November 28th, 2022

Prairie Doc Perspective the Week of November 27th, 2022                            
​"Lung Cancer Screening Saves Lives"
By Daniel G Petereit, MD, FABS, FASTRO
This year nearly 250,000 patients will be diagnosed with lung cancer and 130,000 will die from it. In SD, 660 people will be diagnosed and over 400 will die from the disease. Lung cancer accounts for the most cancer deaths in both the US and in SD.
Smoking is the most important risk factor for lung cancer and accounts for 80% of lung cancer deaths. Although smoking rates continue to decline in the US, in SD there are many rural and tribal communities where the smoking rates are still 20-40%. These patients continue to be at risk for developing and dying from lung cancer. The Lakota Sioux have the highest lung cancer death rates in the nation at 95%.  
Lung cancer screening with low-dose computed tomography (LDCT) has been demonstrated to reduce lung cancer death rates by detecting earlier stages of cancer with relatively high cure rates – similar to other screen detectable cancers such as cervical, prostate, breast and colorectal. An LDCT is a five-minute, outpatient CT scan performed without IV contrast and has minimal radiation exposure. The current recommendations are for healthy adults ages 50-80 with a 20 pack year smoking history or who have quit within the last 15 years.  
Unfortunately, many SD patients are at risk, and are unaware of the value of an LDCT. In SD, there are at least 30,000 patients who are eligible for this test.
If patients are diagnosed with early stage lung cancer, surgery is the standard treatment with high cure rates.  If patients are not surgical candidates, they can be safely treated with 4 to 5 radiation doses, called stereotactic ablative radio-surgery, with essentially no side effects and also very high cure rates. This specialized form of radiation is offered at most cancer centers in SD.
To address the high lung cancer death rates among the Lakota Sioux, we implemented a lung cancer screening navigation program on the west river reservations in an attempt to lower these death rates as part of an ongoing program called Walking Forward that has been in existence since 2002.  This is a community-based program based in Rapid City with staff who live and work in their communities of Pine Ridge and Rosebud. The overarching program goal is to lower cancer death rates for Lakota Sioux, through patient navigation, access to cancer screening and early detection and state of the art cancer treatments. To date we have referred over 420 patients for an LDCT with over 335 completed scans. 

So, if you are a smoker: 1) try to quit; 2) if you are a candidate for lung cancer screening talk to your primary care provider about an LDCT, and 3) for the younger generation – don’t start smoking!

Bottom Line:  lung cancer can be successfully treated if caught early – get screened if you are eligible.