Suffering from constant and severe sinus headaches, Janet Hackley scheduled a routine nasal surgery to bring some relief.
But what her doctor found on her preoperative chest X-ray wasn’t relief at all. Hackley had a suspicious mass in her right lung.
A few days before her 70th birthday this March, doctors at Texas Health Arlington Memorial Hospital removed a grapefruit-size section of cancerous lung tissue.
“I was in shock. I had no symptoms,” said Hackley, a longtime Arlington resident. “I probably would have died of lung cancer had I not gone in for that surgery.”
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Lung cancer is often called a “silent killer,” and one-fourth of people with the disease show no symptoms when they are diagnosed. It’s often caught during chest X-rays or scans performed for other reasons. It is the third-most-common type of cancer in the U.S. and the leading cause of cancer-related death for both men and women.
The medical community hopes that tumors can be caught earlier and deaths reduced through an increase in screenings for those most at risk for lung cancer.
Under the Affordable Care Act, private insurers next year will start covering annual low-dose computerized tomography, better known as CT scans, for people who meet certain age and smoking-history qualifications.
Medicare is set to decide in February whether it will also cover the screening, which a federally funded study found detected lung cancer in heavy smokers far more efficiently than chest X-rays and led to better survival rates.
“Chest X-rays are dirt-cheap compared to anything else, but you can miss things,” said Dr. John Adams, an oncologist at Arlington Memorial. “If you have someone in that high-risk category, anything you can do to try and prove or disprove a lung tumor early is critical.
“If you find something early, you are ahead of the game. The only potential cure for solid tumors is surgery. If it’s out, it’s out.”
Last year, the U.S. Preventive Services Task Force recommended annual CT scans for patients ages 55 to 74 with a smoking history equivalent to one pack a day for 30 years who still smoke or who have quit within 15 years.
With 70 as the median age for lung cancer diagnosis, several medical groups, including the Texas Radiological Society and the Texas Medical Association, are pushing Medicare to cover the screenings, which would apply to an estimated 4 million older Americans. The scans reportedly cost $100 to $400.
“There is obviously additional costs to society to pay for it, but you have to remember you are extending people’s lives and cutting down on more extensive therapies later,” said Dr. Tilden Childs, a diagnostic radiologist at Arlington Memorial and president of the Texas Radiological Society.
Lung cancer doesn’t affect only heavy smokers.
Tarrance Wynn, 34, went to his doctor this year because of chronic pneumonia. Though he’d had chest X-rays for several years, Wynn said, his doctor wanted a better look at his respiratory system.
While in the hospital with pneumonia, Wynn underwent a CT scan and was diagnosed with adenocarcinoma, the most common type of lung cancer found in nonsmokers.
His doctor removed most of a softball-size tumor in his left lung. Wynn, an eight-year employee at Arlington Memorial who also serves on the hospital’s cancer committee, is taking medication to suppress the remaining cancer.
Wynn believes the scans should be more widely accessible.
“I think with lung cancer being where it is, affecting smokers and nonsmokers, screening is needed,” said Wynn, who is married and has three children. “This screening can be beneficial the same way it has been with breast cancer and prostate cancer.”
Dr. Himalaya Lele, a cardiothoracic surgeon at Arlington Memorial, said he has operated on numerous patients who discovered their lung cancer by “dumb luck.”
Unlike people with testicular, skin or breast cancer, those with lung tumors may not be aware of the problem until the cancer is fairly advanced, he said.
“Oftentimes they are very silent. By the time it is symptomatic, that cancer in your colon or stomach or lungs has grown to a pretty big size,” said Lele, who removed a 21/2-inch tumor from Hackley’s lung.
Hackley smoked occasionally in her youth but said most of her exposure to cigarette smoke was secondhand.
The national study, which involved 53,454 current or former heavy smokers ages 55 to 74, found that those who underwent low-dose CT scans had a 15 to 20 percent lower risk of dying from lung cancer than those who received standard chest X-rays.
“If you find it early, you can make a difference,” Lele said. “Screening works. It should be cheap, easy, quick and accessible to everybody.”
Susan Schrock, 817-390-7639