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Low radiation lung CT

Lung cancer is the leading cause of death in the USA and in Israel in male and female patients

Lung cancer kills more people than breast cancer, colon cancer, ovarian cancer and prostatic cancer together. The 5-year survival of lung cancer patients is among the lowest and does not exceed 13% of all patients. Lung cancer is usually not noticed until it has reached an advanced stage, when the therapy is no longer sufficiently effective. On the other hand, treatment of lung cancer at an early stage of the disease can cure up to 70% of cases. Early detection of lung cancer by chest X-rays or sputum tests for malignant cells is disappointing. Recently, computerized tomography has been introduced as a diagnostic tool for the early detection of lung cancer.

What is lung cancer?

This kind of cancer originates in the lungs, which are two sponge-like organs located in the chest, exchanging air during the breathing process. The right lung has three lobes, and the left one only two. The left one is also smaller, since the heart lies closer to it. During breathing, oxygen containing air is inhaled into the lungs and air containing carbon dioxide, the gaseous compound formed during body metabolism, is exhaled. The lungs are surrounded by a protective membrane called the pleura. The trachea, the windpipe carrying air from the mouth to the lungs, branches into increasingly smaller branches called bronchi, ending up in tiny air spaces, called alveolar spaces. These alveoli resemble small air balloons or bubbles. It is in these alveoli that air exchange takes place. Most lung cancers are located in the bronchial walls, but the disease can also originate in the alveoli and from bronchioles, sub-branches of bronchi. The development of lung cancer usually takes many years.


Lung Cancer-Who is at Risk?

  • Smokers – about 87% of all lung cancers are caused by smoking.The lung cells of smokers undergo changes that may result in cancer.The longer the period of smoking and the bigger the quantity of cigarettes per day, the higher the risk of developing lung cancer.
  • Close exposure to smokers or living with a person who smokes (passive smoking), is a risk factor as well.
  • Exposure to asbestos
  • Exposure to various substances, such as radon gas
  • Advanced age
  • Family history of lung cancer
  • Lung scarring
  • Certain forms of pneumonia
    Some people without any risk factor can also develop lung cancer. It seems that there is insufficient knowledge as to the causes of this disease and no sure prevention methods exist.

How is my personal risk calculated?

If you are over fifty and a smoker with the smoking equivalent of "10 pack-years", you are at high risk for developing lung cancer. Multiply the number of smoking years by the number of cigarette packs per day to obtain your "pack-years" (for example, if you smoked 2 packs per day for 5 years, your score is "10 pack-years"). It is strongly recommended that anyone with an index of "10 pack-years" should join the lung cancer early detection program.

What are the early warning signs of lung cancer?

  • Coughing that does not subside
  • Weight loss and loss of appetite
  • Chest pain
  • Fever without clear cause
  • Hoarseness
  • Bloody or "rusty" sputum, shortness of breath
  • Recurrent infections, such as pneumonia or bronchitis

If you have any of these symptoms, you must consult your doctor.

What is the lung cancer early detection program?

Each year, more than 172,000 patients are diagnosed with lung cancer in the United States. 160,000 of these patients die of this disease. In the majority of cases, the disease is diagnosed too late, when therapy is already ineffective. Once the disease is symptomatic, i.e. symptoms are present, there is no chance of cure. The purpose of the lung cancer early detection program is that by means of CT, the disease can be diagnosed early enough (before the appearance of any symptoms) to be able to apply effective treatment. It has been shown that in this way an 80% survival rate can be achieved, which represents a dramatic improvement. Papers published by New York’s Cornell University in the prestigious medical journal "The Lancet" show that survival and cure chances are proportional to the size of the tumor removed during surgery. Due to early diagnosis, it is possible to surgically remove 96% of the early detected tumors, in contrast to the usual situation of late detection, where 50% of tumors are inoperable. In the framework of this early detection program, smokers undergo low radiation CT lung examinations annually in order to increase chances of a full cure.


Why CT and not a regular chest X-ray?

A Cornell University study published in the scientific journal, "The Lancet"- shows that in 85% of all cases regular chest X-rays failed to diagnose early tumors which, by contrast, were visible on CT screening. On a regular chest X-ray, the lungs are scanned only on anterior-to-posterior and lateral planes, while a CT visually “slices” the chest into 1 mm thin sections (similar to a loaf of sliced bread). Thus, small nodules are visible on CT that would not be apparent in regular X-ray imaging. Even minuscule tumors can be seen using this form of imaging. In this study, 1,000 smokers and former smokers over the age of 60 were examined and a significant number of early stage cancers were detected.

Is it possible to diagnose other chest conditions besides cancer?

Yes. It is possible to see old scars, old or current pneumonias, recent tuberculosis infections and signs of chronic lung disease, such as emphysema. The heart as well as other inner organs can be seen, but due to the low radiation dose and lack of intravenously injected contrast medium, the view of these organs is limited.

Is the radiation dose needed for CT lung scanning dangerous?

This is a low-dose radiation procedure. The radiation dose is equivalent to 1-3 chest X-rays only, and the risk was calculated to be equivalent to smoking one single cigarette pack during an entire lifetime.

What is the duration of this examination? What preparation is necessary?

Although the actual time spent in the examination room is several minutes, the CT lung scan takes only a few seconds, during which time you will be asked to hold your breath. Prior to the examination you will be required to fill in a personal questionnaire. There is no need for any prior preparation whatsoever.

How is the appointment made? Is a referral by the attending physician necessary?

If you are scheduled to undergo another CT examination, a low-dose chest CT scan can be performed at the same time and there is no need for a referral. The low-dose CT lung scan is not covered by the "health basket" and cannot be performed by presenting the "Form 17" payment order.

When will I receive the results?

An expert radiologist will review the examination and print out the interpretation. The results will be sent to your attending physician, who will continue your treatment according to the results. The examination is considered normal if no small nodules (masses) are discovered. If you are at high risk for lung cancer, we recommend repeating this examination annually. Remember, the best chance for cure is early diagnosis. If the examination result is positive, meaning that tiny suspicious nodules were detected, we will recommend that you visit a specialist in pulmonology (lung diseases) for further evaluation and possible additional diagnostic procedures. Small pulmonary nodules that show up on CT scans or regular chest X-rays are often granulomas – small scars originating from old diseases or other small benign scars and these show no changes on follow-up examinations. Therefore, a positive examination does not necessarily mean that the patient has lung cancer.




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