Lung Cancer

By: Dr. Sanjay Gupta
By: Dr. Sanjay Gupta

More accurate testing to detect lung cancer is available, but medical specialists are warning against it.

After the tragic news about the death of Peter Jennings and Dana Reeve, people have thought about lung cancer more than ever before. The number of calls to "quit smoking" hotlines went up by 50 percent as a result. Just about every smoker and former smoker were worried, more worried than normal, and many of them could relate to Peter Kennings

“We smoked, Peter and I; certainly that was a big factor.”

Micki McCabe had her own scare 12 years ago. It was a cough that wouldn’t go away, so she decided to get it checked out by her doctor.

“I had the CT scan, which seemed to indicate that there were some tumors. I remember asking him then, did it seem likely that I had lung cancer? He answered me forthrightly, that more than likely I did have lung cancer.”

Micki was lucky. The CT or CAT scan, did reveal lung cancer, but it was caught early enough that an operation was able to remove all of it. She was cured.

“I am certainly grateful to whatever spiritual forces were in the universe that were part of me getting a good break.”

But it was more than just a spiritual force. Miki had demonstrated a basic tenet of medicine: catch cancer early and you are more likely to beat it. Not so fast, says Dr. Sanjay Saini.

Whether or not lung cancer screening with CT does in fact save lives, we don’t know that yet. He buys into the idea that catching cancer is good, but unfortunately as you look inside the human body, there are things you can find that can be potentially bad, but we also find things that are of no consequence. It's those inconsequential findings that bring into question just how useful CT scans are.

We call them "false positive" results and they are estimated to occur somewhere between 25 to 70 percent of the time. The patient ends up having other tests done, and even surgery done, to determine what that is, and that’s a downside to the patient.

Dr. Len Horovitz says that may be true, but it's still worth the risk. If there's a 25 percent false positive rate, that means there's a 75 percent positive rate and he points out another possible virtue of a false positive. Simply having any kind of abnormality, even if it turns out to be nothing bad, can still scare people enough to make them stop smoking.

But as it stands now, organized medicine hasn't yet decided whether CT scans should become as common as mammograms for breast cancer or a colonoscopy for colon cancer. Recommendations like that could still be years away. Micki McCabe, though, didn't wait for any recommendations. She is convinced that she is alive today because of one scan years ago.

“The early detection probably is why I'm talking to you now.”


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