Low-dose CT scans find lung cancer before X-rays, save lives

Low-dose computed tomography, commonly known as CT scans, are reducing lung-cancer deaths by finding the cancer early before it spreads to other parts of the body, UK HealthCare reports. Used as a screening tool, the American College of Radiology says CT is "the only test ever shown to reduce mortality in high-risk smokers."

This is good news for Kentucky, which leads the nation in both lung cancer and deaths from it.  It also leads, by some estimates, in smoking, the leading cause of cancer.  An estimated 25 to 28 percent of Kentuckians are smokers, compared to 18 to 19 percent nationally.

Low-dose CT screening for lung cancer is recommended for high-risk patients, defined in a Mayo Clinic article as someone 55 to 79 who's smoked the equivalent of a pack of cigarettes every day for 30 years, or those 50 and older who have smoked a pack a day or more of cigarettes for 20 years or longer and have one additional risk factor for lung cancer.

Chest X-rays, the other screening technique, typically are not done until a person has symptoms because studies have shown that they are not effective in detecting lung cancer early. However, researchers have found that heavy smokers screened with low-dose CT scans can pick up much smaller tumors than chest X-rays and have a "20 percent lower risk of dying from lung cancer than those screened with chest X-rays," UK HealthCare reports.

A recent study found that nearly one in five lung tumors detected on CT scans are probably so slow-growing that they would never cause problems, reports Lindsey Tanner of The Associated Press. These tumors are not false positives, but cancerous tumors without symptoms, which are unlikely to become deadly, according to the research. However, National Lung Cancer Screening Trial results conclude that the benefits from low-dose CT scans significantly outweigh the "comparatively modest rate of over-diagnosis," according to the American College of Radiology. "Overdiagnosis is an expected part of any screening program and does not alter the benefits you get from the screening,"

Dr. Paul Ellenbogen, chair of the American College of Radiology Board of Chancellors, said in the release, "Physicians should certainly discuss the risk and benefits of CT lung-cancer screening with patients – including that of overdiagnosis. However, for high-risk patients, the group in which CT lung cancer screening is proposed, the lifesaving benefit outweighs the risks."

1 in 3 don't get potentially life-saving screening for colon cancer, second leading cause of cancer death in Ky. and U.S.

Federal officials said Tuesday that although detecting colon cancer early saves lives, only about two-thirds of Americans aged 50 to 75 have undergone recommended screening.

The U.S. Preventive Services Task Force recommends that men and women 50 and older get screened for colon caner, which is about 23 million Americans. However, only 28 percent of people who should be screened have ever done so and about 7 percent of people have received but are not up-to-date with their screening, says the federal Centers for Disease Control and Prevention.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

"Despite research that shows colorectal cancer screening saves lives, screening rates remain far too low," CDC Director Dr. Tom Frieden said during a noon press briefing Tuesday. "Colon cancer is the second-leading cancer killer for both men and women. In fact, it's the leading killer of nonsmokers in this country, killing about 50,000 people a year," he said. The CDC report was published online Nov. 5 in its Morbidity and Mortality Weekly Report.

The number one reason people aren't being screened is because their doctor didn't recommend it, Frieden said, and the CDC is encouraging doctors to talk with their patients about screening. Certain preventive screening tests may be free under the Affordable Care Act, but be sure to check your individual policy.

"It is also important that individuals learn about testing options and get the test that's right for them," Frieden said. "But, we also know that not having health insurance greatly reduces the likelihood that someone will get tested and that's why increasing coverage is another way of saving lives."

MedLine Plus reports that several screening options can be used alone or in combination, including the following: Fecal occult blood test or fecal immunochemical test every year. These tests can be done at home; Flexible sigmoidoscopy, done every five years, with home fecal tests done every three years; Colonoscopy done every 10 years.

All these tests are effective and one is not necessarily better than another, Frieden said.  The CDC says that as many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly.

"The best test is the one that gets done," he said. For some people, however, colonoscopy may be the best option, Frieden said. "These are people with a strong family history of colon cancer or an intestinal condition such as inflammatory bowel disease, or people who have had polyps removed in the past. But for everyone else, and that's the majority of people, there is no proven benefit to one versus another," Frieden said.

Ovarian cancer screening is critical in detecting tumors that don't show up on clinical exams, and increases chance of survival

Kentucky First Lady Jane Beshear joined some of the state's female legislators to highlight the importance of screening for ovarian cancer, which can be done for free through the University of Kentucky Markey Cancer Center's ovarian cancer screening program.

Ovarian cancer is fifth among cancer killers of American women and accounts for more cancer-related deaths, causing more deaths than any other cancer of the female reproductive system, says the federal Centers for Disease Control and Prevention.

