Tag Archive for: lung cancer screening

What Should Veterans Know About Lung Cancer Screening and Risk?

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What Should Veterans Know About Lung Cancer Screening and Risk? from Patient Empowerment Network on Vimeo.

What lung cancer screening advice and lung cancer risks should veterans know about? Expert Dr. Michael Kelley from Duke University School of Medicine discusses two factors that drive lung cancer risk in veterans, studies about military exposures, and proactive patient advice for lung cancer screening.

[ACT]IVATION TIP

“…if you are eligible for lung cancer screening, then that should be available from VA. And if you have smoked ever in your lifetime, please talk to your primary care provider to ask if lung cancer screening is right for you.”

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Transcript:

Lisa Hatfield:

Is there a standard for screening veterans for lung cancer who may have had exposures that create a greater opportunity for lung cancer? Is there a scan that may be done for them, or can they request that?

Dr. Michael Kelley:

Yeah, that’s a great question. So the criteria that are used in the VA for lung cancer screening are the same as they are in the rest of the country. And that’s because the risk of developing lung cancer from all the different possible risk factors is really driven by smoking. Smoking and age are the two factors that really drive the risk of lung cancer. There are some other proposals that are out there to use like lung function and maybe some other characteristics of the patient that we don’t really do right now, but there are some studies that are ongoing.

In terms of military exposures, we can’t really quantify them at this point for lung cancer exposure, so we don’t really integrate that into the medical recommendations around lung cancer screening. But lung cancer screening let me just go to my activation tip is,is that if you are eligible for lung cancer screening, then that should be available from VA. And if you have smoked ever in your lifetime, please talk to your primary care provider to ask if lung cancer screening is right for you.

Lisa Hatfield:

Okay, thank you. That’s really helpful. Dr. Kelley, there is a stigma around military personnel being at higher risk for lung cancer than civilians. Is there an elevated risk for those in the military? And if so, why is that?

Dr. Michael Kelley:

There have been some reports in the medical literature of a higher risk, but those studies were small and initially didn’t control for some important risk factors, in particular, smoking. So smoking is the greatest risk factor for lung cancer. And if you’ve ever smoked, then you should be considered for lung cancer screening, but the military personnel have a higher rate of having smoked sometime in their life. Luckily, there’ve been a lot of people who’ve quit, and that has resulted in the current smoking rate of being about the same as the general population.

But the fact that they have smoked in the past, military veterans have smoked in the past does increase the risk. Military exposures, we don’t really take into consideration right now in terms of lung cancer screening or treatment, but if you do have a particular exposure that you’re concerned about, then please talk to your primary care doctor, and we can discuss with you whether there’s a screening test that might be appropriate. But generally, we don’t do that.

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Veteran Lung Cancer Risk | Understanding Exposures and Screening Protocols

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Veteran Lung Cancer Risk: Understanding Exposures and Screening Protocols from Patient Empowerment Network on Vimeo.

What’s important for veterans to know about lung cancer risk? Expert Dr. Drew Moghanaki from UCLA Health discusses known veteran lung cancer risk factors, screening recommendations, and proactive patient advice involving the PACT Act.

[ACT]IVATION TIP

“…if you’ve had an office job, well, you probably have the same risk as your neighbor wherever you’re living. But if you were in a combat zone or on a base where there were a lot of chemicals, probably want to pay a little more attention and check in with your primary care doctor to get some appropriate screening tests for yourself.”

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Transcript:

Lisa Hatfield:

Dr. Moghanaki, there is a stigma around military personnel being at higher risk for lung cancer than civilians. Is there an elevated risk for those in the military? If so, why and who should be screened?

Dr. Drew Moghanaki:

Yeah, the stigma of veterans being at higher risk for lung cancer is real. And I think Hollywood had a big role in it. And is it appropriate? Well, I never liked the word stigma, but I think it’s important for the public. And of course, soldiers or any military personnel who served in the armed forces appreciates that back in the days the bases were much dirtier than they are today. And there was a lot of exposure to a lot of things that can cause cancer and actually other health problems as well, such as diabetes and Parkinson’s disease and Alzheimer’s and other things.

So yes, it’s true that our veterans, especially if they were working around toxic chemicals or in the Middle East, where the open burn pits were leading to inhalation of a lot of toxic fumes, that these folks are at a higher risk and should be more proactive with any symptoms. So if you’re just a 45-year-old, 55-year-old male or female, and you’ve got a cough, generally speaking, you may not be so worried and just hope it goes away.

