Lung Cancer Screening: Is it Right for You?

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here’s Deborah Howell.

Deborah Howell: Welcome to the show. I am Deborah Howell and today we’ll be talking about lung cancer screening and finding out if it’s right for you or someone you love. Our guest today is Robin J. Phillips, a registered nurse with over 25 years of experience. She’s held many different positions in nursing and currently is the nurse navigator at Orange Coast Memorial Medical Center for cancer patients, but primarily lung cancer patients. Robin manages the lung screening program as well as many other aspects of lung cancer care and patient education. Welcome, Robin.

Robin Phillips, RN, MSN: Oh, hi Deborah. Good morning. Thank you for having me this morning.

Deborah Howell: Pleasure is all ours. I'll begin with my first question: what is a low-dose CT lung screening and who would benefit from receiving one?

Robin Phillips, RN, MSN: Well, a low-dose CT lung screening is a computed tomography scan. What you’re doing is you’re laying on a table and a big donut-shaped circle is around you. This screen helps to detect any abnormalities in your lungs. And what we’re looking for are lung nodules, which are little abnormal spots or round masses of tissue that can be detected. Now, not all nodules are cancer. Some can be scarring, infection, or inflammation. At Orange Coast, this is read by a board-certified radiologist. High-risk individuals that are current smokers or former smokers that quit within the last 15 years really should undergo a lung screening.

Deborah Howell: Okay, that makes perfect sense. And what is the criteria to qualify for a lung screening?

Robin Phillips, RN, MSN: The criteria is very strict for this lung screening. Lung cancer screening is recommended annually for certain individuals that meet the criteria:

• You have to be between the ages of 55 and 77.
• You have to be a current smoker or a former smoker that’s quit within the last 15 years.
• You have to have smoked one pack of cigarettes for 30 years.

Deborah Howell: That’s a pretty high bar. And why is a lung screening so important for people who fit the criteria?

Robin Phillips, RN, MSN: Well, a CAT scan... why is it so important? Lung cancer accounts for about 27% of all cancer deaths. More people die from lung cancer than colon, breast, or prostate. Screening high-risk individuals dramatically improves lung cancer survival rates by finding the disease early, which is treatable, and this is key.

Deborah Howell: Okay. Now, are there any risks involved with this particular screening?

Robin Phillips, RN, MSN: First and foremost, it’s always best to discuss lung screening with your healthcare provider. But of course, you’re going to be exposed to some radiation during this exam, as you would with any other imaging.

Deborah Howell: All right, that’s only fair. And then what are some of the benefits of CT lung screening?

Robin Phillips, RN, MSN: You might ask when was this all started, and it was started through the National Lung Screening Trial. This was a randomized study to evaluate if low-dose CT lung screening would reduce death from lung cancer among 53,000 individuals. The study found a 20% reduction in lung cancer deaths from annual screening for those that had a significant tobacco smoking history. So, lung screening can detect lung cancer early when it’s most treatable and possibly curable.

Deborah Howell: Now the big question for you, Robin: are lung cancer screenings covered by insurance as a preventive service?

Robin Phillips, RN, MSN: This is always the question because of course we’re always thinking about cost. It’s always best to check with your insurance carrier to see if preventive services are part of your plan. Most insurance companies have recognized that lung screening as a preventive measure for lung cancer is a good thing. But of course, with anything, you might have a co-payment or other fees for the lung screening.

Deborah Howell: Sure. Well, that’s the way the insurance business works and we have to work within that frame.

Robin Phillips, RN, MSN: Well, at Orange Coast Memorial, we do have a cash price and so that’s part of the lung screening program as well.

Deborah Howell: Good. And payments are possible?

Robin Phillips, RN, MSN: Yes.

Deborah Howell: Okay, well that’s good. How does someone schedule a low-dose CT lung screening?

Robin Phillips, RN, MSN: Well, they can contact me, the nurse navigator at Orange Coast Memorial, and I will ensure that they have a very smooth process, provide education, and contact their physician.

Deborah Howell: Lung cancer, of course, is most treatable when it’s identified in the earliest stages. So what would you tell anyone who thinks they might have a possible cancer in the lung?

Robin Phillips, RN, MSN: I think that they should really contact their physician and really discuss their symptoms and present the issue about maybe possibly having a lung screening. It’s really important with anything as far as your health to discuss these with your physician. And don’t be afraid, just go ahead and let the doctor know how you’re feeling.

Deborah Howell: And once again you said 20%?

Robin Phillips, RN, MSN: Yes, through the lung screening there’s a 20% reduction - it was found through that research study - a 20% reduction in lung cancer deaths through lung screening as compared to a traditional chest X-ray.

Deborah Howell: Well, knowledge is power and we thank you so very, very much. Of course, people are wondering: does the scan hurt? Could you walk us through the procedure a little bit?

Robin Phillips, RN, MSN: The scan with the low-dose CT lung screening, you don’t get any IV contrast or oral contrast because it is low dose. So you would be admitted into the imaging center. You wouldn’t have any kind of invasive procedure at all. You go into a room and, like I stated previously, it’s like a big donut. And the reason this CAT scan is so important, because if you think of a loaf of bread, it’s taking pictures and looking at it in slices. This way they get a very accurate picture of the lungs.

Deborah Howell: I see. So all you do as a patient is just lie there and you don’t need to be medicated for this procedure?

Robin Phillips, RN, MSN: No, no medications. You would just have to change into a hospital gown so that they could get a clear picture and the whole process would take about one hour.

Deborah Howell: So you don’t even need to take a day off work.

Robin Phillips, RN, MSN: No, you could actually do it at your lunch break.

Deborah Howell: There you go! Because sometimes people just get afraid of any medical procedure and think it’s going to hurt or it’s going to cost me a day of work, and that’s not the case in this case.

Robin Phillips, RN, MSN: No, and that’s a good point to bring up because a lot of people do schedule these before work or after work. It’s usually an eight-hour period that the imaging center is open and we do accommodate patients. The first appointment is at 7:00 in the morning and the last appointment is at 4:00 in the afternoon. And a lot of people do come on their lunch break, so we try to accommodate our patients as best as we can.

Deborah Howell: Always worth it to have knowledge. Knowledge is power.

Robin Phillips, RN, MSN: Absolutely.

Deborah Howell: Robin, thank you so very, very much for your time today. We really appreciate having you on the show.

Robin Phillips, RN, MSN: Oh, thank you so much. It’s really great to be able to provide the community with this valuable information.

Deborah Howell: We're happy you're there and the community is well served by it. For more information or to listen to a podcast of this show, please visit memorialcare.org. That’s all for this time. I’m Deborah Howell. Thank you so much for listening and have yourself a great day.