SYMPTOMS OF OVARIAN CANCER (CDC)

When ovarian cancer is found in its early stages, treatment is most effective, but most women with ovarian cancer don't have symptoms of it until the disease progresses into a more advanced stage. As it progresses, survival rates drop sharply, making screening and early detection critical. Data from the screening program at UK shows that regular screening increases survival rates, says a UK news release.

"This preventative ovarian cancer screening is free, quick and confidential – an easy way for women to protect themselves from this life-threatening illness," Jane Beshear said. "This simple procedure is available to women in all parts of Kentucky, not just the Lexington area, and I encourage all who are at-risk for the disease to participate in the program."

Dr. John van Nagell, professor of obstetrics and gynecology at the Markey Cancer Center, said "While regular pelvic examinations are important and can detect many other abnormalities, including cervical cancer, they are not effective in detecting ovarian cancer in its earliest and most treatable stages."

Van Nagell started the screening program in 1987 to test the use of transvaginal sonography to detect ovarian tumors that are too small to be detected during an annual exam, says the release. Over the program's 26 year period, more than 241,000 free screening examinations have been provided to more than 41,000 Kentucky women, and 558 ovarian tumors and 86 malignancies have been detected.

Women from every county in the state have participated in this program, says the release. Screenings through the program are now being performed in Lexington, Elizabethtown, Somerset, Prestonsburg, Maysville, Paducah and Greenup County.

All women are at risk for ovarian cancer, but older women are more likely to get the disease. About 90 percent of women who get it are older than 40, says the CDC.

The UK screening program is free and open to women age 50 or older, or women over the age of 25 who have a family history of ovarian cancer. For more information, call (859) 323-4687 or (800) 766-8279. Click here for more CDC information.

Free medical screenings, dental work for teens and adults available in Mayfield through Tuesday

West Kentuckians in need of health care can get free medical, dental and optical screenings through Tuesday, Aug. 13 at the old Morgan Haugh Clinic building at 220 W. Walnut St. in Mayfield from 9 a.m. to 7 p.m., including Saturday and Sunday.

The screenings are a program of the Delta Regional Authority and the Department of Defense. Anyone is eligible to receive the free services, which do not include emergency or obstetrical treatments. For adults and children age two and up, medical screenings, non-emergency medical treatment, minor lab tests, prescription assistance and optometry exams are available. For adults and children 13 and up, dental exams, extractions and fillings are also available.

Services will be provided by 152 medical personnel from the U.S. Army Reserve and the Army National Guard. Other current clinic sites are in Blytheville, Ark., Hayti, Mo., and Dyersburg, Tenn. Earlier clinics were held in Martin, Tenn., Helena-West Helena, Ark., and four communities in western Mississippi.

Obama and allies tout preventive-services and drug benefits of health-reform law to Medicare beneficiaries in Ky.

The federal health-reform law has made drugs more affordable for seniors, broadened coverage for preventive services and made Medicare more solvent, the Obama administration and its allies are pointing out today, the 48th anniversary of the enactment of the Medicare program.

According to the Department of Health and Human Services, Medicare beneficiaries in Kentucky have saved nearly $141 million on prescription drugs because of the Patient Protection and Affordable Care Act. Last year, 72,391 Kentuckians saved more than $51 million, or an average of $703 each, on prescriptions because those in the “donut hole” of Medicare Part D got a 50 percent discount on covered brand-name drugs and a 14 percent discount on generic drugs. The law will keep expanding coverage for both types of drugs until it closes the donut hole, the gap in coverage between modest and huge prescription needs.

The law also eliminated deductibles and co-payments for screening and other preventive services for seniors and people with disabilities. Last year, 485,843 Kentuckians with traditional Medicare used one or more free preventive service.

"The health care law extends the life of the Medicare Trust Fund by 10 years," said a news release from U.S. Rep. John Yarmuth, D-Louisville. From 2010 to 2012, Medicare spending per beneficiary grew 1.7 percent a year, much more slowly "than the per capita rate of growth in the economy," the release said. "And the health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology."

Earlier, the administration noted that Americans received $504 million in rebates from insurance companies because of the law's requirement that a certain percentage of premiums paid must be used for health care. In Kentucky, the rebates totaled $14.4 million to 206,771 consumers (slightly more than half, totaling almost $11 million, in the individual market) and averaged $100 per family. For other data on the effects of the law in Kentucky, click here.