But if you’ve been on these dirty bases, it’s important to look into this and find out now how dirty are the bases? Well, there’s been the media I think over exaggerates exactly what was going on and what was on these bases. But there are lots of federal reports that have documented exactly some of the, for example, like if you were stripping aircraft with a certain stripping material, a lot of these substances are currently now chemicals are banned because we as soon as we learn that they’re toxic, we basically ban them.

But generally speaking, yeah, health concerns are a little bit elevated if you’ve served in the military and especially if you’ve been deployed in the field of battle. And so my activation tip is if you’ve had an office job, well, you probably have the same risk as your neighbor wherever you’re living. But if you were in a combat zone or on a base where there were a lot of chemicals, probably want to pay a little more attention and check in with your primary care doctor to get some appropriate screening tests for yourself.

Lisa Hatfield:

Are there any programs in place right now where veterans who’ve had those exposures or potential exposures, where they are being screened regularly or is it up to the veteran to ask that question?

Dr. Drew Moghanaki:

So if a veteran is plugged in with the VA healthcare system, the primary care network here is set up to offer the appropriate screening. But if you’re not, it’s important to look into this. Again, I’m just going to keep saying over and over again, if you’re a veteran who’s not yet eligible, if you know anyone, please check in. Congress has radically expanded the eligibility within the PACT Act is actually primarily centered around this issue of risk. It’s about toxic exposures that the VA is still learning about and VA physicians like myself are still learning about. And so these programs definitely exist to address them, but the best way to do it is to get registered for VA healthcare.

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Lung Cancer Strategies for Veterans: Research and Care Insights

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Lung Cancer Strategies for Veterans: Research and Care Insights from Patient Empowerment Network on Vimeo.

What’s important for veterans with lung cancer and care partners to know about research and care? Expert Dr. Drew Moghanaki from UCLA Health discusses research initiatives, screening recommendations, and patient advice for proactive care.

[ACT]IVATION TIP

“…if you’ve got a cough that won’t go away, push hard to say, ‘Look, I really just want to take a look inside my chest.’ It won’t be a low-dose screening chest CT. It’ll be a regular chest CT. And that CT, even if normal, can be a nice baseline for future scans in the future if more scans are needed.”

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Transcript:

Lisa Hatfield:

Dr. Moghanaki, can you speak to your research around strategic initiatives for veterans facing lung cancer? And what should your patients, their care partners be asking as they seek care?

Dr. Drew Moghanaki:  

I really care about driving down the symptoms and the burden of lung cancer, and there’s a lot of great treatments out there that are safer and more effective than ever before. Our patients are living better lives and longer lives, and I really focus a lot on that type of research. But one of the things that really probably has the biggest benefit is just earlier detection. And early detection takes place by having an annual chest CT scan with a certain type of CT scan that’s a lower dose of radiation that the scan requires. And we don’t scan people who have symptoms.

So I’m talking about people who are at risk. And right now, our best measure of who’s at risk for getting lung cancer are people who smoked a lot of cigarettes in their lifetime. And they basically once a year get a scan, and we’re looking for lung cancers at the earliest time that they’re sprouting, and that’s because if we catch it early, we’ve got the safest treatments and the most effective treatments and the highest cure rates, and so my activation tip is if you know anybody or if you yourself are at risk for lung cancer because there’s a lot of smoking going on, please get your lungs screened and talk to your primary care provider to get that lung screening scan ordered.

Lisa Hatfield:

Okay. And just a follow-up question for that, if a person does have some type of symptoms, or if I guess if they’re a smoker also, but they have some type of symptoms and they say, “Oh, I’d like to have this low dose chest CT scan.” Can they just ask their primary care provider about that? Or are they, are PCPs automatically going to screen people who have symptoms or have been long-time smokers?

Dr. Drew Moghanaki:

It’s really a standard of care to get some imaging of the chest. If you’ve got somebody with a cough that won’t go away or some sort of pain inside the chest. In that situation, we don’t get a low-dose chest CT. We get a regular CT to take a look. Now, one of the things is if a patient has smoked a lot, people really start to worry, this might be lung cancer. But one of the things that we’re seeing is there’s a lot of people getting lung cancer who never smoked or they just smoked a little bit. And the doctor may say, “Well, I don’t think you’re going to get lung cancer.” And they don’t get a scan. And that’s actually a problem.

