My wife died of lung cancer on Thanksgiving Day, 2004. She had started smoking in college in 1956 and finally stopped in 1989. In Aug. 2004 she developed a chronic cough and our family doctor diagnosed it as an upper respiratory infection. In Sept. the cough had not stopped and our family doctor changed the diagnosis to viral pneumonia and began he treating her for that. Her cough remained the same throughout Sept. and our doctor took and x-ray. He said all he could see was the pneumonia but admitted that it was not possible to see "under it". In Oct. her cough continued and she began to have balance problems and difficulty walking. Finally in late Oct. we saw our doctor again (together) and gave him a list of all my wife's symptoms and she finished the conversation by saying "Doctor I just feel awful and there has to be something else wrong with me. We asked for an emergency appointment with a pulmonary doctor and our family doctor said he didn't see anything that would warrant that but he did schedule a CT scan in early Nov. The result of the scan was that my wife had lung cancer and it had traveled to her brain. She died three weeks later on Thanksgiving day. I believe that if a CT scan had been taken in Sept. she would still be alive.

Posted by: lincsara | March 4, 2010 7:54 AM

I would prefer to "worry" (your word) about a so-called benign lump than have a malignant one that has been discovered too late. In fact, I find the medical community's attitude very patronizing.

I wouldn't worry. I'd just be grateful that that *particular* lump had been found benign.

Posted by: jinglebts | March 4, 2010 12:48 PM

This advice appears to be at odds with other Johns Hopkins advice. You advise to "skip" prescreening for lung cancer and also say the advantages of prescreening for lung cancer is in the same group as prostate and breast cancer screening.

Are you then advising to not screen for breast cancer and prostate cancer?

In my case I had a rise in my PSA to 8.3. I had a referral for a prostate biopsy and have a Gleason 7 prostate cancer score. Doctors advise without intervention in a few years I will have significant problems. I am scheduled for prostate surgery in 2 weeks, while I am healthy and to lessen or remove the possibility of the cancer spreading.

Thanks to prescreening I can take steps to prolong my life. I know of many women who are thankful for breast cancer prescreening. The above advice as stipulated or implied in the article is faulty.

Posted by: perplexed | March 6, 2010 8:45 AM

I had a CT scan done in December of 2009 due to Clogged Arteries, and the radiolgist noticed a cancer cell on the right lobe of my lung. This was done at Shands which is a highly recognized hospital, and the radiogist assured me it was malignant. It was in the very early stages and of course I had the lobectomy. This was obviouslhy great luck since I had no symptoms of lung cancer, and I haven't smoked for 30 years. I am continuing to have screenings as my doctor sees necessary. I would advise ANYONE to have CT scans, hoping they are benign, but YOU NEVER KNOW!

Posted by: leewilson1214 | March 6, 2010 10:33 AM

If not for Lung Cancer screening by a Pulmonologist my Cardiologist referred me to after a heart attack, I would probably be dead by now as the cancer would not have been found.

I may be missing the author's point(s), but I find it hard to argue against screening for this insidious disease-

Bob Jones Bradenton, FL

Posted by: SunGuy34209 | March 6, 2010 11:00 AM

I had been a light smoker for 10 years about 40 years ago. Three years ago I had some lung irritation and convinced by GP to order a CT scan. It showed a small nodule on my upper right lobe. The GP tried an antibiotic but the nodule was still there. I saw a pulmonologist who did a CT/nuclear scan and then a broncoscopy, both negative. I had repeated CT scans every 4 months for a year and the nodule continued to grow approaching 2cm. The pulmonologist thought there was a slight chance of cancer. So, 15 months ago I had a biopsy which showed the nodule was malignant and the lobe was removed with no lympth node malignancy (Stage 1A). I had a clear CT scan 3 months ago. I consider myself very fortunate and advise anyone with symptoms to get scanned.

Posted by: Nordron | March 6, 2010 12:12 PM

Referring to my comment about my CT scan on December 2009, It was actually December 2008.

