Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:14) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Lung cancer is the second most common cancer in the U.S., and the deadliest. But there is promising news. Less cases of lung cancer and death occur every year, partly because more people are quitting smoking.

"Ninety percent of lung cancers are related to cigarette smoking," says Dr. Karen Swanson, a Mayo Clinic pulmonologist and critical care specialist.

Early detection and treatment also help lower the numbers.

"The holy grail, so to speak, is to find it at the earliest stage possible, where it can be surgically removed or treated with radiation or ablation for cure," says Dr. Swanson.

But that's often not the case because there usually aren't any early symptoms.

"One of the problems with lung cancer is that by the time a patient presents and is diagnosed with lung cancer, 80% of the time the lung cancer is spread — meaning it's not localized disease," says Dr. Swanson.

Which is why the U.S. Preventive Services Task Force recently lowered the lung cancer screening guidelines from age 55 and a 30 pack-year history to age 50 and a 20 pack-year history.

"Some sort of smoking intervention to help the patient stop smoking is an essential part of any program because rather than diagnosing an early lung cancer, it's more important to stop the exposure," says Dr. Swanson.

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For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where social distancing and other safety protocols were followed.

The post Mayo Clinic Minute: Understanding lung cancer appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I am 62 and recently had a physical. My doctor suggested that I should be screened for lung cancer. I used to smoke a pack of cigarettes a day but quit about a decade ago. I've not had any problems, so I'm wondering if this is necessary. What does screening involve?

ANSWER: More than 600,000 people die annually from cancer in the U.S. Lung cancer remains the leading cause, accounting for about 25% of all deaths. More people die in the U.S. each year from lung cancer than from colon, breast and prostate cancer combined.

Well-conducted and reputable studies have shown, however, that a properly organized screening program can reduce the number of people who die from lung cancer by 20%.

Screening programs are used to find lung cancer at an early stage when it is more likely to be successfully treated. In general, screening is recommended for people at higher risk of developing lung cancer. That often includes people like you who smoked heavily at some point in their lives.

One research study performed in the U.S., called the National Lung Screening Trial, found that three specific segments of the population benefit the most from screening. The first group includes people who have previously had lung cancer. The second group is people who smoked a pack of cigarettes per day or more for 30 years or longer.

The third group includes people who smoked a pack a day or more for 20 years or longer and who also have another factor that raises their risk of lung cancer. Those factors may include a family history of lung cancer, having emphysema or another lung disorder, having undergone radiation treatment, or a previous cancer diagnosis in another part of the body.

One important component of a lung cancer screening program involves a radiology test of the lungs called low-dose CT. Getting a CT scan of the lungs involves a medical appointment that lasts about an hour, although the scan itself usually takes less than five minutes.

A low-dose CT scan is a painless procedure, similar to getting an X-ray. The detailed images of the lungs and surrounding structures created during the scan are generated by a computer and reviewed by a radiologist, which is a doctor who specializes in diagnosing conditions with imaging tests.

Using CT scans to screen for lung cancer is important because these scans can reveal lung cancers long before they cause symptoms or show up on a chest X-ray. A CT scan can spot cancers as small as a grain of rice. The importance of finding cancer early is significant because survival after lung cancer treatment is directly related to the stage at which the cancer is first found.

When lung cancer is identified at an early stage with a screening CT scan, the cancer often can be cured with surgery. In addition, treatment for early stage lung cancer usually can be performed using minimally invasive techniques, which allows patients to recover more quickly and return to their usual activities sooner than they would with more invasive surgical approaches.

It is important to know that lung cancer screening, when done correctly, is more than just an imaging exam of your lungs. Rather, proper cancer screening is an integrated multidisciplinary program that includes an initial individualized risk assessment to determine if participating in a screening protocol would benefit you.

A reputable screening program should include proper analysis and have structured plans to address anything that is identified on the CT scan, since not every spot found in the lung is cancerous. Having an expert evaluation of the radiology images in the context of the individual patient is important, too, along with ensuring that an overview of the findings is shared and explained to the patient. Following the review, next steps may include additional tests, a plan for future testing or discussion of treatment options. For many patients, the plan may simply come down to an annual chest CT.