So for those patients, my activation tip is, look, if you’ve got a cough that won’t go away, push hard to say, “Look, I really just want to take a look inside my chest.” It won’t be a low-dose screening chest CT. It’ll be a regular chest CT. And that CT, even if normal, can be a nice baseline for future scans in the future if more scans are needed. It’s always good to have a baseline at an earlier age, so we can see if new things show up, if they’ve been there for a while, or if they really are new.

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Combat and Courage | A Veteran’s Lung Cancer Battle

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Combat and Courage: A Veteran’s Lung Cancer Battle from Patient Empowerment Network on Vimeo.

Derrick, a resilient veteran and lung cancer survivor graciously opens up about his journey, detailing his experience from initial screening and diagnosis through to treatment. He candidly discusses crucial aspects of lung cancer care for veterans and offers insights drawn from his journey. In Derrick’s own heartfelt words, he emphasizes the importance of empowerment through knowledge, stating, “It’s your body and your life, and you deserve to learn all you can to gain knowledge and confidence about your cancer.” 

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Persistence in the Face of Dismissive Healthcare: One Patient’s Journey 

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Transcript:

Derrick:

Being ACTIVATED in your lung cancer care is a necessity, take it from me. 

After my friend who I served with in Iraq was diagnosed with lung cancer, I knew that it was time to get  serious about my lung cancer screenings at the Veterans Affairs Hospital. As a lung cancer survivor, I want to share my story as a Black military veteran. Lung cancer is the leading cause of cancer-related death in veterans, and Black veterans are less likely to complete lung cancer screening.  However, a recent VA report showed that Black veterans receive equal or superior care through VA hospitals in comparison to Black patients in the general population.

I was already 52 when I received my first lung cancer screening. I only learned later that I should have started receiving screening at age 50 at the VA. It was winter when I went in for my screening. I’d had a nagging cough but didn’t think twice about it. It was a winter season with multiple respiratory viruses circulating at the time. I was shocked when the radiologist informed my doctor that they found a spot on one of my lungs. I felt like I wasn’t old enough to have cancer.

I was really nervous about it beforehand, but I had surgery to remove the tumor from my lung. I felt fortunate to have my friend I served with to talk with about lung cancer, but I know not everyone is this fortunate. I’m sharing my story in the hopes that it will help other veterans. I continue to receive regular scans of my lungs and urge other veterans to start your lung cancer screening on schedule. Ask your doctor or VA administrator if you’re unsure about when you should start. It’s your body and your life, and you deserve to learn all you can to gain knowledge and confidence about your cancer.

There have been a lot of recent advancements in lung cancer diagnosis and treatment. I hope that sharing my perspective will make a difference for other veterans. We served proudly for our country, and we deserve the best lung cancer screening and care as part of the respect that we earned.

Stay [ACT]IVATED with these tips. 

  1. Don’t allow stigmas to keep you from getting the best care, now is the time to get the right care no matter how you got the cancer.
  2. Ask your care team questions to learn about treatment options and what to expect during and after treatment.
  3. Ask if a clinical trial may be a potential treatment option for you.
  4. Stay abreast of lung cancer treatment options and research advancements

Whether it’s combat in war or fighting cancer, no matter who you are, being proactive is everything. Stay [ACT]IVATED by being informed, empowered, and engaged in your care.

What Are the Noted Disparities in Lung Cancer Screening and Access?

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What Are the Noted Disparities in Lung Cancer Screening and Access? from Patient Empowerment Network on Vimeo.

What are some lung cancer disparities in the U.S.? Dr. Lecia Sequist shares insight about disparities in lung cancer screening and care, some causes of the disparities, and ways that advocacy groups are trying to decrease disparities. 

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…be sure to ask your doctor if genetic testing has been performed on your cancer, and if not, can it be performed? It’s not always the right answer, depends on the type of cancer that you have and the stage, but if you have adenocarcinoma and an advanced cancer, like stage III or stage IV, it is the standard to get genetic testing and that should be something that can be done.”

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Transcript:

Lisa Hatfield:

Thank you. Dr. Sequist, with cancer care, there are some noted disparities, particularly with access to screening and care. What are some of those disparities with lung cancer screening and care?

