McLEOD REGIONAL MEDICAL CENTER 19 APRIL 2021

Juleidy Turnipseed, PA-C, MPAS

Lung cancer is the leading cause of cancer-related deaths in both men and women in the United States, more than breast, prostate and colorectal cancers combined. In addition, 90 percent or more of all lung cancers are caused by cigarette smoking, according to the Centers for Disease Control and Prevention (CDC).

The risk of developing lung cancer for a current smoker with a history of smoking a pack a day for 40 years is about 20 times higher than that of the non-smoker. The best way to minimize the risk of developing lung cancer is to never start smoking.

Our mission at McLeod through the Healthy Lung Initiative Program is to save lives in our community through early detection and enhance access to care. This will allow us to see an increase detection in early lung cancer diagnoses with curative options while decreasing later stages of lung cancer. We want to provide not only access to screening, but for patients to also have easy access to our experts in pulmonology, thoracic oncology surgery, radiation oncology, and medical oncology.

As with most cancers, early detection remains the key to survival. Until recently, there were not reasonable tests for early detection because the tumors are not always visible on a chest X-ray. Historically, a patient would be diagnosed with lung cancer once they developed symptoms such as coughing up blood, unintentional weight loss, or shortness of breath.

Additionally, early-stage lung cancer patients often do not have symptoms and can go for months and potentially years without detection. These are the reasons that screening for those at high risk for lung cancer has been recognized as an important method in saving lives.

Fortunately, for those who have been smoking for years and are considered high risk, there is now a screening tool to detect lung cancer with scientific data showing the benefits. Screening means testing an individual before they have symptoms of disease. A landmark study, called the National Lung Cancer Screening Trial (NLCST), published in 2011 indicated that low-dose computed tomography (CT) scans of the lungs of a patient with a significant smoking history led to earlier diagnosis, treatment, and a reduced chance of death. A lung CT scan can detect small nodules on the lungs years before they can be seen on a regular chest X-ray.

The NLCST involved more than 53,000 patients who were former or active smokers. Results showed a low-dose CT scan of the chest was better than a chest X-ray for detecting lung cancers. The study went on to reveal that for every 320 high-risk patients screened, one life was saved. Additionally, the study of patients ages 55 to 74 years with a 30 pack-year history of smoking or former smokers, who met the requirements such as being without signs, symptoms or history of lung cancer, found that there was a 20 percent risk reduction in mortality using low dose CT scans versus chest x-ray.

In 2014, the McLeod Lung Cancer Screening Program was established based on the results of this trial and a recommendation in 2013 by the United States Preventive Services Task Force. McLeod follows the Centers for Medicare and Medicaid Services (CMS) criteria for who should be screened for lung cancer, which includes:

• Those between 55 to 77 years of age who have had a 30 or more pack-year history of cigarette smoking (30 pack-year is equivalent to one pack per day for 30 years or two packs per day for 15 years)
• Currently exhibiting no symptoms of lung cancer
• Currently smoking or have quit smoking within the last 15 years

This is the biggest advancement in lung cancer detection for more than 25 years. Physicians can now detect small, early-stage, potentially curable lung tumors. In fact, when lung cancer is detected at an early stage, patients have a five-year survival rate of 56 percent after treatment. If the cancer has spread to nearby organs, the five-year survival rate declines greatly to five percent.

Similar to cancers of the breast, colon, and prostate, it is obvious that the early detection of lung cancer with a screening CT scan provides for a greater chance to be cured with surgery including the possibility of minimally invasive surgery or radiation treatment such as stereotactic body radiation therapy.

At McLeod Health, we offer robotic-assisted minimally invasive surgery for early-stage lung cancer for patients who are good surgical candidates. This allows the patient to have a faster recovery with less pain and return to work and their daily lives sooner than if they would have undergone a thoracotomy.

In addition to the low-dose lung CT screening, McLeod now offers a smoking cessation clinic involving one-on-one sessions with a certified Smoking Cessation Specialist to help individuals take that next step in the process of quitting tobacco use. The clinic is designed to explore an individual’s tobacco use and create a plan that will address their needs and goals. Participants do not have to be prepared to quit on the first visit and, if interested, nicotine replacement therapy resources are available. The clinic is held each Friday in the McLeod Pulmonary and Critical Care Associates office located at 401 East Cheves Street, Suite 202 in Florence, SC. Individuals can be referred by their primary care physician or self-refer by calling (843) 777-7863.

For More Information on Lung Cancer Screenings
Medicare and most private insurance companies now cover the cost of the low-dose CT scan if an individual meets the criteria for a lung cancer screening. Ages covered by Medicare range from 55 to 77; private insurance will pay for those 55 to 80. If an individual does not have Medicare or private insurance or cannot afford the deductible (and meet certain financial criteria), the McLeod Foundation offers scholarships through two groups — McLeod Men and McLeod Angels — to assist in paying for the screening. For additional questions on the screening or scholarships, please call the McLeod Healthy Lung Initiative at (843) 777-5953.

Juleidy Turnipseed is a physician assistant in thoracic oncology surgery and surgical robotics coordinator with McLeod Health. Additionally, she is the Director of the McLeod Healthy Lung Initiative Program and a Smoking Cessation Specialist. Turnipseed completed her Masters in Physician Assistant Studies from Wingate University and her Bachelor of Science in Biology from Florida State University.