Posted by: leewilson1214 | March 6, 2010 2:03 PM

MY HUSBAND WAS A SMOKER FOR MANY YEARS AND QUIT IN 2001. HE WAS SCHEDULED FOR HERNIA SURGERY IN 2006, WHEN HE DEVELOPED A SLIGHT TEMP. ME, BEING A NURSE, DID NOT WANT HIM TO GO TO SURGERY WITH AN INFECTION, SO TALKED HIM INTO GOING TO THE DR. THE DR DID A CHEST X RAY AND FOUND A LESION IN THE UPPER RIGHT LOBE. A CT / PET SCAN SHOWED A BASEBALL SIZE TUMOR AND A BIOPSY SHOWED IT WAS MALIGNANT. HE HAD A RADICAL SURGERY TO REMOVE THE UPPER RIGHT LOBE, SECTIONS OF 4 RIBS IN THE BACK THAT THE TUMOR HAD ALSO INVADED AS WELL AS A LOT OF CHEST MUSCLE. HE IS STILL CANCER FREE AT THIS TIME, BUT WITHOUT HIM GOING TO THE DR FOR A MINOR TEMP HE WOULD NEVER HAVE KNOWN. FORTUNATELY HIS WAS NON SMALL CELL SO IT DIDN'T GROW FAST. THE DRS SAID THAT HE HAD PROBABLY HAD THAT TUMOR FOR TWO TO THREE YEARS PRIOR WITH NO SYMPTOMS. I DISAGREE WITH WHAT YOU ARE SAYING AND BELIEVE THAT ANYONE WHO HAS THE CHANCE SHOULD HAVE TESTS DONE TO PREVENT GROWTH OF TUMORS. MY DAUGHTER'S MOTHER IN LAW WAS DIAGNOSED WITH SMALL CELL LUNG CANCER IN SEPTEMBER AND DIED IN FEBRUARY. THESE TESTS CAN SAVE A LOT OF LIVES.

Posted by: PGILT | March 8, 2010 6:59 AM

Wow!.....That's quite a health alert. Is someone drunk? When only one in ten people with lung cancer are considered to be operable upon diagnosis it seems a bit unlikely that the other 9 would prefer to die. I'm totally happy knowing that a CT scan was able to detect a very small tumor that I had removed 14 days after it's discovery. That was a little over 5 years ago. I'm very glad I wasn't one of the 9 out of 10.

My son-in-laws mother, was diagnosed with lung cancer a few years before I was. She too was a smoker. (By the way, I had quit smoking about 7 years before I was diagnosed.)She did not receive any sort of screening. She was inoperable and became one of the 9 out of 10. She did live for about another 6 months. Something tells me she would have prefered to be playing with the same grand-daughter that I have the privelege of having so much fun with. I know her son would prefer it. I'm 100% certain that our grand-daughter is all for early detection, but.... she's not drunk either.

Posted by: keithu | March 9, 2010 10:05 AM

In response to the many comments to this Health Alert, here is a clarification from the Editor:

The use of a CT scan for screening discussed in this Health Alert refers to use of the test in a person who has no symptoms of a disease--in this case lung cancer. When symptoms, such as a persistent cough, are present in a smoker, imaging tests are indeed appropriate. In this case, the test would be used for diagnosis, not screening.

While chest x-rays, sputum examinations, and spiral CT scans have been used to screen for lung cancer, none has been shown to reduce the chance of dying of lung cancer. Consequently, no guidelines for lung cancer screening currently exist. However, once results from the National Lung Cancer Screening Trial (which is comparing results from spiral CT scans with those from chest x-rays) become available, doctors may have sufficient information to develop guidelines for lung cancer screening.

Unlike lung cancer screening, guidelines do exist for the use of screening tests to detect prostate and breast cancer. For these two cancer types, research shows that screening healthy people without symptoms will likely save lives. Still, experts have not reached a consensus about the best age to begin screening or how often to be screened. It’s also important to note that guidelines are general recommendations that apply to the population as a whole, rather than to individuals. And that’s why a discussion with your doctor is essential to determine the best screening approach for you, based on your health history and that of your family.

Posted by: editor | March 11, 2010 8:59 AM

I totally disagree with the above statement. I had negative chest xrays, had no symptoms; however had been a smoker for 30 years. For another reason had a CT-chest and they saw a "dot". I was told I could wait and see if it grew or go ahead and let them go in and if it was something-- take care of it, and if it was not I would be back to work in 2-3 weeks. I chose not to wait. The "dot" was at a place in the back it would have had to be so large before any chest x-ray would have ever shown a problem and the prognosis poor. It was cancer 0.5 cm,-no nodes-- I was a swimmer, and a bag pipe player, I was back to work in 3 1/2 weeks, 1/2 time, then 4 1/2 weeks full time. It took a while to get myself back, but that was 1998.

I totally disagree with the statement about not taking CT, no chest xray would have ever picked up this cancer as it was in the back and hidden, it would have been too late.

Another thing, I tried to "quit smoking" on my own several times- There are plenty of people who "know it all" but who are/were not addicted and can tell people like me " what to do". They need to shut up. It was not until I went to a physician and he put me on slow upgrading doses of Bupropion all the way up to 450 mg and then on the 3rd day of 450 mg it was like a cloud lifted and I had no recollection or need to smoke again. Had it not been for Bupropion I do not know what I would have done. I will have to take it the rest of my life. To me it is a miracle drug. I tried every thing before. To each his own. Drs. need to use their ears instead of their egos when dealing with this type of addiction in patients, one shoe does not fit all and a dogmatic approach just runs some patients away to never find a solution to quit smoking. I hope this blog helps one patient quit smoking before they develop lung cancer also I bless the intellect of the physicians/surgeons at the University Medical Center I went to who did not adhere to the little box you are trying to get physicians to stay in. They used "common sense".

Posted by: adcoc005 | January 20, 2011 12:26 PM