>> 27 PERCENT OF CANCER DEATHS ARE CAUSED BY LUNG CANCER, AND
NOVEMBER IS LUNG CANCER AWARENESS MONTH.
CAROLEE MCGRATH SAT DOWN WITH DR.
ROO-SEW, THE DIRECTOR OF THE LUNG CANCER
SCREENING PROGRAM AT HOLYOKE MEDICAL CENTER, TO LEARN MORE
ABOUT DETECTION AND TREATMENT FOR THIS TYPE OF CANCER.
>> WE NOW KNOW THAT LUNG CANCER IN THIS COUNTRY CAUSES ABOUT
250,000 DEATHS PER YEAR.
NOW THAT NUMBER IS MORE THAN BREAST CANCER, COLON CANCER,
PANCREATIC CANCER COMBINED PER YEAR.
SO WE KNOW LUNG CANCER IS A VERY PREVALENT AND VERY DEADLY
PROBLEM.
AND THE REASON IT'S SO DEADLY IS LIKELY BECAUSE WHEN WE FOUND
LUNG CANCER PREVIOUSLY, WE FOUND IT LATE STAGES.
STAGE THREE OR STAGE FOUR AND IT'S VERY DIFFICULT TO TREAT ANY
CANCER IN LATE STAGES BUT IN PARTICULAR LUNG CANCER.
SO THAT WAS THE NIGHT -- TO DEVELOP A LUNG CANCER SCREENING
SYSTEM OF SOME KIND AND PEOPLE HAVE BEEN TRYING FOR YEARS, BUT
WITH A LARGE TRIAL ACROSS THE COUNTRY, LOW DOSE CAT SCANS WERE
USED IN SMOKERS OR FORMER SMOKERS ON A YEARLY BASIS TO SEE
IF WE COULD FLIP THE SCRIPT AND FIND LUNG CANCERS AT EARLIER
STAGES.
AND BE THERE BE ABLE TO TREAT IT BET AND DECREASE THAT MORTALITY
FROM LUNG CANCER.
AND WHAT WE FOUND IN THAT STUDY IS THAT THE LUNG CANCERS FOUND
WITH THE CAT SCANS WERE EARLY STAGES AS OPPOSED TO LATE STAGES
AS THEY WERE BEFORE.
WHAT THAT ENDED UP MEANING IN THE END WAS THAT THERE WAS A
DECREETS IN DEATH FROM -- DECREASE IN DEATH IN LUNG
CHANCER FROM THAT TRIAL.
A VERY SUBSTANTIAL BENEFIT.
AND THAT IS HOW LUNG CANCER SCREENING CAME TO BE IN LOW DOSE
CAT SCANS CAME TO BE AND AT HOLY OAK MEDICAL CENTER WE SAW THE
VALLEY AND WHY WE STARTED TO START A LUNG CANCER SCREEN
PROGRAM.
>> TELL US ABOUT THE PROGRAM AT THE MEDICAL CENTER.
WHO IS SOMEBODY WHO WOULD QUALIFY FOR THAT PROGRAM AND THE
AGES.
>> YES, SO THE CRITERIA FOR QUALIFICATION FOR LUNG CANCER
SCREENING AT HOLYOKE MEDICAL CENTER IS THE SAME CRITERIA THEY
USE FOR THE STUDY I TALKED ABOUT.
SO AGE 55 TO 80.
SMOKER OR FORMER SMOKER.
AND IF YOU ARE A FORMER SMOKER YOU HAVE TO HAVE QUIT WITHIN 15
YEARS.
AND THERE IS SOME DETAILS ABOUT HOW MUCH SMOKING YOU HAVE TO
HAVE DONE TO QUALIFY.
BUT THAT'S -- THAT'S SORT OF A DETAIL THAT WE CAN WORK OUT AS
WE SEE PEOPLE AND COUNSEL THEM ABOUT THEIR SMOKING AND LUNG
CANCER SCREENING IN GENERAL.
>> IS IT ESSENTIALLY A CAT SCAN OR THERE MUST BE OTHER
COMPONENTS.
>> NO.
THERE IS CERTAINLY ARE OTHER COMPONENTS AND THE WAY WE DESIGN
THE PROGRAM IS THERE IS A VISIT.
SO IT'S BASICALLY A REFERRAL TO A PROGRAM THAT YOUR PRIMARY CARE
MIGHT MAKE OR PEOPLE CAN MAKE THEMSELVES IF THEY MEET THE
CRITERIA.
AND YOU COME IN FOR A VISIT WITH ONE OF OUR PRACTITIONERS OR
MYSELF AND WE TALK ABOUT WHAT THE PROGRAM IS.
IT'S A YEARLY LOW DOSE CAT SCAN AND HOW THEY GET THE RESULTS AND
WHAT THE BENEFITS ARE AND WHAT THE SOME OF THE RISKS ARE.
AND THAT DAY YOU GET YOUR LOW DOSE CAT SCAN.
WITHIN A WEEK OR TWO YOU GET THE RESULTS AS DOES YOUR PRIMARY
CARE PHYSICIAN OF THE CAT SCAN AND IT'S SCORED ON A RISK
SCALE.
SO ONE, TWO, THREE, FOUR.
FOUR BEING THE HIGHEST RISK.
AND ONE BEING THE LOWEST RISK.
AND MOST PEOPLE, THE VAST MAJORITY ACTUALLY ARE ONE AND
TWO.
AND THEN THERE ARE THREES AND FOURS WHICH ARE DEALT WITH A
LITTLE BIT DIFFERENTLY.
