The goal of the screening is to detect lung cancer in its earliest and most treatable stages, which gives patients a better outlook. When doctors identify lung cancers on CT screening scans before patients show any symptoms, the prognosis is more favorable. “The evidence from four large clinical trials have demonstrated that high-risk individuals screened with low-dose CT scans are associated with lower lung cancer-specific mortality rates,” says Matthew Schabath, PhD, an associate member in the departments of cancer epidemiology and thoracic oncology at Moffitt Cancer Center in Tampa, Florida. “It is a fast, painless, and is covered by Medicare and by most healthcare plans,” Dr. Schabath says. While the test itself is simple, what happens afterwards can be more complicated. Sometimes more testing is needed. You could receive a false positive result. Or you might have to face a cancer diagnosis. RELATED: Can You Survive Lung Cancer? A technician will talk to you and might instruct you to hold your breath at specific times. The test is painless and takes only about five minutes. Most of the time, patients get their results the same day or within a few days. Once your results are in, your doctor can discuss the findings with you. If your test shows that your lungs are clear, you won’t need another screening until your next yearly exam. Your scan may reveal a nodule on your lungs, but that doesn’t mean that you have cancer. According to the American Thoracic Society, lung nodules are found in up to half of adults who have a chest X-ray or CT scan. But, less than 5 percent of all nodules turn out to be cancer. These spots are usually the result of old infections, scar tissue, or other causes. Your doctor will analyze certain features of the nodule to determine if it’s more or less likely to be cancerous. RELATED: Why Are ‘Never-Smokers’ Getting Lung Cancer?
What if I Have a Low-Risk Nodule?
Small nodules usually don’t cause any problems and can be safely left alone. Your physician will probably recommend that you undergo more CT scans to keep a close eye on the nodule. If a nodule isn’t cancer, it typically won’t grow. You may need to have a CT scan every few months or every year, depending on how the nodule looks. Your doctor will examine its shape, size, location, and other characteristics to determine how likely it is to be cancerous. A nodule that doesn’t grow over a two-year period is very unlikely to be cancer. If a repeat scan reveals that the nodule has grown or changed, your healthcare provider might recommend that you have a positron emission tomography (PET) scan to get a better look. In some cases, a biopsy, a procedure that involves removing a sample of tissue to test for cancer, is recommended. RELATED: 5 Early Signs of Lung Cancer
What if a Nodule Looks Suspicious?
If your nodule is large or looks concerning (typically if it’s 9 millimeters or larger), your doctor might recommend a PET scan or a biopsy right away. There are different types of biopsies for lung nodules, also known as lesions, including the following: Needle Biopsy With this procedure, a needle is inserted into the lung to take out a sample of tissue. Imaging technology may be used to guide the biopsy needle into the correct spot. Transbronchial Biopsy It’s done with a bronchoscope — a long, thin tube with a camera on the end. The scope is placed down the throat through the windpipe and into the main airways of the lungs. Thoracoscopic Biopsy This method involves placing an endoscope — a flexible, lighted tube — into the chest cavity. Tools used through the scope remove small pieces of lung tissue. Open Biopsy A surgical incision in the skin is made to get to the lung and remove a piece of tissue. This method is typically used if the sample obtained from a needle biopsy is too small to make an accurate diagnosis. There are risks involved with lung biopsies, which vary depending on the type of biopsy you have. Some possible complications are infection, bleeding in the lung, air or fluid buildup in the space between the lung and inner chest wall, blood clots, pneumonia, and pain. If the results of your biopsy reveal that the tissue is cancerous, you and your physician will work together to come up with an optimal treatment plan. RELATED: What Is a Liquid Biopsy for Lung Cancer — and Do You Need One?
False Positives: A Drawback to CT?
A downside to having CT screening is that the test could reveal false-positive findings that lead to unnecessary medical procedures. For instance, your doctor might spot a nodule that looks suspicious, but after further testing, turns out not to be cancerous. Sometimes, biopsies or surgeries are performed when they aren’t needed. False positives also trigger unwarranted anxiety and stress for patients. In a large, randomized study known as the National Lung Cancer Screening Trial, researchers found nearly one-fourth of participants who underwent further work-up for nodules seen had a false-positive result over three rounds of yearly CT screening, according to the National Cancer Institute. RELATED: 5 Things Not to Say to Someone With Lung Cancer (and 4 Things You Should Say)
Coping With a Lung Cancer Diagnosis
One possible outcome is that you will get a lung cancer diagnosis, which can obviously be scary. The good news is that tumors caught early are more treatable, and targeted drugs and immunotherapy have improved the survival rates for many patients. If tests confirm you have lung cancer, there are certain measures you can take to live a better and longer life. “Many factors have been shown to be associated with longer survival time among patients diagnosed with lung cancer,” Schabath says. “Maintaining or adopting a healthy lifestyle have shown to benefit patients including healthy diets, physical activity and exercise, maintaining your weight (excessive weight loss is detrimental for lung cancer patients), and of course smoking cessation.”
