Friday, May 25, 2018
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‘Smokeout’ a perfect opportunity to focus on lung health


James Willey, M.D., is professor of medicine and pathology in the pulmonary and critical care division at The University of Toledo and director of the Cancer Research Center.


This is one in a series of columns about health issues written by staff members of ProMedica, Mercy, Toledo Clinic, and the University of Toledo Medical Center, the former Medical College of Ohio.

It’s too easy to say, “I’ll quit tomorrow.”

I’ve heard those words countless times from patients who smoke, as I’m sure their families and friends have. With the Great American Smokeout this week, we can make that abstract idea of “tomorrow” on Thursday.

The American Cancer Society marks the third Thursday of November each year as a set date on the calendar to encourage smokers to quit or make a plan to quit. It gives you a deadline to commit to and occasion to celebrate the effort. Take that opportunity.

Despite the negative health impacts, 43.8 million Americans still smoke cigarettes. That’s nearly one out of every five adults in the country. Smoking is responsible for one in three cancer deaths. And lung cancer specifically is the most common cause of cancer death in both men and women, killing more per year than the next three cancers combined: prostate, breast, and colon.

In 2013, the American Cancer Society estimates 228,190 new cases of lung cancer and more than 160,000 deaths from lung cancer. I wish the diagnosis was more promising for more people.

The reason lung cancer is so deadly is that it typically is not caught early enough to be cured by surgical means. The reason for this is that it does not cause symptoms until it is very advanced. The Lung Nodule Clinic at the Eleanor N. Dana Cancer Center at The University of Toledo Medical Center is one of a growing number of efforts to address that concern.

A lung nodule is a spot on the lung, usually about 1.5 inches in diameter or less. And while most are harmless and don’t impact health, nodules also can indicate serious conditions including lung cancer. Most of these nodules are discovered during an X-ray or CT scan for another purpose.

Receiving a test for one ailment and then learning of an unexpected spot on your lungs can create a lot of anxiety as you wonder if it’s a benign tumor or something more serious. At the same time, once a spot is discovered it generates a challenge for physicians as they need to decide whether to do a follow-up CT scan, a PET scan, which better distinguishes between lung cancer and benign conditions, or biopsy or removal of the nodule.

A benefit of the UTMC Lung Nodule Clinic is that physicians and other care workers with considerable experience work as a multidisciplinary team to ensure that the most efficient and effective means are used in diagnosing and managing lung nodules to get the answers you want and need. If treatment is required after a specific diagnosis is made, it is important that a multidisciplinary team quickly designs a treatment plan and key specialists and treatment programs are present in a single facility for patient comfort and convenience.

In a recent study sponsored by the National Institutes of Health which enrolled 50,000 participants at risk for lung cancer due to age and smoking history, it was determined that screening for lung cancer with an annual chest CT led to earlier diagnosis and that this reduced mortality from lung cancer by 20 percent. Annual CT screening for lung cancer is now recommended by several major health care organizations, including the American Thoracic Society (ATS), the American Cancer Society (ACS), and the National Comprehensive Cancer Network (NCCN).

UTMC, the former Medical College of Ohio, has established a Lung Cancer Screening Program under the umbrella of the International-Early Lung Cancer Action Program. The UTMC Lung Cancer Screening Program has been recognized as the only program in northwest Ohio that meets the guidelines established by the by Lung Cancer Alliance, a national advocacy group. UTMC also is among a select group of academic medical centers within the Midwestern Lung Cancer Screening Consortium.

If there is a concern regarding your lungs, help is available. But you can help yourself now. Take advantage of the Great American Smokeout and make a plan to quit smoking.

The first step is to set a date. Don't leave it as the obscure "tomorrow," but mark it on a calendar and tell family and friends to have a support system in place ahead of time. Prepare for the day by making a plan that could include nicotine replacement therapies or not, and get rid of cigarettes and ashtrays. Some find it helpful to stock up on oral substitutes like gum.

When your quit day comes, don't smoke at all — not even a couple puffs, keep active, drink a lot of fluids, and avoid situations where you would be tempted to smoke. When you get the urge, I ask patients to wait 10 minutes and hopefully the urge will subside, and if not there are nicotine replacement therapies to try instead of going back to cigarettes.

There is no fail-safe method and different people respond differently to various methods. But the first step for every person is making the decision to quit and sticking to it.

Within hours and days of quitting smoking, your heart rate and blood pressure drop and the carbon monoxide levels in your blood returns to normal. In just weeks your circulation improves and lung function increases and within months coughing and shortness of breath decreases.

Take advantage of the Great American Smokeout. Quit and visit​healthy/​stayawayfromtobacco/​greatamericansmokeout for tips to help you quit. Don't wait until tomorrow. Do it today.

James Willey, M.D., is professor of medicine and pathology in the pulmonary and critical care division at The University of Toledo and director of the Cancer Research Center.

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