I Hate Lung Cancer by Evan L Lipkis MD

There’s 2 big reasons that I hate lung cancer. But in order to explain myself, let’s do a little question and answer.

Who should be screened?

Men and women between 55-75 who have smoked at least 1 pack per day for 20 years AND either are current smokers or have quit within the last 15 years. If you meet these criteria then you need to get annual low dose cat scans to screen for early lung cancer.

What’s wrong with the screening and also why is it needed?

Most lung cancer I have seen has occurred in patients who stopped smoking over 15 years ago. These people are not screened because they don’t meet the criteria. Also by the time symptoms occur such as cough, shortness of breath, weight loss, hoarseness and chest pain, the cancer is already advanced. I HATE this. The screening tests need to be easier and encompass a larger age range.


What if you never smoked?

Sadly, you can still get lung cancer. There are other causes besides smoking. Personally, I feel that pollution is underestimated especially in big cities. Radon is another risk factor that can be tested in the home. Passive smoke inhalation due to living with a smoker is likely another risk factor. Finally there are a number of occupational causes such as asbestos exposure (shipyards, brake lining, aeronautics, building materials, excavation).


So I HATE lung cancer because the screening tests are not sufficient and sometimes lung cancer occurs without smoking.


What can be done?

Lung cancer is the second most common tumor after skin cancer. I am investigating adding additional testing so that we can screen everyone. So what are some possible options?


—-The Aristotle test by StageZero Life Sciences. Allegedly this panel screens for lung, breast, prostate, ovarian and a few other cancers reliably. I will be getting the data shortly so just stay tuned because I will critically evaluate this test.


—-Early CDT. This is also a blood test that screens for antibodies that are associated with lung cancer. Unfortunately this panel is only about 50% sensitive  in detecting lung cancer.


——Stop smoking any tobacco product. Chantix works best and the nicotine patch, Zyban and vaping can also help. Follow up with your doc a week or two after your quit day. Also avoid the previously stated occupational exposures.


Dr’s Rx: Be sure to be screened for lung cancer if you meet the standard criteria’s as previously stated. The screening process is just not broad enough and we need better early detection with a simple blood test. In the next blog, I’ll talk about these new blood tests and let you know if they are useful.


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