Quitting smoking was an excellent decision — perhaps the best health care decision you will make in your life. Stopping smoking dramatically lowers the risk for many health problems and increases overall health and well-being. Getting screened for lung cancer simply reinforces that decision by continuing to protect your health now and into the future. — Dr. Stephen Cassivi, Thoracic Surgery, Mayo Clinic, Rochester, Minnesota

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Related Articles 

• Consumer Health: What is lung cancer screening, and who needs it? published 7/28/22
• Why lung cancer screening is important, especially for minorities published 5/10/21

The post Mayo Clinic Q and A: How early should I be screened for lung cancer? appeared first on Mayo Clinic News Network.

World Lung Cancer Day was recognized on August 1, to raise awareness about the leading cause of cancer deaths worldwide. Lung cancer accounts for 12% of new cancer cases annually in the U.S., and more than 21% of all cancer deaths this year will be attributable to lung cancer, according to National Cancer Institute estimates.

People who smoke have the greatest risk of developing lung cancer, but it can occur in people who don't smoke, as well. One of the challenges is that lung cancer is often diagnosed at an advanced stage.

"Unfortunately, when tumors grow within our lungs, it's not something that our bodies can sense or feel," says Dr. Aaron Mansfield, a Mayo Clinic medical oncologist. "So we miss it at its earliest stages, unless we're doing screening. For more than half the patients, lung cancer presents when it is already metastatic."

Research has shown that lung cancer screening can detect cancer at an earlier stage and reduce the risk of dying from lung cancer.

"Right now, this screening is recommended for people who are at higher risk based on their age and smoking history," says Dr. Mansfield.

On the Mayo Clinic Q&A podcast, Dr. Mansfield, discusses screening, diagnosis and treatment for lung cancer.

Watch: Dr. Mansfield discuss lung cancer:

Read the full transcript.

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For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.

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To help better understand lung cancer, reporter Jason Howland talks to Dr. Karen Swanson, a Mayo Clinic pulmonologist and critical care specialist, in your Mayo Clinic Minute.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:14) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Lung cancer is the second most common cancer in the U.S., and the deadliest. But there is promising news. Less cases of lung cancer and death occur every year, partly because more people are quitting smoking.

"Ninety percent of lung cancers are related to cigarette smoking," says Dr. Swanson.

Early detection and treatment also help lower the numbers.

"The holy grail, so to speak, is to find it at the earliest stage possible, where it can be surgically removed or treated with radiation or ablation for cure," says Dr. Swanson.

But that's often not the case because there usually aren't any early symptoms.

"One of the problems with lung cancer is that by the time a patient presents and is diagnosed with lung cancer, 80% of the time the lung cancer is spread — meaning it's not localized disease," says Dr. Swanson.

Which is why the U.S. Preventive Services Task Force recently lowered the lung cancer screening guidelines from age 55 and a 30 pack-year history to age 50 and a 20 pack-year history.

"Some sort of smoking intervention to help the patient stop smoking is an essential part of any program because rather than diagnosing an early lung cancer, it's more important to stop the exposure," says Dr. Swanson.

_________________________________________

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where social distancing and other safety protocols were followed.

The post Mayo Clinic Minute: Learn about lung cancer appeared first on Mayo Clinic News Network.

Lung cancer is the second most common type of cancer and the leading cause of cancer death in the U.S. By the time lung cancer symptoms develop, the disease is usually too far advanced to cure. Studies show that lung cancer screening reduces the risk of dying from the disease.

Screening is usually reserved for people who are at highest risk. It uses a low-dose CT scan to create images of the lungs and detect abnormalities that might lead to a cancer diagnosis. The U.S. Preventive Services Task Force recently updated its lung cancer screening guidelines. It recommends annual lung cancer screening for adults ages 50–80 who have a 20 pack-year smoking history ― that's someone who smoked a pack a day for 20 years or two packs a day for 10 years ― and currently smoke or quit within the past 15 years. This new screening guideline lowers the minimum age from 55 and smoking history from 30 pack-years.

"One of the most important reasons I think that the United States Preventive Services Task Force has created these different guidelines to include lower age and less pack-year smoking history is that it's very important for us to reach patients that we've not reached in the past ― for example, Blacks, Latinos, Native Americans, etc. Those patients typically have not been enrolled in these kinds of trials, and they're at higher risk for developing lung cancer," says Dr. Karen Swanson, a Mayo Clinic pulmonologist and critical care specialist.

