Editor’s Note:
AHMC Healthcare and National Yang Ming Chiao Tung University Hospital presented seven expert lectures on screening, treatment, and prevention. This is the Third article in the series.
A 65-year-old nonsmoker was diagnosed with stage I lung adenocarcinoma. Her 68-year-old sister underwent low-dose CT screening—and received the same diagnosis.
Both cancers were caught early and surgically removed.
Dr. Chien-Ho Tsai, chief of thoracic surgery at National Yang Ming Chiao Tung University Hospital, shared their story during his lecture, “Can Lung Cancer Be Prevented?” His message: Not smoking does not mean no risk.
Don’t wait for symptoms. Through clinical cases and imaging, Tsai emphasized identifying those at high risk, choosing appropriate screening, and treating cancer early.
Effective screening starts with knowing your risk.
Know Risks Screen Early
Dr. Chien-Ho Tsai explained that lung cancer risk is linked to smoking, family history, and environmental exposures.
Tell your doctor about prolonged exposure to secondhand smoke, air pollution, or workplace carcinogens.
The two sisters’ diagnoses underscore why family history belongs in every risk assessment—even for nonsmokers.
Early lung cancer may cause no noticeable symptoms. Coughing, coughing up blood, shortness of breath, persistent chest pain, and hoarseness are not specific to lung cancer, either.
Feeling well does not rule it out. Persistent or unexplained symptoms warrant medical evaluation; don’t wait for your next checkup.
Prevention and screening serve different purposes. Quitting smoking, avoiding secondhand smoke, and reducing harmful exposures can lower risk.
Screening seeks to detect cancer before symptoms appear, when treatment may be more effective. It does not prevent cancer from developing.
Scan Smarter Weigh Benefits
A normal chest X-ray does not rule out lung cancer. Small tumors can be difficult to detect, especially when obscured by the heart or ribs.
Low-dose computed tomography (LDCT) provides more detailed lung images and is an important screening tool.
Citing the U.S. National Lung Screening Trial, Tsai noted that LDCT reduced the relative risk of lung cancer death by about 20% compared with chest X-rays among high-risk heavy smokers who met the study’s criteria.
That finding does not mean everyone benefits equally from regular scans.
More testing is not always better. The U.S. National Cancer Institute cautions that LDCT screening can lead to false positives, additional testing, overdiagnosis, and radiation exposure.
Track Nodules. Manage Risk.
A lung nodule is not a cancer diagnosis. Abnormal findings need medical interpretation, followed by monitoring or further testing as appropriate.
Don’t assume every nodule is cancer—or ignore one because you feel well.
Before a screening consultation, gather prior chest images and record how much you smoked, for how many years, and when you quit.
Note which relatives have had lung cancer. These details help your doctor assess your risk and testing needs.
Ask three questions: Am I a candidate for screening? How often should I be screened? What happens if a scan finds something abnormal?
Screening eligibility and coverage vary by location; standards from one region may not apply elsewhere.
Treat Precisely Follow Closely
Treatment depends on the cancer’s type and stage, as well as the patient’s overall health.
Surgery is an important option for eligible patients with early-stage lung cancer.
Preoperative heart and lung assessments help balance cancer control with quality of life after surgery.
Tsai also introduced intraoperative CT and precision localization systems for finding small or multiple lesions, along with thoracoscopic and robotic surgery.
The approach must fit the individual patient. Continued follow-up remains essential after surgery.
Can lung cancer be prevented? Tsai’s clearest answer: Reduce risks you can change, screen appropriate candidates, and follow through on abnormal findings.
Know your family history, document your smoking history, and discuss screening with your doctor.
Each step can help secure an earlier diagnosis and timely treatment.(Part 3 of 7)
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