Anecdotally, as an ex-smoker who quit after my mother died from lung cancer, I spoke to my doctor about screening. He did a lot of dismissing and hand waving about it. It upset me greatly at the time. This article explains it all well enough. Doctor/patient communication is very important.
How long did you smoke? My own anecdote: I was athletic when I was younger, but I was a regular smoker through most of my twenties. I quit a few years back. My doctor would check my breathing, etc, with everything I'd told him about my habit. He gave me the surprising news that my lungs would be virtually back to virgin health in 4-5 years (after nearly 10 years of smoking). And to get back to exercising more.
Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
71–80 of 94 posts
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#72Earlier quoted context omitted.
This could be the most controversial thing comment I've posted on here, but...: Why are we even spending resources figuring out how to extend the lives of people who have smoked a pack a day, for 30 years, and are currently in old age? Even if we find cancer and save their lives now, will that prevent then from picking up smoking again? Will it prevent the heart disease they're going to encounter ten more years down…
Most diseases have some human choices involved. Living in a city with bad smoke, not running every day, poor diet, or drinking. Maybe you're perfect and run every day, living in the country side, only eat fruits and vegetable and have never had a cigarette or beer your entire life. But most of us aren't perfect. And honestly if you are the perfect specimen you are going to cost society far more because everyone dies…
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#73Earlier quoted context omitted.
This could be the most controversial thing comment I've posted on here, but...: Why are we even spending resources figuring out how to extend the lives of people who have smoked a pack a day, for 30 years, and are currently in old age? Even if we find cancer and save their lives now, will that prevent then from picking up smoking again? Will it prevent the heart disease they're going to encounter ten more years down…
One of the truisms of medicine is that ultimately every disease and every treatment has a 100% mortality, so we can never truly save a life. What we can do is promote the quality and quantity of life. In the US, the rule of thumb is that it's worth spending $50,000 to keep someone alive for a year, with that being the approximate cost of dialysis therapy. So, to save 10 years of life would be expected to be worth spe…
I am stating that people who are presumably in some way responsible for their disease are not MORE worthy of care. It is only these people who are receiving free screenings - as per the article.
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#74I've watched my family go through smoking, and cancer hasn't been the issue. I don't know how representative it is, but my experience definitely reflects the premise of this article: cancer testing could have caused way more harm than good. Both my mother and her father were still smoking frequently when they were on oxygen. In other words: When they should have known better. Her mother was looking really bad at 50 a…
This could be the most controversial thing comment I've posted on here, but...: Why are we even spending resources figuring out how to extend the lives of people who have smoked a pack a day, for 30 years, and are currently in old age? Even if we find cancer and save their lives now, will that prevent then from picking up smoking again? Will it prevent the heart disease they're going to encounter ten more years down…
Are those people really that old?
Imagine if you started smoking at 13 (which is pretty common). If you smoked for 30 years, now you're 43. If you potentially live to ~80, you've barely passed the half way mark.
Not only that but someone at 43 is likely still working and paying taxes, so they are putting money into the system and could potentially be doing that for another 20ish years.
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#75Earlier quoted context omitted.
Most diseases have some human choices involved. Living in a city with bad smoke, not running every day, poor diet, or drinking. Maybe you're perfect and run every day, living in the country side, only eat fruits and vegetable and have never had a cigarette or beer your entire life. But most of us aren't perfect. And honestly if you are the perfect specimen you are going to cost society far more because everyone dies…
I think you're oversimplifying the situation. Alzheimers could be caused by human choice and 40 years of human life has more than monetary value.
And cardiovascular disease and exercise definitely seem to influence Alzheimers. Nigerians for instances have high rates of APOE4 but very low rates of Alzheimers and I think the reason is they also have very low levels of cholesterol.
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#76Earlier quoted context omitted.
This could be the most controversial thing comment I've posted on here, but...: Why are we even spending resources figuring out how to extend the lives of people who have smoked a pack a day, for 30 years, and are currently in old age? Even if we find cancer and save their lives now, will that prevent then from picking up smoking again? Will it prevent the heart disease they're going to encounter ten more years down…
> Why are we even spending resources figuring out how to extend the lives of people who have smoked a pack a day, for 30 years, and are currently in old age? Are those people really that old? Imagine if you started smoking at 13 (which is pretty common). If you smoked for 30 years, now you're 43. If you potentially live to ~80, you've barely passed the half way mark. Not only that but someone at 43 is likely still wo…
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#77Earlier quoted context omitted.
> Why are we even spending resources figuring out how to extend the lives of people who have smoked a pack a day, for 30 years, and are currently in old age? Are those people really that old? Imagine if you started smoking at 13 (which is pretty common). If you smoked for 30 years, now you're 43. If you potentially live to ~80, you've barely passed the half way mark. Not only that but someone at 43 is likely still wo…
The benefit is only for those from the ages of 55 through 77 per the second sentence of the article.
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#78Earlier quoted context omitted.
Honestly curious: are most radiologists actually following guidelines like Lung RADS in practice, especially just after publication? Is it part of any standardized CME? It's my impression that there's often a big gap between ACR best practices and what's happening on the ground in most places, which was a key point the doctor in the article was making.
Adoption of Lung-Rads is essentially required to be designated as an ACR screening center. To be reimbursed for Lung Cancer Screening, you must provide registry data to CMS (the registry is run by the ACR). It's not codified into Federal Law, but if reimbursement requires a Lung-Rads code, then it's more or less mandated. I'd argue out of all the fields of medicine, Radiology is pretty quick to adopt new technology o…
Re: Why Some Doctors Hesitate to Screen Smokers for Lung Cancer (2015)
#79Earlier quoted context omitted.
I thought the 7.3's were supposed to be super solid? How many miles does it have, what's wrong with it? My extremely limited knowledge of diesel engines is something like "they go a ton of miles, then need a major overhaul, then go a ton more miles". If you're at some kind of major overhaul milestone, then I could see the response you're getting. '99-ish Ford kicked off the Super Duty series, but it isn't sufficientl…
It's nearing 400k miles. It's had service - new turbo and engine control components, suspension and frontend, brakes, glow plugs, etc. Original everything else though, nothing fancy, just a work truck. But anything "newer", even 10 years old, is $25k minimum for any halfways decent duty truck.
Newer trucks aren’t more reliable. They’re just newer. You won’t find a truck cheaper to maintain than the one you’ve already got.
(The people who tell you your truck ain’t worth fixing sound like my mother in law who traded in her car ‘cause the windshield wipers broke.)