VA lung cancer screening saves lives: Dr. Martin Edelman

I want to talk about our veterans right now, and for a lot of veterans, protecting their health after service means understanding the risks that they may not be able to see. Smoking history, potential military-related exposures to things like burn pits, Agent Orange, asbestos, other hazardous substances can increase their chances of lung cancer, a disease that often develops without any obvious symptoms. Joining us now, Dr. Martin Edelman, thoracic medical oncologist, chairman of the Department of Hematology, Oncology at Fox Chase Cancer Center up there in Pennsylvania. Dr. Edelman, so good to have you this afternoon. Why are veterans needing to be particularly proactive here when it comes to cancer screenings, even if they feel perfectly healthy and they have no symptoms? So thank you for that question and good afternoon. We'll Veterans, like others, if they're at risk for lung cancer should be screened. We've demonstrated that be lung cancer screening saves lives. So veterans have a higher than normal incidence of or typical right Thank you. To begin with, and we know smoking is the overwhelmingly major cause of lung cancer, back. but they also have exposures to other things such as asbestos, radiation that are known carcinogens, as well as suspected carcinogens like burn pits. So therefore, I think veterans are at particular risk for lung cancer. They need to make their providers aware of that. We know that lung cancer screening unquestionably saves lives. A little known fact is that screening for lung cancer What about the risks? Doctor, of getting screened, a lot of people are afraid to get things like x-rays and tomography exams for fear of the radiation itself. Is that risk so small that it's not worth worrying about it if you're trying to screen for a serious condition like cancer? Yeah, the risk is really infinitesimal. If you look at what I said about it, low dose, that means low radiation dose CT screening, very low radiation dose, the benefits definitely way exceed the risks. So I'm going to take a few minutes We've done the randomized phase three study, to talk about the risks. and it showed that screening for lung cancer clearly saved lives. So any minuscule increase in risk from radiation is more than outweighed for the potential benefits in the appropriate population. Veterans administration doctor did a study that you're familiar with finding that three-year lung cancer survival rates among veterans treated within the VA system more than doubled. All right, so some good news from the cancer front. My question is what's driving the improvement and what should veterans sort of take away from that study? That study demonstrated that veterans were doing much better than they were before and that goes along with improvements in the general population. This is a result of more patients being detected by screening, which means lower stages of lung cancer, as well as increasingly effective and less toxic treatments for lung cancer, which mean that even patients with the most advanced disease still benefit substantially in terms of survival from treatment. Treatment of lung cancer has really become a team sport. You need to integrate the efforts of primary care physicians, radiologists, medical oncologists, radiation oncologists, and others in order to get the optimal results. The VAs, about three-quarters of them are part of academic medical systems. These groups tend to have much more organized teams and clear metrics. For success and improvement that are usually not seen at a typical community hospital and what was demonstrated in that study was that the outcomes in the VA system were better than that in the community. What about veterans who may have had a history on the front lines overseas exposure to things like asbestos, hazardous materials and sort of military or combat? So we don't completely know or understand the increase in relative risk of lung cancer. in these groups but certainly we need to know about that. The VA has a program that specifically looks at these issues of exposures and trying to figure out how much that increases the risk over the baseline population and the smoking population. So the best way to do this is to make sure that one's health care provider is aware of these risks and particularly if one is in the VA participating in the program that assesses these risks. All right. And I'm assuming that with all cancers, the earlier you can detect it, the better your chances are for treatment and survival. Dr. Martin Edelman, thoracic medical oncologist, the chairman of the Department of Hematology Oncology at Fox Chase Cancer Center up in Pennsylvania. Doctor, thanks so much for joining us this afternoon. Thank you.