Watch: Dr. Karen Swanson discusses new lung cancer screening guidelines.

Journalists: Broadcast-quality sound bites with Dr. Swanson are available in the downloads at the end of the post. Please courtesy: "Karen Swanson, D.O. / Pulmonary and Critical Care Medicine / Mayo Clinic"

The U.S. Preventive Services Task Force reports an especially higher rate of lung cancer among African American men, which the updated screening recommendation would address.

"I totally understand lowering the age range to try to capture those patients. But the only way we can capture those patients is getting into the community and reaching out to those patients," says Dr. Swanson.

She says it's important that people become more aware of the risks of lung cancer and talk to their local health care providers.

"Patients should talk to their primary care provider about lung cancer screening, especially if they have any history of smoking. And primary care providers can help get them into lung cancer screening programs if they are between the ages of 50 to 80 years old and have a 20 pack-year history or more, and if they're currently smoking or if they've quit smoking within the last 15 years," says Dr. Swanson.

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For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where social distancing and other safety protocols were followed.

The post Why lung cancer screening is important, especially for minorities appeared first on Mayo Clinic News Network.

Lung cancer screening  
Lung cancer screening is a process that's used to detect the presence of lung cancer in otherwise healthy people with a high risk of lung cancer. The goal of lung cancer screening is to detect lung cancer at a very early stage — when it's more likely to be cured. By the time lung cancer signs and symptoms develop, the cancer is usually too advanced for curative treatment. Studies show lung cancer screening reduces the risk of dying of lung cancer. Should you consider lung cancer screening? Here's what you need to know.

Cancer survivors: Late effects of treatment  
Your cancer treatment is over, but the treatments that may have saved your life also may continue to cause side effects. As more people are living longer after cancer treatment, more is becoming known about late side effects of cancer treatment. Learn about late and long-term effects of cancer treatment, so that you can take more control of your health as a cancer survivor.

Treating lymphedema  
Lymphedema most commonly is caused by the removal of, or damage to, your lymph nodes during cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. There's no cure for lymphedema. Treatment focuses on reducing the swelling and controlling the pain. Learn more about the treatment options that might be right for you.

The post Living With Cancer: Lung cancer screening — do you need it? appeared first on Mayo Clinic News Network.

What researchers found was that long-term quitters — pack-a-day smokers who stopped more than 15 years ago — and also those age 50 to 54, have a similar risk of lung cancer death as those which meet the national criteria.  

Researchers say the findings highlight the need to update the screening criteria when determining who is at high risk for lung cancer and should be screened.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:00) is in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network." Read the script.

Screening for lung cancer with an annual low-dose CT scan saves lives, and is recommended for those at high risk. The U.S. Preventive Services Task Force defines that as a person who is age 55 to 80 and smoked a pack a day for at least 30 years, or quit smoking within 15 years.

Dr. David Midthun (MID-toon), a Mayo Clinic pulmonologist and critical care specialist, says calculating a person's risk for lung cancer and screening recommendations isn't one-size-fits-all.

"Maybe they stopped smoking at 28 pack years. Maybe they are younger — age 50 — but have two siblings who died of lung cancer or have COPD (chronic obstructive pulmonary disease)," says Dr. Midthun.

He recommends considering additional factors. And age isn't strictly 55 and older.

"We include people who are perhaps a little younger than that, have a little less smoking history than that, but have other risk factors, such as COPD, family history, personal history of cancer," says Dr. Midthun.

And experts emphasize that education about lung cancer screening availability is especially important.

"Fewer people died of lung cancer in those who are screened with CT," says Dr. Midthun.

The post Mayo Clinic Minute: Who is at high risk for lung cancer? appeared first on Mayo Clinic News Network.

However, recent research published in The Lancet Oncology, suggests screening could benefit even more high-risk people.

“A few recent studies, including our own, have shown that only a third of patients with lung cancer would meet the USPSTF screening criteria,” says Mayo Clinic epidemiologist Ping Yang, M.D., Ph.D., and senior author of the new Mayo Clinic-led study. “We aimed to assess survival outcomes in the two largest excluded subgroups: people who quit more than 15 years ago, called long-term quitters, and people age 50 to 54 who otherwise meet the current USPSTF smoking history and age criteria.”

