John Heim, MD
Lung cancer may exhibit recognizable symptoms, but they normally don’t present themselves until the late stages of the disease—when a cure is less likely.
Fortunately, screening for lung cancer using low-dose-radiation CT scans has proven effective at detecting lung cancer in its earlier stages, when it is most treatable, said John Heim, MD, chairman of the Department of Surgery at Penn Medicine Princeton Medical Center (PMC).
Lung cancer is the leading cause of cancer deaths among both men and women in the United States, claiming more lives than colon, prostate, ovarian and breast cancer combined, according to the American Cancer Society.
Screening is recommended for current and former smokers who are 55 and older with a smoking history of at least 30 pack years—that is, a pack a day for 30 years, two packs a day for 15 years, and so on.
“Anyone in the at-risk population should consider having a low-dose CT scan to identify tumors and nodules as early as possible,” said Heim, who is board certified in general and thoracic surgery. “The earlier that we can detect a problem, the more options we have and the greater chances at successful treatment.”
Most insurance plans cover screening for at-risk individuals, and Penn Medicine Princeton Medical Center (PMC) offers a Lung Cancer Screening Program that makes low-dose CT scans available at no cost to patients who meet the eligibility criteria.
If a tumor or nodule is detected during lung cancer screening, a biopsy will determine whether it is benign or malignant. When a tumor is malignant, doctors will order further tests to determine its size and whether it has spread to nearby lymph nodes or other organs.
This process, intended to pinpoint the stage of the cancer, typically involves a range of imaging tests, such as a CT scan, MRI and PET/CT scan. The CT scan and MRI enable doctors to determine the size, shape and position of any lung tumors and identify any enlarged lymph nodes that may contain cancer that has spread from the lungs.
A PET scan helps to identify cancerous cells through the use of an injectable sugar solution that contains a small amount of radioactive material. Because cancer cells use an abnormal amount of sugar, diseased areas will light up when a patient undergoes the scan, allowing physicians to precisely locate and observe the cancerous cells.
A combined PET/CT scan is more precise than each test alone and allows for more accurate staging, which helps ensure effective treatment and reduces the risk for recurrence.
The test results will help to determine the stage of the cancer and identify the most promising treatment options.
“A newer technology we are using is molecular testing of tumors to determine the genetic makeup of the mass,” Heim said. “This allows us to more accurately determine what will and will not work and whether immunotherapy, which stimulates a person’s immune system to destroy cancer cells, is an option.”
At PMC’s Edward & Marie Matthews Center for Cancer Care, weekly cancer conferences are held with a multidisciplinary team of physicians, including radiologists, surgeons and oncologists who review National Comprehensive Cancer Network guidelines, along with the radiology, pathology and treatment plans for patients with cancer. These weekly conferences are designed to ensure the most appropriate, personalized care is provided to each patient.
To schedule an appointment with PMC’s Lung Cancer Screening Program, call 609.853.7070.