Dr. Lecia Sequist:

Lung cancer, unfortunately, there are a lot of disparities around the globe, but even if we focus on the U.S., there’s a lot of regional disparities as far as who’s getting cancer, who’s getting lung cancer, where the cancer treatment centers are located, where the screening is available. Lung cancer screening is really effective as far as finding cancer in the earliest stages. It’s not equally available across the country. Some of it has to do with there are certain states that expanded their Medicaid coverage as part of the medical care reform that happened about seven, eight years ago, and there are some states that didn’t expand the Medicaid, and then that situation translated into whether lung cancer screening was easy to get started in hospitals in that state. So there are some regions of the country, and a lot of them are in the South as well as the Western U.S., where if you want to get lung cancer screening, you may have to travel more than 30 miles or even more than 50 miles in order to get lung cancer screening.

There’s lots of activists and patient advocacy groups that are working to try and fix that problem so that anyone could have access to lung cancer screening within a reasonable distance of where they live, but there’s a lot of barriers. Similarly, there are barriers to getting genetic testing performed. We know that doing genetic testing on a lung cancer, it can be really helpful, especially if you have adenocarcinoma, the most common type of lung cancer, getting genetic testing done to see if there are targeted therapies that can be used to treat the cancer is a really important step in the diagnosis, but not all patients are having that done. And as you might imagine, there’s disparities, racial disparities in who’s getting these tests ordered and who is not having that testing done. And so it is important. My activation tip for patients would be to be sure to ask your doctor if genetic testing has been performed on your cancer, and if not, can it be performed? It’s not always the right answer, depends on the type of cancer that you have and the stage, but if you have adenocarcinoma and an advanced cancer, like stage III or stage IV, it is the standard to get genetic testing and that should be something that can be done. 

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Can Artificial Intelligence and Machine Learning Help Advance Screening for Lung Cancer?

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Can Artificial Intelligence and Machine Learning Help Advance Screening for Lung Cancer? from Patient Empowerment Network on Vimeo.

How will lung cancer personalized medicine be improved with advanced technologies? Expert Dr. Lecia Sequist explains how artificial intelligence and machine learning help advance screening for lung cancer and shares advice for patients.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“… if you are 50 and you have smoked in the past, I would urge you to talk to your doctor about whether you can access lung cancer screening. But if you’re younger or you haven’t smoked in the past, you can’t access lung cancer screening right now. And we’re hoping to change that with AI that can really help figure out who is at risk of this disease.”

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What Are the Noted Disparities in Lung Cancer Screening and Access

Transcript:

Lisa Hatfield:

Dr. Sequist, technology is advancing at such a fast pace, and we’re hearing words like artificial intelligence and machine learning. And I just read an article about a team that you’ve been working with that is developing or has developed an AI model that can detect future lung cancer risk. I believe it’s based on CT scans. Can you speak to that a little bit more and also talk a little bit more about where you see this AI technology taking cancer research and predicting cancer and also any challenges that we might face with AI and machine learning in healthcare?

Dr. Lecia Sequist:

Yeah. AI seems to be everywhere. You turn on the news or you look at your phone, and it’s talking about AI. And some of it seems scary, and Hollywood doesn’t help because there’s lots of movies about computers or robots kind of taking over the human race. And I think we have to separate Hollywood from real life. Artificial intelligence or machine learning, it’s a very general term. It can mean a lot of different things depending on what the context is. But it’s basically just a tool for understanding patterns. And we all understand patterns in our own life or our own house. I personally know that my dog is going to want to, as soon as we wake up in the morning, is going to want to go outside and then is going to want to have some food, and there are different patterns that you know in your daily life that you recognize, and you can anticipate what’s going to happen next.

AI is a tool that helps us anticipate what’s going to happen next for patterns that are way more complex than, yeah, your dog’s going to want to go outside and eat some food. So computers can sometimes pick up patterns that the human brain can’t really pick up, because they’re just too complicated. And that’s what we’ve found in our research. One of the vaccine things about lung cancer and trying to figure out how we can prevent lung cancer or find it at the earliest stage when it’s most curable is that it’s very hard to know who’s at risk. We know that lung cancer is one of the most common cancers out there, but knowing who is truly at risk and separating one person from the next is not so simple.

In the past, it’s mainly been, you know, determined by whether or not you ever smoke cigarettes. And it’s true that cigarette smoking is one risk factor for lung cancer, but it’s not the only one. And we don’t fully understand what all the risk factors might be, but we know that there are people who have smoked a lot in their life and never get lung cancer. And on the flip side, we know that there’s people who have never smoked or who maybe quit 30, 40 years ago and will still get lung cancer. And how do we know who’s at risk? That’s what we tried to solve with our research that I worked on with my colleagues at Mass General Hospital where I work and also at MIT, Massachusetts Institute of Technology, which is just down the road from us. And so we brought together our medical knowledge and our computer knowledge and tried to come up with a way to predict for any given individual person, are they at risk for lung cancer.

