Example 3: Piyal smoked half a pack of cigarettes (10 cigarettes) a day for 40 years.
• His 'pack-years' = 40 years x 0.5 packs per day = 20 'pack-years' .

So, if your 'pack-year' count is 20 or more, and you meet the other two criteria, you should consider getting this test. If you are not sure about this calculation, that's okay. You can talk to your family doctor and ask for clarification.

How the scan happens

Do I need to prepare before the scan?

Usually, there is no special preparation required for this `LDCT` scan. This means that you do not need to fast or take any special medication. However, if the place where the scan is being performed has given you other instructions, follow them exactly. It is best to wear clothes that you can change into easily and to reduce the amount of metal objects on your body, such as jewelry and watches.

Another important thing is, if you have a respiratory infection like a cold or cough on the day of the scan, let the scan provider know in advance. Doing the scan at such a time can affect the accuracy of the results. So they may give you another day.

What happens during the scan?

This is not as scary as you might think. It's a very quick and painless process.

1. First, the technician performing the scan will ask you to remove any metal objects, watches, or jewelry from your body. You may be asked to wear a gown that they will provide from the waist up.

2. You will then be made to lie down on a bed with a scanner.

3. This time, the patient walks into the scanner, which is shaped like a large donut.

4. As the machine rotates around you and takes pictures, the bed may move forward and backward a little.

5. At this point, the technician will speak to you through a microphone and give you instructions such as inhaling, exhaling, and holding your breath for a short period of time. It is very important to follow these instructions exactly for the clarity of the results.

6. Even though the technician is not in the same room with you, he is watching everything from outside and talking to you. So there is no reason to be afraid.

7. After all the necessary pictures are taken, the bed comes out again, and you can get up and leave. The whole process only takes a few minutes.

What are the risks and benefits of this test?

As with any medical test, there are both small risks and big benefits. Let's be aware of that.

Risks

• False positives: This is the main risk. This means that a scan may show a small lump in the lung that looks like cancer (pulmonary nodule), but it may not actually be cancer. Most lung nodules are harmless. However, having to undergo further tests (and possibly even surgery) until it is clear whether it is cancer or not can be very distressing.
• Radiation exposure: The amount of radiation emitted from an LDCT scan is very low. Much less than a regular CT scan. But it is not zero. Continuous exposure to this radiation over many years may slightly increase the risk of cancer. However, when compared to the risk of lung cancer for a smoker, the risk from this scan is negligible.
• Incidental findings: Sometimes, a scan done to look for lung cancer may show other conditions. For example, a condition called COPD (chronic obstructive pulmonary disease) or a lump in the breast may be found. Some of these may require treatment, while others may not. But they can also lead to unnecessary tests and stress.

Advantages

• Early detection: Even small cancerous lumps that are too small to be detected on a regular chest X-ray can be clearly seen on a CT scan. The earlier a cancer is detected, the greater the chance of treatment and cure.
• Low radiation dose: As mentioned earlier, this uses a lower radiation dose than a regular CT scan, so the risk is lower.

Things that may be in your report

After the scan, a radiologist and your doctor will review the images and give you a report. The report may contain words like these. Let's look at their simple meaning.

If the results are abnormal, what do you do next?

Don't worry if there's something suspicious on the scan report. It doesn't mean you have cancer. It just means that it needs to be investigated further. Your doctor will explain everything to you and guide you on what to do next.

The next step could be one of these:

• Repeat LDCT scan in 3-6 months (to see if the tumor has changed)
• A more detailed `Diagnostic CT` scan or `PET/CT` scan.
• Meeting with an oncologist.
• For other non-cancerous respiratory conditions, see a pulmonologist.

When can we stop doing this test?

This annual test is not required for life. You can stop it if:

• If you are 81 years old or older.
• If you have been smoking for 15 years or more (the longer you have been without a cigarette, the lower your risk of cancer).
• If, due to another health condition, you are diagnosed with early-stage lung cancer but cannot undergo surgery, or you are unwilling to undergo surgery.

In conclusion, lung cancer is a serious disease. However, this simple scan, done once a year, is a powerful tool that can detect this serious disease early and save lives. Lung cancer cannot be detected by blood tests. Therefore, if you think you are at increased risk for this disease, please talk to your doctor about this. It could be a life-saving factor.