1954

For reasons that will become clear as you read on, I am devoting this issues column to delivering an urgent message to all classmates, their loved ones and friends who are or ever have been smokers: It is essential for you to get an annual chest X-ray or CT scan.

Here are some facts that many of you are probably familiar with: Lung cancer is the world's top cancer killer, with about 175,000 Americans diagnosed with this pernicious disease every year; only 16 percent of cases in the United States are detected in stage 1, when tumors are still confined to the lung; smoking is responsible for 87 percent of all lung cancers, according to the American Lung Association. Clearly, early detection of lung cancer can save lives.

Here's a report from Hugh Roberts: "Three and one-half years ago, when I had my left hip replaced, my internist, knowing that I was a smoker, brought in a pulmonary specialist to keep an eye on me. After the hip operation I had a CT scan every six months, followed by a consultation with the specialist. At first a small 'insignificant' spot showed on my right lung. Last June we weighed the idea of a needle biopsy more carefully and decided to put it off for another six months. Then the December scan showed more activity and we did the biopsy. The rest is history—a serious and protracted operation, but a successful one." Hugh was lucky and credits his internist with saving his life. Happily, Hugh's pathology report indicates the complete removal of the malignant tumor. He concludes: "Obviously, based on my recent experience, I wholeheartedly agree with the need for an annual chest X-ray or, preferably, CT scan. This would especially apply to those of us who smoke or smoked in the past, no matter how long ago we ceased."

In mid-March, at this writing one month ago, my beloved Sonja was diagnosed with advanced lung cancer. A chest X-ray that she requested in conjunction with a routine annual physical exam revealed a suspicious mass in her right lung. A CT scan, needle biopsy and surgery followed in short order, and Sonja will soon begin chemotherapy at New York's Memorial Sloan- Kettering Cancer Center. Sonja's last chest X-ray, prior to the most recent one, was taken in mid -2004, and it was during that close to three-year gap that the undetected tumor grew without anyone's awareness. Had it been spotted and treated earlier, as was Hugh's, chances are it would have been caught in time to remove it completely. Yes, Sonja was a pack-a-day cigarette smoker for more than 30 years and stopped smoking in 1986.

Cost and radiation emissions are reasons frequently advanced by doctors for not recommending annual chest X-rays, given the relatively low incidence of lung cancers discovered as a result of the screening process. The debate continues as to whether early detection results in lower lung cancer mortality rates. Well, let the debate continue. But if you've ever smoked, just be sure to get an annual chest X-ray or CT scan.

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