10 Steps to Beat Lung Cancer

CT Scans are painless and non-invasive.

CT Scans are painless and non-invasive.

Screening for lung cancer can save lives – 26,000 to 36,000 Americans every year – by use of low dose CT scans. Dr. Florian Fintleman from Massachusetts General Hospital in Boston reported on the 10-step model at the 2016  American Roentgen Ray Society (ARRS) meeting in Los Angeles.

Dr. Fintelman’s program can be summarized as follows:

  1. Patient Eligibility:
    • Current smokers age 55-77 years old
    • Former smokers age 55-77 with a 30-pack-a year history
    • Former smoker who quit within 5 years
  2. Physicians and Patient Education:
    • Educating primary care physicians on the US Preventative Services Task Force (USPSTF) guidelines and results. Stressing that nearly 30,000 lives can be saved every year. Only 15% of lung cancer patients are found with stage I or stage II disease, with survival rates of 80-85%. With lung cancer screening, that percentage can nearly be doubled, saving many more lives when the lung cancer is caught early.
    • Medicare (CMS) requires a visit between the referring physician and patient, with the visit focusing on “counseling and shared decision making”, i.e. part of a routine visit.
  3. Ordering screening lung CT scans:
    • CMS guidelines call for a physician or qualified non-physician provider such as a nurse practitioner, physician assistant or nurse specialist to order the low dose CT scan.
    • Patients who would simply like a CT scan screening may self refer as long as they meet the screening criteria.
    • First Dayton Cancer Care has special LDCT Lung Screening order forms with the established criteria. We will even acquire the prior authorization if needed. Call us today.
  4. Image Acquisition:
    • The American College of Radiology (ACR) and CMS established parameter for low dose, non-contrast CT scan optimal for lung screening.
    • First Dayton Cancer Care is an approved imaging facility through the Intersocietal Accreditation Commission with the longest accreditation term that they grant so you can be rest assured that the best possible low-dose, non-contrast CT lung screenings will be given here.
  5. Image Review:
    • At First Dayton Cancer Care our scans are read by board certified diagnostic radiologists from ProScan Imaging, a nationally recognized group of radiologists based in Cincinnati.
  6. Communication with Physicians:
    • Clear and concise reporting to referring physicians is provided within 24-48 hours of scan.
    • Images are available for viewing by physicians who so desire.
    • Images are compared to any previous screening scans if made known by the patient or ordering physician.
    • Referring physicians will get a telephone call from the Medical Director, Dr. Edward Hughes, to follow up on any positive CT Scans. Referring physicians can call Dr. Hughes for his medical opinion regarding further follow up, like biopsies and/or PET/CT scans.
  7. Communications with the Patient:
    • First Dayton Cancer Care will educate the patients with a negative screening to continue to follow up with their General Practitioner and the importance of routine care and need for future screenings.
    • Clinical research showed that an unexpected result from screening was the patients with a negative CT scan felt they have a new lease on life and continue to smoke. So we stress that a smoking cessation and or an appointment with their General Practitioner to discuss this habit is imperative.
  8. Quality Improvement
    • CMS has begun a program to collect data on lung screenings. They are just beginning to role out this registry but the hope is that these results will help fine-tune the guidelines and provide some benchmarks for further understanding the importance of these screenings.
  9. Cost/Insurance Coverage
    • Since December 2013, many private insurers will cover the cost of this routine screening for those meeting the criteria.
    • CMS covers lung cancer screening by its own criteria since February 2015 for those enrolled in the registry. Medicare is rolling this registry program out and hopefully soon all screening centers will be enrolled.
    • For other eligible patients, a low dose CT scan is only $99, the cost of a couple of cartons of cigarettes.
  10. Research Frontiers
    • As always, many questions remain unanswered, like the optimal interval between CT scans and how long should one have low-dose screenings.
    • Stereotactic radiosurgery, like that delivered by the Cyber Knife, has the same results as open surgery, but without the risk of thoracotomy. And the risk of surgery is not only confined to surgical complications, but there is a defined risk of death from thoracotomy, especially in elderly patients with multiple medical problems.

If you have any questions, please feel free to write or to call me, Dr. Edward Hughes at 855-DAYTON1.