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Lung cancer more curable if caught early

Odessa American - 12/25/2017

Dec. 25--As Medical Center Hospital's oncology navigator, Maria Scott helps patients make their way through all types of cancer. But as coordinator for lung cancer prevention, that disease is her area of specialization.

Information from the hospital stated lung cancer is the leading cause of death among all types of cancers for men and women. It takes more lives annually than breast, prostate and colon cancer combined.

Lung cancer caused by smoking tobacco accounts for eight of 10 deaths caused by lung cancer, information from Medical Center Hospital said.

The disease is divided into two categories, which have different types of treatment. The two types are non-small cell lung cancer and small cell lung cancer, according to information from MCH.

A way to prevent lung cancer is to stop smoking if you smoke, or not to start. The second is to measure levels of radon in the home and a third is to be aware of chemicals that can cause cancer in the workplace and take measures to protect yourself from them.

Other less common causes of lung cancer are silica, asbestos and some heavy metals and diesel fume exposure.

Radon is a naturally occurring radioactive gas that can cause lung cancer. The gas cannot be seen or smelled, so testing is the only way to know your level of exposure, the U.S. Environmental Protection website said.

Scott, who has worked at MCH and West Texas Oncology Center, said she helps four to eight patients on a daily basis in the hospital, including patients who are newly diagnosed and patients who are here because of the side effects of chemotherapy.

She found her way into oncology at the prompting of a patient who said her personality lent itself to that area of medicine.

Scott has been with Medical Center since 2011, but worked at West Texas Cancer Center as an infusion nurse for two and a half years.

She wanted to go into chemo infusion for emergency cases, which required two years of intensive care unit experience, so Scott returned to MCH and went to work in the ICU. That led to oncology navigation.

"We navigate the patient through the system," Scott said.

After the diagnosis is given to the patient, the next step is usually pathways of treatment for that type of cancer. Navigators also set up appointments and follow-ups.

She said the best thing to do if you're undergoing treatment is to talk to a doctor's nurse, but if you can't reach them, she can be reached anytime.

"My passion is oncology. I love to serve. I'm not going to lie to you: I love bedside nursing. That's my second job here at Medical Center. ... It's on the oncology floor, as well," Scott said.

The best thing is to catch lung cancer at the earliest possible stage. Scott said it can reduce death by 20 percent. This can be done through lung cancer screenings, which are combined with smoking cessation programs.

The most common type of screening is a low-dose computed tomography scan, which shows more than an x-ray.

Once a diagnosis is made, technologies are available that help to locate the tumor, as well as newer radiation treatment therapies that are less invasive and require fewer visits for treatment.

Truebeam technology allows providers to determine the size and exact location of the tumor within a 3-D body image. Truebeam also allows for more accurate dosage administration.

Stereotactic Body Radiotherapy is used as a form of treatment for small-to-medium size tumors in other areas of the body, including the lungs. The cancerous tumor is not actually removed, but stereotactic body radiotherapy changes the DNA of the cancer cells, in effect disabling the cell from being able to reproduce and causing the tumor to shrink, the information said.

SBRT is less invasive than other forms of radiation therapy and requires fewer patient visits to the hospital.

Criteria for lung cancer screening is:

-- Being 55 to 74 years old.

-- Having at least a 30-pack a year smoking history.

-- Being in fairly good health.

-- Being someone who currently smokes, or quitting in the last 15 years.

Scott said Medicare Part B pays for the tests.

Signs and symptoms include:

-- A cough that doesn't go away or gets worse.

-- Coughing up blood or rust-colored sputum (spit or phlegm).

-- Chest pain that is often worse when you take a deep breath, cough or laugh.

-- Hoarseness.

-- Weight loss and loss of appetite.

-- Shortness of breath.

-- Feeling tired or weak.

-- Infections such as bronchitis and pneumonia that don't go away, or keep coming back.

-- New onset of wheezing.

"We'll do a chest x-ray, then CT, generally in that order. We can have a pretty good idea of what is going on. If there is a mass in there, the next step is to do a biopsy. And the next step is to see the extension of the growth, said Dr. Jorge Alamo, of ProCare Occupational Medicine and who divides his time between occupational and family medicine.

A biopsy is conducted first to determine whether the tumor is benign or malignant. Then the location is determined and physicians check to see if it has gone to the lymphatic nodes and whether it has spread.

"If there is any extension, you have to go through radiation and chemo. Then they'll do another CT in six months and another six months. If there's nothing, they are a cancer survivor," Alamo said.

If lung cancer is detected early, the chances of survival increase, Scott said.

According to information from Dr. Joseph Kaczor of Texas Oncology-Odessa West Texas Cancer Center, if lung cancer is detected in the five-year overall survival rate, the survival rate is 60 percent.

The overall five-year survival rate is about 15 percent. In the early stages, symptoms may not be present or be minimal and ignored by patients, he wrote.

It is estimated that more than 200,000 new cases of lung cancer will be diagnosed this year and more than 150,000 deaths from the disease will occur this year, Kaczor said. About 25 percent of teenagers and adults continue to smoke, and in West Texas, the rates are higher, he wrote.

Lung cancer accounts for almost one third of cancer deaths, his information said. The primary cause of lung cancer is smoking and exposure to tobacco smoke. More than 80 percent of lung cancer is caused by smoking tobacco.

Scott said her job can be sad and depressing sometimes, but her faith carries her through. God gives her comfort in knowing that she can do something to help patients and getting them to treatment faster.

When people learn they have cancer, it is the only thing echoing in their heads, but she advocates education at all points.

"You are in charge of your health at the end. This is the beauty of being independent and having critical thinking. Education is key," Scott said.

The most rewarding part of her job is seeing patients get better.

"I unfortunately have lost a lot of patients to cancer. When I see them after I give them chemo two or three years ago and I see them at the hospital doing something else, for them to recognize me and just being alive and being better and believing they can take charge of their health I think that's the best" outcome, Scott said.

Alamo said there were 50.4 deaths per 100,000 people, as calculated by the National Cancer Institute during the period from 2009-2013.

Alamo said cancer cells are cells that "go crazy."

"Every cell in your body, they know where to be born and they know where to die. Cells are replicating and dying every single day and every single minute," Alamo said.

He added that cancer cells lose that ability to know when to be born and die and multiply instead. "So what happens is they form tumors, they expand and they cause problems. It can happen anywhere your body," Alamo said.

Being imaged is not always advisable because it could end up in complications.

"We do imaging when we have a reasonable suspicion. ... Screening for lung cancer is very important and we do it when we think there is an increased risk. Who has an increased risk? Well, people who smoke 80 to 90 percent of the cancers are in smokers. Does that mean we cannot have a cancer in non-smokers? Unfortunately, we can, but it's only 10 to 20 percent," Alamo said.

Alamo said people sent for screening is very specific. It depends on how much the person smokes.

For smoking cessation information, call 1-877-YES-QUIT (the Texas Quitline).

There also is a web-based cessation program at https://www.quitnow.net/texas/.

To set up an appointment for a lung cancer screening, contact the oncology navigator/lung screening coordinator at 432-640-2607.

Ruth Campbell covers education for the Odessa American. Reach her at 432-333-7765 or 432-333-7765 or rcampbell@oaoa.com


(c)2017 the Odessa American (Odessa, Texas)

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