8 early lung cancer signs & how screening can catch it before symptoms start

Article Summary

Lung cancer screening can help detect cancer before symptoms appear.

Early detection is the biggest advantage in any cancer fight. Yet lung cancer - still the leading cause of cancer deaths in the U.S. - is far too often diagnosed in its later stages, when treatment options become more limited.

While watching for symptoms is essential, early screening for those who qualify is one of the most important things you can do, stressed Endeavor Health interventional pulmonologist Neeraj Desai, MD. "Don't wait for symptoms. If you qualify for screening, you should get screened," he said.

Screening before symptoms start

One in five cancer deaths in the U.S. is attributed to lung cancer. Colon, breast and prostate cancer deaths combined are still not as high as lung cancer deaths, said Dr. Desai who laments the relatively low number of eligible people taking advantage of screening.

"Only 18.7 percent of eligible patients nationwide are getting screened," he said.

For those at high risk of developing lung cancer, non-invasive, low-dose CT (LDCT) scans have proven to be a tremendous tool for early detection.

Who qualifies for routine screening?

Endeavor Health was an active participant in the International Early Lung Cancer Action Program (I-ELCAP), which helped establish guidelines for screening which have been linked to a 20% reduction in lung cancer deaths.

Adults aged 50 to 80 with a 20-pack-year smoking history (e.g., smoking one pack a day for 20 years) should consult their physician about annual screening, urged Dr. Desai.

Screening is quick, painless, uses a fraction of the radiation of a standard CT scan, and is covered by Medicare and most insurance plans for those who qualify.

Subtle symptoms people often overlook

Many people expect lung cancer to bring severe pain or obvious illness. In reality, early symptoms are frequently subtle and easily dismissed as a seasonal cold, allergies, or simply a normal part of aging.

People with lung cancer often have one or more of the following symptoms:

1. Persistent cough that lingers more than a few weeks
2. A cough that changes character or becomes more hoarse
3. A change in voice/more hoarseness
4. Coughing up blood
5. Shortness of breath
6. Repeated or unresolving pneumonia or bronchitis
7. Unexplained weight loss
8. Unexplained fatigue/change in appetite

Because many of these symptoms, like shortness of breath, can easily be dismissed as part of aging or attributed to other issues, it's important to listen to your body.

"Anything new that you can't explain is worth getting checked out," said Dr. Desai. "In many cases these signs won't be lung cancer, but you will at the very least have peace of mind by seeing your physician."

Why non-smokers should pay attention too

While smoking remains the leading cause of lung cancer, there is also a recent increase in never-smoker lung cancer. Environmental factors, like radon exposure, secondhand smoke, occupational exposures such as asbestos, silica and air pollution, are the largest known risk factors.

Because nonsmokers rarely suspect lung cancer, subtle symptoms like a lingering cough, are even more frequently ignored.

"The trend now is that we are seeing more never-smokers and more women diagnosed with lung cancer, so we encourage everyone to pay attention to possible symptoms and be proactive," said Dr. Desai.

Advanced technology: What happens if a scan shows something suspicious?

Sometimes lung cancer is first detected on a chest X-ray or CT scan given for another health concern.
If an X-ray, often the first test ordered, reveals a problem, the next step will likely be seeing a pulmonary specialist who may order a CT scan for a more detailed image and the ability to detect smaller abnormalities, explained Dr. Desai.

If imaging reveals something suspicious, specialists can use advanced technology, like Ion robotic bronchoscopy, to biopsy the smallest nodules at the earliest stages.

Ion robotic bronchoscopy uses an ultra-thin, flexible catheter guided by the physician through the airways to reach nodules deep in the outer parts of the lung, areas that were once very difficult to sample without a needle through the chest wall.

"This state-of the-art equipment allows us to biopsy and diagnose lung cancer early and, combining it with endobronchial ultrasound, allows us to stage the cancer and see if it has spread to the lymph nodes during the same procedure," said Dr. Desai.

Endeavor Health combines this platform with cutting-edge technologies like cone beam CT and cryobiopsy that make the diagnosis more accurate.

In a single minimally invasive procedure, often done as an outpatient, physicians can diagnose the nodule, stage the cancer by sampling lymph nodes, and gather the tissue needed for molecular testing.

Early action changes everything

Finding lung cancer early changes everything.

"When it is caught while still confined to the lung, roughly two out of three patients are alive 5 years later; once it has spread to distant organs, 5-year survival drops below 10 percent. Many early-stage cancers can be treated with surgery or targeted radiation alone, often with a realistic chance of cure," said Dr. Desai.

Prevention, screening and early diagnosis work together. Reducing exposure to known risks, getting screened if you qualify, and having any new or unexplained symptom checked promptly give you the best chance of preventing lung cancer or catching it when it is most treatable.