CT scan shows lung cancer undetectable by x-ray

TAMPA, Fla. - Two years ago, Kathy Swan went into to her primary care doctor's office for a routine physical. At the time, she felt fine.  Kathy was turning 55 and smoked cigarettes, so her Baycare doctor ordered a low-dose CT scan of her lungs.

"I had my physical and chest x-ray done and it came back perfectly clear," Swan recalled. "I went thinking there would be absolutely nothing wrong, and that's when they found that I had the nodules."

One of two nodules, or growths, found in her lungs was cancer. Although it wasn't visible on her chest x-ray, it was easily picked up by the CT scan.  

Since 2013, low-dose scans have been recommended for patients between the ages of 55 and 80 who have a 30-pack-year smoking history and who still currently smoke or quit within the last 15 years.      

The number of pack years is calculated by multiplying the number of years someone smoked by the number of packs they smoked per day.  For example, smoking one pack a day for 30 years would be 30 years x 1 pack per day = 30 pack-years. 

But according to a 2017 study, less than four percent of eligible patients were getting screened even though most insurance companies, including Medicare and Medicaid, cover the cost.  

Because it's recommended by the U.S. Preventative Task Force with a "B" rating under the Affordable Care Act there should be no co-pay. 

Pulmonary specialist Dr. Michael Alvarez, who works with Swan's doctor, says part of the reason patients aren't getting screened is because they don't know it's available.

"I feel some people are not aware that the screening exists, physicians, including primary care physicians, are not aware," Dr. Alvarez said.     

That's a problem because people with early stage lung cancers have no symptoms. By the time symptoms do develop, the cancer is at a late stage, making it difficult to treat and 12 times more likely to be fatal within the next five years. 

"Patients diagnosed at a late stage have a five-year survival of about 4.5 percent, versus patients that are diagnosed at an early stage, or localized stage, have a five-year survival of about 55 percent," explained Alvarez.  

Swan's tumor was so that small surgeons at St. Joseph's Hospital in Tampa removed all of it.  

"There was no radiation, no chemotherapy needed, I've never been so elated, I mean I had no idea what it was going in, what they would actually find," Swan smiled.

Swan stopped smoking cigarettes and is now using eCigs. Her doctors are still tracking the second nodule they initially found in her other lung, although so far, it hasn't grown. 

"Until they're 100-percent positive that the other one will turn into cancer, then as far as I'm concerned I'm cured, and very happy, very happy," she said.  

Swan has more time to spend with her husband and pets. She hopes her experience will inspire others to get screened

"It saved me, it can save your life, you definitely need to do it," Swan added.  

Researchers continue to study the process with some investigating whether a different population, some as young as 50, would have more benefit. Others are tracking false positive rates and are concerned about people who don't meet the current guideline criteria, that are getting the scans.