'Incredible Colon' to march across the state in Colon Cancer Awareness Month; more than a dozen stops scheduled

A special tour throughout the state of the Incredible Colon — an inflatable model of a human colon, large enough for visitors to walk through it — will promote education about risks and preventive measures of colon cancer during March, National Colon Cancer Awareness Month.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly, according to the federal Centers for Disease Control and Prevention. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon, and when detected early, polyps can be easily removed during a colonoscopy before they develop into cancer. When colon cancer is found early and treated, the five-year relative survival rate is 90 percent, underscoring the need for preventive health exams.

However, only 63 percent of Kentuckians who should have screening tests have had them, according to Kentucky data from the federal Behavioral Risk Factor Surveillance System, an ongoing national survey.

The colon tour is a coordinated promotion by the Kentucky Cancer Program, local cancer councils and the Kentucky Colon Cancer Prevention Project. It is free and open to the public and will take place in 13 Kentucky communities March 4-28:

• March 4: Fleming County Hospital, Flemingsburg (10:30 a.m. - 2:30 p.m.)
• March 5: Walmart, Manchester (Noon - 4 p.m.)
• March 6: Hazard ARH Medical Mall, Hazard (10 a.m. - 3 p.m.)
• March 7: Rowan County Chamber of Commerce, Morehead (members
  only, 9:30 a.m. - 3 p.m.)
• March 8: Frankfort Regional Hospital, Frankfort (9 a.m. - 4 p.m.)
• March 19: Lexmark, Lexington, (Employees only, 8:30 a.m. - 2 p.m.)
• March 20: Lawrence County High School, Louisa (8 a.m. - 5 p.m.)
• March 21: Lady of Bellefonte Health Center, Grayson (10 a.m. - 2 p.m.)
• March 23: Phillip Sharp Middle School, Butler (8-11 a.m. )
• March 25: Town Center Mall, Ashland (10 a.m. - 3 p.m.)
• March 26: Walmart, Georgetown (3-6 p.m.)
• March 27: Adron Doran University Center, Morehead (9:30 a.m. - 3 p.m.)
• March 28: Walmart, Somerset (10 a.m. - 2 p.m.)

Attendees are invited to dress in blue, the color of colon cancer awareness, and there will be door prizes, giveaways (while supplies last), refreshments and educational information about colon cancer screening, prevention and early detection. (Read more)

Avoid virus-linked cancers, including cervical cancer, with shots

With a simple vaccine, you can avoid HPV-linked cancer, including cervical cancer and many cancers of the mouth, throat, anus and genitals, which constitute more than 3 percent of all U.S. cancer diagnoses. Vaccination against the human papilloma virus (HPV) thwarts the virus’s spread, wrecks its ability to jump between people and inhibits a virus that in 2009 led to a cancer diagnosis for 30,000 people in the U.S., according to the National Cancer Insititue. 

HPV infection is common. More than half of women between 14 and 59 catch a genital HPV. Many of these infections are low-risk, but when the body does not sweep out HPV intruders, high-risk HPV infected cells may lead to the unchecked growth of cancerous cells, according to Newswise, a research-reporting service.

HPV is actually a family of more than 150 viruses that infect human skin and mucosa, the moist membranes lining the nostrils, mouth and genital cavities. Two vaccines, Gardasil and Cervarix, prevent people from getting HPV infections by helping the body stockpile a medley of cellular defenses. Gardasil and Cervarix target HPV types 16 and 18, the two responsible for most cervical, anal, genital, and oropharynx cancer.  Blocking infection by types 16 and 18 also fights off other cancers, and the vaccines’ protection could last a lifetime. Gardasil also targets types 6 and 11.

It is important to complete the three-dose series for the vaccines; series completion rates are low for people in the Southern states, especially those that are poor and without private insurance, according to Newswise. Scientists are working to make a single vaccine that blocks infection by all HPV types, but today’s vaccines can prevent infection by two of the most common high-risk HPVs and may be the first step toward preventing HPV-linked cancers. (Read more)

Breast cancer awareness: Testing urged, guidelines explained, misconceptions explored

Women with BRCA1 and BRCA2, the
genes most commonly involved in breast
cancer, have up to an 80 percent chance
of getting the disease.

October is Breast Cancer Awareness Month. Although Kentucky's breast cancer rate is slightly lower than the nationwide rate, almost 600 women die every year from breast cancer in the Commonwealth. The American Cancer Society predicts approximately 3,160 new cases of breast cancer will be diagnosed in Kentucky this year. Early detection and prompt treatment can significantly reduce suffering and death from the disease.