By looking at their lungs and not looking at the lungs the way a human radiologist sort of says, okay, there’s the right lung, there’s the left lung, and they’re looking for things that already exist like a tumor or a mass. The computer looks at a different type of pattern that human eyes and brains can’t really recognize and has learned the pattern, because we trained the computer with thousands and tens of thousands of scans where we knew this person went on to develop cancer and this one didn’t. And the computer learned the pattern of risk. And so using an X-ray or a CAT scan to predict future risk is something a little different. In medicine, we usually use an X-ray to say, okay, what’s happening now? Why does this patient have a fever? Why is this patient bleeding? And using an X-ray or a CAT scan in this case to predict the future is kind of a new thought for doctors. But we think that it could be a really valuable tool to help us understand who’s at risk for many different kinds of diseases. We happen to look at lung cancer, but I think you could use this idea for other diseases too.

Lisa Hatfield:

So will this AI model become mainstream anytime soon if a patient wants to access that? Or is it only being used for research purposes?

Dr. Lecia Sequist:

Well, we do before we start to offer anything mainstream or as part of routine care, we really need to understand how it can be used to help patients. So we are running some clinical trials right now to try and understand, is this a tool that could be used, for example, to give someone access to lung cancer screening? Because right now, if you want to have lung cancer screening, which is a very effective screening test to try and find cancer in people who feel completely well, trying to find cancer at the earliest stage before it has spread, can we give people access to lung cancer screening by using this AI test? Right now and if you want to get lung cancer screening, you have to be 50 or older, and you have to have smoked in the past. And if that fits your, if you are 50 and you have smoked in the past, I would urge you to talk to your doctor about whether you can access lung cancer screening. But if you’re younger or you haven’t smoked in the past, you can’t access lung cancer screening right now. And we’re hoping to change that with AI that can really help figure out who is at risk of this disease.

Lisa Hatfield:

Thank you. I’m excited to see where this goes in the future. 

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Do Lung Cancer Screening Guidelines Differ for Certain Populations?

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Do Lung Cancer Screening Guidelines Differ for Certain Populations? from Patient Empowerment Network on Vimeo.

Who should ensure they receive lung cancer screening? Expert Dr. Lecia Sequist explains lung cancer screening, the importance of screening, and patient age range and health history who should ensure they receive screening.

Dr. Sequist is program director of Cancer Early Detection & Diagnostics at Massachusetts General Hospital and also The Landry Family Professor of Medicine at Harvard Medical School.

[ACT]IVATION TIP:

“…if you are 50 years or older and you have smoked cigarettes in the past or someone that you know or love that’s that criteria, please talk to your doctor about whether you can access lung cancer screening. It’s very easy. It could save your life.”

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Transcript:

Lisa Hatfield:

Dr. Sequist, is there any population that you would recommend regular screenings for lung cancer?

Dr. Lecia Sequist: 

This is a great question. Screening for lung cancer is really important. Screening basically means testing someone who doesn’t have cancer or doesn’t know that they have cancer and doesn’t have any symptoms of cancer. So someone who’s just walking around feeling healthy, living their normal life. But screening them for cancer is important in order to try and catch it early. Because we know that the outcomes for cancer, the likelihood of being cured, for example, is much better if it’s found at the earliest stages before symptoms start. Lung cancer screening is one of the most effective types of cancer screening that’s out there. It can be more effective than screening for breast cancer or colon cancer, but a lot of people don’t know that there even is a screening test for lung cancer.

The screening test for lung cancer is simple. It’s easy. It’s called a low-dose CAT scan. It takes less than five minutes to perform. It’s completely non-invasive, so you don’t have any tubes or even needles or IVs put into your body. You just lay on a CAT scan table, take a deep breath and hold it, and it just takes about 30 to 40 seconds for you to go through the machine. So it couldn’t be easier. And it’s available for people who are 50 years or older and have a history of smoking cigarettes. So if that applies to you or your loved ones, you should definitely ask your doctor about whether you can get access to lung cancer screening.

So my activation tip for this question would be if you are 50 years or older and you have smoked cigarettes in the past or someone that you know or love that’s that criteria, please talk to your doctor about whether you can access lung cancer screening. It’s very easy. It could save your life. 

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