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Patients > Current Practices
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Current Practices
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Why don't doctors routinely screen for lung cancer?
The fact is that lung cancer is still difficult to test for. The most
reliable test for lung cancer is to sample cells from the tumor ('tissue
biopsy'). However, without a very strong suspicion that the disease is
present, no doctor would order such an invasive and potentially dangerous
procedure. Currently, doctors rely primarily on the following four methods
of lung cancer detection:
1. Sputum cytology:
one of the oldest approaches to detecting lung cancer, sputum cytology
relies on finding cancerous cells in the fluids brought up from the lungs.
Sputum Cytology is not widely used for early detection, since malignant
cells are usually not found in the sputum specimens of patients with early
lung cancer.
2. Bronchoscopy:
an examination during which a thin, flexible tube, called a bronchoscope,
is passed down the throat and into the main airways of the lungs. Although
bronchoscopy does allow direct observation of the large airways, it is not
applicable for visualizing the lung's periphery, where approximately 40% of
all lung cancers occur. Furthermore, the invasiveness and expense of
bronchoscopy limit its use as a detection tool.
3. X-ray:
X-ray technology has been a much-used lung cancer detection method for
many years. However, x-rays do not identify tumors smaller than 2cm,
making them useless for early detection. X-rays also generate a high
number of false positive readings, since other pulmonary conditions,
such as infections, TB and sarcoidosis, produce radiographs with
similar appearance to lung cancer.
4. CT Scans:
is emerging as a powerful tool for the detection of lung cancer.
Unfortunately, CT scans alone cannot distinguish between benign and
malignant nodules. For every 100 nodules found through screening CT, 95
will eventually be labeled benign. Once a nodule has been discovered,
however, it has to be followed up. A regime of CT scans, lasting up to
two years, may be required to monitor the nodule's growth.
Although the radiation exposure from a single CT scan poses little health
risk to the individual, there is concern within the medical community that
the widespread use of CT scans may create more public health risks than
benefits. With this in mind, many doctors will not order CT scans for
the purpose of screening for lung cancer. In general, only patients who
exhibit symptoms of lung disease are sent for further evaluation with CT.
By the time the decision is made to order a CT scan, the cancer, should
it exist, may already have progressed to a later, less treatable stage.
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Perceptronix is a cancer diagnostic service company focused on detecting cancer
at early stages to improve patient outcomes.
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