IF YOU GET A ONE OR A TWO, THEN THE LETTER THAT YOU GET AND THE
LETTER THAT YOUR PRIMARY CARE GETS WILL SAY, OKAY, WE WILL
CALL YOU WHEN IT'S TIME FOR YOUR NEXT LOW DOSE CAT SCAN WHICH
WILL BE IN A YEAR.
IF YOU GET A THREE OR FOUR, WE REVIEW IT AS A GROUP.
SO THERE IS SPECIALISTS THERE THAT LIKE MYSELF AND SURGEON,
THORACIC SURGEON, AND PULMONOLOGY THERE AND
ONCOLOGISTS THERE, RADIOLOGISTS AND PATH OLINGSZS --
PATHOLOGIES.
-- PATHOLOGISTS.
WE DISCUSSION WHAT WE DO AND WE DISCUSS THE PATIENT AND EITHER
MYSELF OR THE PRACTITIONER HAS SEEN THAT PERSON AND WE DISCUSS
THE IMAGING.
AND DECIDE WHAT THE NEXT STEP IS.
AND THEN THAT NEXT STEP GO EZ COMMUNICATE -- NEXT STEP GETS
COMMUNICATED TO THE PATIENT AND PRIMARY CARE AS TO WHAT THE
RECOMMENDATIONS ARE.
ARE WE GOING TO DO A BIOPSY OR A CAT SCAN AT A SHORTER INTERVAL.
SIX MONTHS INSTEAD OF A YEAR.
THINGS LIKE THAT AND BY DOING THAT WE SORT OF GET A CAPTIVE
AUDIENCE, A GROUP OF PEOPLE THAT ARE ENGAGED IN THEIR HEALTH AND
WILLING TO PARTICIPATE AND SORT OF GET PEOPLE THROUGH A
DIFFICULT TIMES RELATIVELY QUICK.
>> SO HOW DO YOU HANDLE PEOPLE WHO ARE SMOKERS AND THEY JUST
CAN'T KICK THE HABIT.
OBVIOUSLY THEY KNOW THEY HAVE THIS HUGE HEALTH RISK AND HAVE
THIS HABIT THAT IS JUST SO DIFFICULT TO BREAK FREE FROM?
HOW DO YOU ENCOURAGE THOSE PEOPLE?
>> SO ONE OF THE THINGS IS INTERESTING IS THAT IN THAT
TRIAL AND THEN IN SUBSEQUENT STUDIES SINCE, BUT IN THAT TRIAL
SMOKING CESSATION WAS A PART OF WHAT THEY LOOKED AT.
SO TO HAVE A LUNG CANCER SCREENING PROGRAM WITHOUT
SMOKING CESSATION, THAT JUST DOESN'T MAKE SENSE.
AND WHAT THEY FOUND IN THAT TRIAL IS BECAUSE IT'S A CAPTIVE
AUDIENCE AND YOU HAVE VARIOUS DIFFERENT AVENUES TO EDUCATE
PEOPLE ABOUT SMOKING AND SMOKING CESSATION, THEY WERE HAVING A
SUCCESS RATE FOR SMOKING CESSATION OF ABOUT 25%.
NOW THE NATIONAL AVERAGE FOR SMOKING CESSATION IS 7%.
SO IT'S A HUGE DIFFERENCE AND THE REASON FOR THAT PROBABLY IS
BECAUSE IT'S A CAPTIVE AUDIENCE AND TWO, THERE ARE AVENUES WE
CAN GO DOWN THAT OTHER PEOPLE CAN'T.
SO WE HAVE A PHYSICAL PICTURE OF THE LUNGS AND WE CAN SHOW THAT
PICTURE TO A PATIENT THAT'S TRYING TO -- WHO WANTS TO STOP
SMOKING AND SAY, YOU KNOW, THIS RIGHT HERE IS EMPHYSEMA AND
THAT'S FROM SMOKING.
SOME OF THAT WILL GET BETTER.
>> WHAT'S THE REACTION YOU GET FROM PATIENTS?
>> A LOT OF PEOPLE ARE SHOCKED AT IF YOU SHOW THEM A NORMAL CAT
SCAN AND THEN WHAT THEIR CAT SCAN LOOKS LIKE, THEY ARE
SHOCKED.
THEY ARE SCARED.
AND SO IT DOES -- IT CAN SPARK MAYBE THAT FINAL THING THAT'S
GOING TO MAKE THEM ULTIMATELY STOP.
THE OTHER ASPECT OF IT IS THAT THERE ARE MULTIPLE AVENUES THAT
YOU CAN GO DOWN TO STOP SMOKING.
SO THERE ARE PATCHES.
THERE IS PROGRAMS IN PERSON AND PROGRAMS OVER THE PHONE
SUPPORTED BY THE GOVERNMENT.
THERE IS ALL SORTS OF RESOURCES THAT WE CAN GIVE TO PEOPLE TO BE
ABLE TO STOP SMOKING.
>> AND THEY KNOW THEY ARE SUPPORTED THROUGH THE PROGRAM AS
WELL.
YOU HAVE AN EVENT COMING UP TO INFORM MORE PEOPLE ABOUT THE
VERY REAL DANGER OF LUNG CANCER.
TELL US ABOUT THAT.
>> THAT'S RIGHT.
IT'S A COMMUNITY EDUCATION DISCUSSION REALLY.
AT HOLYOKE MEDICAL CENTER WHERE IT'S MYSELF AND OTHER EXPERTS
WITHIN THE PROGRAM TALKING ABOUT LUNG CANCER AND LUNG CANCER
SCREENING AND A LOT OF THE THINGS WE JUST DISCUSSED HERE.