According to the Cabinet for Health and Family Services, all health plans serving Kentuckians must, by law, cover mammograms. Medical guidelines strongly recommend that women older than 40 have annual mammograms and women younger than 40 with a family history of breast cancer should also have regular screenings. Through local health departments, the Kentucky Women's Cancer Screening Program provides breast cancer screenings, mammograms and Pap tests to eligible women in every county. During the 2011 fiscal year, KWCSP provided breast cancer screenings to 14,212 women. Services are provided to low-income women through the Kentucky Department for Public Health. Those women must be uninsured with incomes less than 250 percent of federal poverty guidelines.  For more information about breast cancer or screening services, call your local health department.

There are many misconceptions about the risks of developing breast cancer. Genetics, of course, is a well-documented factor but lifestyle issues have gotten a lot of talk. So what's true? Wendy Chen, MD, MPH, a breast cancer expert at Dana-Farber Cancer Institute in Boston, a principal teaching affiliate of Harvard University, tackles some of the more common questions here:

1) Soy may increase the risk of breast cancer returning.
False. Chen, who was part of a study that looked at over 9,500 American and Chinese breast cancer survivors who ate soy every day, says that eating soy may be linked to a lower risk of recurrence of breast cancer.

2) Alcohol consumption can increase the risk of breast cancer.
True. Dana-Farber researchers found that women who consume one alcoholic drink a day may increase their risk for breast cancer.  Chen and her colleagues analyzed data from over 105,000 women in the Nurses’ Health Study. Those who consumed three to six glasses of wine a week were 15 percent more likely to receive a diagnosis of breast cancer. Those who drank fewer than three drinks a week had no increased risk.

3) Fertility treatments increase a woman’s risk of breast cancer.
False. According to a recent study from the National Institutes of Health, ovulation-inducing fertility treatments like Clomid and follicle stimulating hormone (FSH) do not significantly increase a woman's risk of developing breast cancer.

4) Wearing deodorant can increase the risk of breast cancer.
False. According to the National Cancer Institute, there is no conclusive research linking underarm deodorants to breast cancer.

5) The bigger the baby the bigger the risk of getting breast cancer.
Possibly true. “This is a tough one because the research is still evolving,” says Chen. "But the latest research shows that women who have larger babies have more than twice the risk of developing breast cancer than mothers who give birth to smaller infants. Researchers say that having a heavier baby may create a hormonal environment in pregnancy that could lead to the future development of breast cancer. They found that during pregnancy in women who have heavier babies, the ratio of estrogen to anti-estrogen is unusually high. The greater the level of estrogen, the higher the risk of breast cancer. However, Chen emphasizes, women who have larger babies should not panic. There is definitely a need for further research.” (Read more)

Federal panel says PSA screening for prostate cancer does more harm than good, but no better test is available

Prostate cancer cells. Getty Images photo by Abbey Michael.

An influential federal panel says testing healthy men's prostate-specific antigen levels to detect prostate cancer does more harm than good.

The PSA test can lead to unnecessary biopsies for men who turn out to be cancer-free. Those biopsies can also lead to men being treated for cancers that are so slow-growing (a characteristic of most prostate cancers) that they didn't need to be detected.

An estimated 1,000 to 1,300 men die annually from complications associated with treatments that are initiated because of PSA screening, reports Alice Park for Time magazine. Moreover, treating harmless prostate tumors increases the chances of making men impotent or incontinent.

The U.S. Preventive Services Task Force published the recommendation in the Annals of Internal Medicine. In 2009, the panel also recommended that women delay routine mammograms until the age of 50. That was controversial, and "The task force's recommendation goes against two decades of widespread use of the PSA test, a $35 blood test," Park reports.

"The recommendation is not just counter to what the lay public has been taught about cancer prevention but what physicians have been taught as well," said Dr. Michael LeFevre, co-vice chair of the USPSTF and a professor of family and community medicine at University of Missouri. "We've been told for decades to be afraid of cancer and that the only hope is early detection and treatment. So it's hard for physicians and patients alike to accept that not all cancers need to be detected or need to be treated and that there are harms associated with screening, not just benefits."

Through PSA testing, physicians "were finding the cancer earlier, so the time from diagnosis to death was longer, but the patient wasn't actually living longer," explained Dr. Otis Brawley, chief medical officer of the American Cancer Society.

But there isn't a better test to replace the PSA, and Ian Thompson, chairman of urology at the University of Texas Health Science Center, said to reject it completely is unwise. He said U.S. death rates from prostate cancer dropped between 30 and 50 percent since the screening became commonplace in the early 1990s, though those numbers could also have been influenced by more effective treatments. Thompson said he didn't want to go back to the "bad old days" when doctors only found prostate cancer when it was already unable to be cured, reports Liz Szabo for USA Today.  (Read more)