Finding Lung Cancer Early, Before Symptoms Appear

We sometimes discover lung cancer after a radiologist sees a concern unrelated to the reason your doctor ordered an imaging study. This is known as an incidental finding. Our multidisciplinary Pulmonary Nodule Advisory Board reviews these findings, and if the group recommends follow-up, we let your primary care provider know.

Medical research and innovation have led to advancements in lung cancer treatment that make it easier to control the disease — even in later stages. Still, the most effective path for a positive outcome is early detection and treatment.

“At Doylestown Hospital, our goal is to find lung cancer early," says Gina Smith, Director of the Doylestown Hospital Cancer Institute. 

The Early Detection Difference

As it stands, only about 6% of people in the nation who are at high-risk for lung cancer are screened, according to the Centers for Disease Control and Prevention (CDC). Consequently, we find most lung cancers after symptoms occur, when the disease is more advanced and harder to treat.

According to the National Cancer Institute (NCI), about 40% of new lung cancers are stage IV, when the five-year survival rate drops to 10% or less. In contrast, the five-year survival rate for stage I lung cancer is over 92%, according to a study in the journal “Chest.”

"Educating our patients about risk factors and early detection is vital to the health of our community and our mission," says Gina, noting that early screening happens in two ways.

Low-Dose CT scan

Right now, the only recommended screening test is a low-dose computed tomography scan (LDCT) for people at high risk for lung cancer. Using a lower radiation dose than a traditional CT scan, this test is for current and former cigarette smokers who meet certain requirements.

The American Cancer Society (ACS) released an update of its lung cancer screening guidelines on November 1, 2023, to help reduce the number of people dying from the disease due to smoking history. The new guideline recommends yearly LDCT screening for people who:

• Have a 20 pack-year or more smoking history

and

• Smoke now or formerly smoked

and

• Are between 50 and 80 years old

We recognize that other societies may offer different guidelines for lung cancer screening. Talk with your primary care provider about whether screening is right for you. Discuss your smoking history and risk factors as well the as the known benefits, limitations, and potential harms linked to lung cancer screening. We also suggest checking with your health insurance provider regarding your lung cancer screening coverage.  

Incidental Finding

A second way doctors discover lung cancer earlier is an incidental finding, meaning the radiologist sees a concern in your imaging study that is unrelated to the reason you had the test.

“We call this an incidental pulmonary (lung) nodule, and it means the radiologist spotted an area in your lung that is denser than normal lung tissue. This can appear as a shadow, a spot, or a mass on your lung,” explains Gina. That’s where the Doylestown Hospital Pulmonary Nodule Advisory Board (DH-PNAB) comes into the picture.

About Our Pulmonary Nodule Advisory Board

“A program for early detection and management of lung cancer, the DH-PNAB is designed to provide redundant layers for patient safety,” says Gina. Meeting every other week, the multidisciplinary team includes Pulmonology, Radiology, Radiation Oncology, Medical Oncology, Primary Care, our nurse navigator, and Cancer Institute director.

"The team functions solely in an advisory role to the primary care provider (PCP) and not a direct care provider," Gina explains. "Based on the review of the incidental finding and recommendations by the multidisciplinary team, your PCP is notified. While the majority of these findings are benign, our goal is to optimize management of all pulmonary nodules to improve patient care and continue to increase the quality of healthcare delivery.”

Your PCP will notify and work with you to determine next steps.

The Bright Side of an Incidental Finding

From Early Detection to Diagnosis and Treatment

As a Nationally Accredited Community Cancer Center by the American College of Surgeons Commission on Cancer, Doylestown Hospital is a resource for high-quality cancer care.

“Our hospital employs a multi-pronged approach to lung cancer care. In addition to our suspicious nodule advisory program, we have a well-established lung cancer-screening program and nurse navigation, genetic counseling, survivorship nurse practitioner, and a social worker with resources supported by Doylestown Hospital and community partners,” says Gina.

We offer the most advanced technology for early lung cancer screening and diagnosis in the region. Our team uses the minimally invasive robotic-assisted bronchoscopy called the ION Endoluminal System, to find and biopsy smaller, early-stage lung cancer nodules, according to Carlos Sotelo, MD, an interventional pulmonologist who diagnoses and treats conditions of the lungs. 

“Early-stage lung cancer can be challenging to diagnose because the tissue samples need to come from hard-to-reach areas deep within the lung,” says Pinak Acharya, MD, pulmonologist. The ION features a thin, moveable, camera-equipped catheter that works with the robotic platform. A computer-generated path guides us in moving the catheter through small, difficult-to-navigate airways and around tight bends to reach all 18 segments of the lung. This technology allows our doctors to locate, biopsy, and mark nodules for surgical resection in one, minimally invasive procedure.

If surgery is recommended, our cardiothoracic surgeons use the da Vinci® robotic-assisted surgical system to remove tumors precisely, performing complex surgeries through tiny incisions. 

Build Your Lung Cancer Awareness

Prevention remains the best defense against lung cancer. Smoking is the main risk factor.

• Avoid smoking and second-hand smoke as well as other forms of tobacco. If you need help, our Community Outreach team can connect you with tobacco cessation assistance, classes, events, and screenings.

• Be aware of the risk factors for lung cancer and avoid lung cancer-causing agents such as asbestos and radon.

• Speak openly with your doctor about your smoking history and discuss whether early screening is right for you.

Lung Cancer Symptoms

Inform your PCP if you experience lung cancer symptoms, which may include the following:

• Coughing that is persistent, gets worse, or will not subside; approximately 50 percent of people with lung cancer experience coughing as a primary symptom
• Coughing up blood
• Chest pain that is new or unexplained
• Feeling exhausted or extremely tired all of the time
• Hoarseness of voice
• Pneumonia or recurrent pneumonia
• Shortness of breath
• Swollen glands or lymph nodes in the chest area near the lungs
• Unexplained weight loss
• Wheezing

Learn More

For information visit Lung Cancer Services at Doylestown Hospital or contact our Cancer Institute by calling 215.345.2489.  

Further Reading

• For more information on lung cancer screening for high-risk individuals, visit the American Lung Association.

• Learn more about lung cancer screening from the Centers for Disease Control and Prevention.