Lung cancer screening, tobacco cessation programs help save lives

Lung cancer. Despite having a 40-year smoking history, it was still a diagnosis that 61-year-old Larry West wasn’t expecting.

“When I first heard I had cancer, I said, ‘Oh wow, this is the lowest point in my life.’ I never thought I’d have it,” he said.

After all, it had been four years since Larry touched a cigarette. He quit smoking in 2009 when his wife, Mary, came home and told him that her employer, WVU Healthcare, implemented a tobacco ban. Mary wasn’t happy about the ban at the time but now said it was the impetus for her quitting.

“They were taking my smoking breaks away, so we said, ‘Yeah, let’s try it,’” she said. “It was the best decision we could have made.”

The couple quit smoking together with help from the West Virginia Tobacco Quitline, a statewide cessation education and phone coaching program. Mary said having her husband on board made it possible, and she thinks that quitting when he did is what saved his life.

“We had a healthy competition. It wasn’t mean in any way. We both felt better. It didn’t take long to get used to not smoking,” Mary said.

Larry said, “It was a nasty habit. It was nice to kick it after 40 years. I was up to two packs a day, and Mary was up to a pack a day. She figured we were spending about 12-15 bucks a day on cigarettes.”

It was an accident in the kitchen that brought Larry to Ruby Memorial Hospital last summer. He dislocated his shoulder in a fall, and after getting an x-ray, his physician noticed a nodule and sent him to the WVU Healthcare Lung Cancer Screening Program.

Larry found out he had cancer. Because it was found before he showed any symptoms, he credits the screening program with helping save his life.

“If you smoked as long as I have or if you still smoke, you should get screened. It’s an excellent program,” he said. “I’m retired. My wife is retired. We get to enjoy each other now. I could be in the hospital right now instead of out enjoying life.”

Effective screening has played a critical role in catching lung cancer in the early stages. John Parker, MD, WVU pulmonary medicine specialist, said early detection has led to a 20 percent increase in survivability.

In July, the U.S. Preventive Services Task Force released its draft recommendation that those at high risk for lung cancer receive annual low-dose CT scans.

“This is a good thing. For many years, we’ve had good screening for breast cancer with mammography, for cervical cancer with pap smears, and for the general public for colon cancer. For 30 or 40 years, we have not had an effective screening tool for people at risk for lung cancer. What this new recommendation does is build upon important research done the last five years or so,” Dr. Parker said.

The lung cancer screening program is currently for patients 55 to 74 years old who are active smokers with at least a 30 pack-year history or have quit smoking within the past 15 years. (Pack years are calculated by multiplying the number of packs per day smoked by the number of years smoked.) Patients must be referred by a physician and are charged a $99 fee, but Parker hopes that eventually this cost will not fall on patients.

“With this new task force recommendation, I think that Medicare and Medicaid and national private insurance companies are going to probably be forced to have lung cancer screening be a covered benefit,” he said.

Still, he said, smokers cannot solely rely on screenings, which is why the screening program also offers a one-time smoking cessation counseling session through the WVU Prevention Research Center. The certified tobacco treatment specialists who provide the counseling also offer longer-term counseling through the WVU Tobacco Cessation Clinic for pulmonary patients.

“Statistics and studies have shown that a person’s chances of quitting increase with one-on-one counseling. It’s a lot more effective,” said Jayne Kinney, certified tobacco treatment specialist for the WVU Prevention Research Center. “We have seen more than 60 patients since January and have referred most of them to the West Virginia Tobacco Quitline. If the patient isn’t interested in enrolling in the quitline, physicians can still offer nicotine replacement or prescription medications to help them quit.”

Patients interested in the lung screening program or smoking cessation counseling should first contact their primary care physician.