Dr. Yang explains that the study focused on newly diagnosed lung cancer patients to find out what proportion would have been identified by screening under current criteria. The study used two independent patient cohorts, one from Olmsted County, Minn., and the other from referral patients, both followed for 20 years, to look into the same question.

“The common sense is that the two subgroups would have better overall survival than those meeting the criteria,” says Dr. Yang.

But they didn’t.

“We found that the people who quit more than 15 years prior to diagnosis and the younger age group have a similar risk of death to those individuals who meet all USPSTF criteria,” she says.

In this prospective, observational study, the researchers combined information from the Rochester Epidemiology Project*, Olmsted County, and patients from Mayo Clinic diagnosed between 1997 and 2015. The population included 140,000 people, 83 percent of whom were non-Hispanic white. Median follow up of patients was 6.5 years and median overall survival was almost 17 months.

Dr. Yang says that in both cohorts – community and hospital – patients’ survival (measured as risk of death) did not differ between the patients eligible for screening by USPSTF criteria and those in the two excluded subgroups.

“Our findings highlight the need to update the USPSTF screening criteria and the conventional risk assessment model based on age and smoking history,” says Dr. Yang. “Careful consideration of the optimal screening criteria is needed to guide the decision to screen individuals at high risk of developing lung cancer.”

Next, the research team plans to investigate biological markers to pin-point individuals who would benefit most from screening, as well as to identify measurable personal risk factors leading to lung cancer in never smokers, particularly in women.

Mayo Clinic authors on the paper are Yung-Hung Luo, Jason Wampfler, Dan Liu, Alex Adjei, M.D., Ph.D.; and David Midthun, M.D. Other authors include: Lei Luo, Guizhou Province People’s Hospital; Yi Wang, Wenzhou Medical University; Yuh-Min Chen, Taipei Medical University.

Funding for this work was provided by the National Institutes of Health, National Cancer Institute, and the Mayo Clinic Foundation. The authors declare no competing interests.

*About the Rochester Epidemiology Project:The Rochester Epidemiology Project (REP) is a collaboration of clinics, hospitals, and other medical facilities in Minnesota and Wisconsin and involves community members who have agreed to share their medical records for research. Using medical record information, medical scientists can discover what causes the diseases, how patients respond to medical and surgical therapies, and what will happen to patients in the future. The REP receives administrative support from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery.

The post Science Saturday: Researchers say yes to expanding lung cancer screening appeared first on Mayo Clinic News Network.

Infographic: Stomach cancer
Did you know that while the rates of stomach cancer have been declining for decades, until the late 1930s, stomach cancer was the leading cause of cancer death in the U.S.? Did you know that most often symptoms of stomach cancer don't appear until the disease is advanced? Do you know the four lifestyle changes that can reduce your risk of stomach cancer? Learn more in this stomach cancer infographic.

Cancer pain: Relief is possible 
Cancer pain takes many forms. It can be dull, achy, sharp or burning. It can be constant, intermittent, mild, moderate or severe. How much pain you feel depends on a number of factors, including the type of cancer you have, how advanced it is, where it's situated and your pain tolerance. Controlling your pain is essential to your treatment. Dr. Timothy Moynihan, an emeritus Mayo Clinic oncologist, offers some insight into cancer pain, why people might not get the pain treatment they need and what they can do about it.

The post Living With Cancer: Should you consider lung cancer screening? appeared first on Mayo Clinic News Network.

On this week's Mayo Clinic Radio podcast, Dr. Shanda Blackmon, a thoracic surgeon at Mayo Clinic, explains lung cancer screening and surgical options for treating the disease. Dr. Blackmon also covers mesothelioma, another type of cancer that often occurs in the tissue surrounding the lungs. Also on the podcast, Dr. Jamie Van Gompel, a neurosurgeon at Mayo Clinic, explains how deep brain stimulation is being used to control seizures for some epilepsy patients. And Dr. Jon Ebbert, an internal medicine and addiction specialist at Mayo Clinic, discusses alcohol use disorder.

The post #MayoClinicRadio podcast: 9/29/18 appeared first on Mayo Clinic News Network.