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High Risk Lung Cancer Screening

John Miltier

Two big steps: Getting a lung scan and quitting tobacco

Sentara High Risk Lung Screening

John Miltier, 72, knew it was time to quit smoking.

“I want to live a few more years,” he jokes, “and my daughter’s been on me to quit.” And with good reason.

John’s wife, Dorothy, died in 2010 from mesothelioma, a lung cancer tied to asbestos exposure.  John is a retired sheet metal mechanic and general foreman from Norfolk Naval Shipyard.  Asbestos fibers clinging to his clothes infiltrated Dot’s lungs over the years when she shook out the laundry, eventually causing cancer.  Her father also worked in a shipyard and John wonders if her exposure started in childhood.  John could just imagine his own cancer risk, between pack-a-day smoking and decades of direct exposure to asbestos at work.  After retirement, a routine physical led to a diagnosis of pleural plaques, a form of asbestosis in his lungs.  The plaques themselves do not necessarily lead to lung cancer, but, a lifetime of smoking adds greatly to the risk that they will.

“I was just worried,” John says.  

He found an answer in a newspaper advertisement about the Sentara High Risk Lung Screening initiative.  It invites long-time smokers, age 55 or more, to see if they meet criteria to receive a low-dose CT scan of their lungs.  Patients like John, with no cancer symptoms, pay $250 out of pocket.  However, certain health plans are starting to cover the cost of the initial scan for high-risk patients who meet criteria, following new recommendations by the National Preventive Services Task Force. 

John called program coordinator Robin McClelland, RN, and found out he met criteria, which includes a 30-year history of pack-a-day smoking and, in John’s case, workplace exposures to certain carcinogens.  He had a low-dose CT scan performed and soon received a letter informing him that he had a nodule in one of his lungs that required additional attention.

“They’re usually benign,” he says, “but they wanted me to follow up with my doctor and get a second scan after six months.”

He’s had that second scan and plans to stay on top of his health in the future, armed with new knowledge of his baseline health.

“It was well worth the money,” John says.
To quit: discipline and medicine

John quit smoking on December 17, 2012. To help him quit, John chewed nicotine gum for about two months and his doctor recommended a prescription for Wellbutrin® (buproprion,) an anti-depressant which can also help smokers quit by reducing the cravings, irritability, anxiety and other symptoms that come with tobacco withdrawal.

 “The gum is expensive,” John says, “but it’s no different than buying a carton of cigarettes every week.”

John’s been tobacco free for more than nine months.  He's 'backing off' Wellbutrin because he thinks he can stay off tobacco on his own.  He sleeps better, he says, and breathes better, without the ‘growling’ he used to hear in his own lungs.  However, there are still temptations.  John joined a shag club and goes dancing with newfound friends, most of whom don’t smoke, but old habits die hard.  “One of the hardest times is socializing,” he says.  “But if I’m tempted (to smoke,) I tell myself, ‘Just don’t do it.’”

More resources:
High Risk Lung Cancer Screening at Sentara
Sentara Cancer Network

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