If you are fifty years old or above, and you are a current or former smoker, you should get a lung scan. This has been recommended since the 1990s so maybe I was just out of the loop, but I had no idea. Neither did my forty-something former-smoker daughter and her current-smoker husband. Hence this post.
A scan is no big deal. Your biggest problem might be parking, depending on where you go. You lie down on a cot that pulls you into the CT scanner. An electronic voice tells you to hold your breath, then you're pulled out of the machine and the voice tells you that you can breathe again. You'll probably go in two or three times. That's it. No undressing. No boob squishing. No turning your head to cough. You'll get your results through your provider's portal. If there's something significant, your doctor will let you know.
They found something in mine, a 'nodule'. They didn't say 'tumor', just 'nodule'. Not all nodules are cancerous. Not all tumors are cancerous. I went back for a CT scan with contrast. Or maybe it was an MRI. I know I had both in the weeks following the initial scan, I'm just fuzzy now on the order of things. The 'nodule' was identified as cancerous very early on. It was fairly sizeable, 5.3cm x 4.8 x 4.8, which translates roughly to 2" x 2" x 2". Fortunately, there were no other 'nodules'. It hadn't spread. I had a biopsy, a breathing test, a bronchoscopy, and a PET scan after that, and an MRI specifically for my head since lung cancer likes to spread to the brain. I had no idea that different cancers had preferred secondary sites. Cue the star and 'The More You Know' music.
Just a note here: I thought that being out of breath, coughing a lot, phlegm, and being tired were all signs of cancer, and I think they are, but my breathing test - that one where you breathe into a tube and the tech keeps saying, 'Blow, blow, blow, blow...' - said that I have moderate COPD. I was prescribed inhalers, two for every day, one for as-needed, and those symptoms decreased measurably. So, I'm led to believe, and this is just me, that cancer in its earlier stages doesn't have significant symptoms that will send you running to your doctor. Just FYI.
My oncologist discussed potential surgery with me, but I'm older, I'm overweight and out of shape, and I have COPD. Oh, and I'm low-key superstitious, and talking about friends and friends of friends who have died during operations, made me a little leery of invasive surgery. It didn't help that this discussion took place a week after the bronchoscopy which was really hard on me and only involved a tube down the throat and into the mid-chest area to check on lymph nodes. So I declined. I was also nervous that the tumor would get bigger in the intervening time and possibly start spreading. I wanted to get going on whatever they were going to do to me.
The PET scan, aka 'positron emission tomography'. Boy. It takes forever, or at least it seems like it does. You get a shot of what I call 'radioactive sugar' and you wait an hour or so while this goes through your body. The idea is, your organs use sugar to operate but they only use a little sugar so their intake is minimal. The sugar, with the radioactive stuff, shows up as light on the scan and is measured numerically, with most organs giving off light at under a 3 of whatever scale they're using. Sorry, it's been months. I don't recall all the technical details. Most cancers eat sugar like a kid at the fair and show up in the double digits of this scale. For me, my tumor showed an impressive 31-point-something while my organs gave off paltry 2.5s and I think one 3. After the hour wait, you're taken to either a CT machine or an MRI machine and placed on its cot. They ask if you want to be strapped in. Say 'yes'. This keeps your arms still for what might be more than half an hour on the slab as it pulls you slowly through. You will be radioactive so they advise you to stay away from small children and pregnant women for another hour or more after your scan. Funny detail: they do want you to use the bathroom before the scan starts because it does take a good while. The bathroom you use has a sign outside the door reading, 'hot restroom'. I just thought that was funny.
After the tests are out of the way, you get a therapy plan. Mine was for six weeks of chemo-radiation therapy. I sat in the infusion room, along with others, once a week for about three hours, with my own concoction of chemotherapy dripping into my arm. After chemo I trundled up to radiation where I had targeted radiation aimed at my tumor. They get you ready in the weeks before radiation begins by setting the machine to aim right at your tumor. These techs put lines on you and cover the lines with clear plastic dots. Leave them on! Those lines tell the machine where to aim. If you do take them off, or one or three fall off in the shower, they can figure things out, but it takes less time if you just leave them on. I had radiation five days a week.
Did I lose hair during chemo? Yes. Not all of it, no smooth baldy here. And I didn't just lose it on my head. My forearms were pretty sparse. Just know that wigs are a thing and so are headscarves and hats, and hats with hair hanging down. There are places, both physical and online, that cater to people in chemo.
Once the chemo-radiation therapy is over, you have a CT scan and your oncologist discusses what to do next. I'm now in immunotherapy. For me, this is 26 sessions spread over a year. I'll be done sometime next spring. I go every other week and sit in the same infusion room, on a generic recliner, just like in chemo, and have my personalized infusion dripped into my arm. I should mention that, for all of these infusion therapies, you have a blood test before the treatment that determines the make-up of your treatment juice. I see my oncologist once a month, and every third month I get a CT scan. The tumor is shrinking and its edges are no longer well-defined, which is a good thing, I'm told. :)
Treatments are different for each person. This is just how my therapy works. And when you're finished with your therapy, you ring the bell. It's a literal bell. It tells everyone in the place that your treatment is over and you're starting on a new phase of life. You don't have to if you don't want to. I did after my chemoradiation therapy, and I probably will after immunotherapy.
I'm writing this because I had no idea I was supposed to be scanned once a year. I was eighteen years above the recommended start age for the scan when my current primary care physician, a physician's assistant, asked offhandedly if I'd had a lung scan lately. I asked why. She said it's because I'm a smoker and should have been getting one for the last eighteen years. I've had several PCPs in the last twenty years or so and she was the first ever to ask. I'm a little miffed that I wasn't advised sooner. The tumor would have been significantly smaller and easier to treat if this had been done. IMO, of course. Tumors grow fast. Maybe it would have been the same either way. But, I didn't know. My daughter and her husband didn't know. My best friend didn't know, and she's my age. I can only assume that we're not the only ones who have no idea about this. So, if you're a smoker or former smoker, and you're fifty or above, tell your doctor that you want a lung scan. It could save you a lot of grief.
Some links: