Wednesday, August 10, 2005

More on Lung Cancer: Screening, Quitting Smoking, and Attitudes

Screening:
Sharon Cobb posted on lung cancer screening recently, indicating that spiral CT is the best thing for early lung cancer detection. I did some searching, and the existing studies do seem to find that this is a good tool for early detection. The literature also includes, however, discussion of a high rate of false positives from this test, whether the test is cost-effective, and the limited evidence that early detection with this test actually reduces mortality. This may turn out to be a great test for catching lung cancer early and reducing mortality, but based on the literature it seems to be in "ask your doctor" territory, not "demand this procedure" territory.
  • PubMed search on spiral CT for lung cancer diagnosis
  • PubMed search for practice guidelines on lung cancer diagnosis
  • This NEJM article on lung cancer screening is not online for free yet, but you can view the citations, many of which are free online and good reviews of this topic.
  • Information on screening from the National Cancer Institute

    Quitting:
  • MedlinePlus provides some good links on smoking cessation.
  • MayoClinic.com provides this nice overview of products to help people quit smoking, such as lozenges and the patch, with pros and cons for all of them.
  • For the non-smokers, here are do's and don'ts for you while your smoker tries to quit.

    Attitudes:
    The New York Times today has an article called "Nonsmokers can be Lung Cancer Victims, Too," which touches briefly on the stigma associated with lung cancer. The article makes the point nicely that the concept of "innocent" and "not so innocent" victims may not be a particularly useful one, and all people with cancer need support. While it may be true that many lung cancer deaths could be prevented if people didn't smoke, there are also other preventable diseases that don't seem to evoke the same, "Oh, too bad about the disease, but you DID do this..." sentiments. One thing that comes to mind is HIV/AIDS. In general, I think that people have a much more civilized reaction to sexually transmitted diseases. I for one have never heard anyone say, "Oh, you have AIDS? Did you have sex?" in the accusatory tone lung cancer patients may experience. Or, "Oh, you were hurt in a car wreck? That's what you get for driving." In my humble opinion, anyone suffering from cancer, another disease, or an injury needs and deserves the love and support of their friends and family, and true friends and otherwise decent people should and will be caring and supportive, no matter what the cause of a current ill state.

    Next time, I'll put away the soapbox and just bring you the sweet, sweet info. :)
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