Q: How has lung cancer diagnosis/prognosis changed the past few years

A: Dr. Yeam:   
Lung cancer treatment has changed drastically in the last 5-10 years, and the prognosis after a diagnosis is much better than it was before. I think the most important thing to remember is that even those with advanced lung cancer are doing well even 2-3 years after diagnosis. Many people come in with a grim perspective, but there is hope. Radiation therapy, immunotherapy, interventional radiology have all improved, with a direct correlation to treatments improving.

Q: What are the qualifications for lung cancer screening?

A: Sherri Hoag:  
A lung screening is preformed using Low-dose CT scan. There are eligibility criteria for lung screening which include:

  • Between the age of 50-77 years old for Medicare Beneficiaries and 50-80 for private insurance.
  • Have a 20-pack year history of cigarette smoking.
    • (ex. ½ pack per day x 40 years = 20 pack years)
  • Currently smoke cigarettes or quit within the past 15 years.

For those who meet this criteria, Low-dose CT screening is the gold standard for lung cancer screening.

Q: Many people want to get a lung screening, but the lung cancer screening guidelines make it hard to qualify, what else can they do?

A: Dr. Yeam:   
For patients with a family history of lung cancer, used to smoke but quit more than 15 years ago, or smoked less than 20 years, physicians like me can still perform an evaluation and do a chest screening, or chest x-ray. MRIs are not good for the chest, and typically are only good for the brain, spine, and joints.

Q: If you do meet the criteria to quality for a low-dose CT for lung cancer screening, why is it important to do it, and how often should you do it?

A: Sherri:  
If you meet the eligibility criteria for Low-dose CT lung screening it is important to get screened. The National Lung Screening Trial (NLST) which was sponsored by the National Cancer Institute found that the participants meeting strict eligibility criteria for inclusion, who were screened with a Low-dose CT scan vs a chest x-ray, had a 20 % reduction in lung cancer mortality rates. As with any cancer type, early detection increases long term survival rates, allows for more targeted and effective treatments, and improves overall quality of life.

It is important to continue annual lung screening as long as you meet the eligibility criteria to ensure there are no changes from prior imaging such as an increase in the size of any existing nodules or the presence of new nodules. Based on the findings of a Low-dose CT lung screening, recommendations may include a short-term follow-up CT or additional testing based on national guidelines for pulmonary nodules.

Q: Is lung cancer strictly a smoker’s disease or cancer?

A: Dr. Yeam:  
Looking at the data, what historically, or perhaps the stigma around lung cancer is, that it’s a smoker’s cancer, and therefore people may feel they had it coming. But when you look at the data, about 50% of lung cancers are occurring in patients that are non-smokers. So, it’s important to de-stigmatize lung cancer and be open and supportive to anyone who is undergoing a life altering experience such as a cancer diagnosis.

Q: As a referring physician provider in the community, how does the MemorialCare Saddleback Medical Center Lung Program stand apart?

A: Dr. Yeam:  
We have a strong team that works together and the way that Sherri handles the cancer coordination is amazing. Having a nurse navigator, like Sherri, is a distinguishing part of this program. We also have modern technology at Saddleback Medical Center, and a cohesive team that really complements that high-tech, high touch culture. If we do identify a problem, the issue is brought to the tumor board, which is like the meeting of the minds to ensure each patient gets a personalized plan of care. I personally send all my patients who qualify for the Low-dose CT lung cancer screening through Saddleback Medical Center’s program since I’ve always seen amazing results. We also keep your primary care physician involved every step of the way.

Q: How does a nurse navigator support patients?

A: Sherri: 
Our goal at Saddleback Medical Center is to support our patients in living the healthiest life possible. As your nurse navigator, I am here to support you with education about screening and provide you with resources that can help you reduce your risk for lung cancer. I will not pressure you to quit smoking, so smokers should not be deterred from screening. I will ask you how I can support you in your efforts to quit and provide you with the necessary resources when you are ready. We hold no judgment and want you to be the healthiest you can be. Just ask your primary care physician to refer you for a Low-dose CT lung screening (but please remember you must meet the criteria) and once the order comes in, I will take it from there to get you scheduled, screened, and on with your life.