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Early-Warning System?
Supporters Claim Test can Catch Lung Cancer Early

Azerrad audio Listen to Richard Knox's Report

Sept. 1, 2001 -- Lung cancer kills more people each year than breast, colon and prostate cancer combined. More than 90 million Americans are at risk, mostly from smoking. But what if there were a test, like a mammography or a Pap smear, that could detect lung cancers when they're tiny and potentially curable?

As NPR's Richard Knox reports, a controversial early-warning test called spiral CT, a sensitive type of CAT scan, is gaining support among some medical professionals, and loud criticism from others.

book cover

Eileen Murphy with her son Christopher. At 40, she's been smoking for 30 years, and fears lung cancer.
Photo: Richard Knox, NPR

As doctors debate, more Americans are seeking spiral CT. Knox introduces us to one woman who's so worried about lung cancer that she's decided to get the test to find out if her lungs contain the seeds of the deadly disease.

Before she took her test, Eileen Murphy's fiancé Dennis Carson had the attitude that maybe it's best not to know some things. But Eileen felt she needed to go through with it. "I'm 40 years old," she says. "I've spent probably 30 years of my life smoking. I don't think I'd know what to do with myself not picking up a cigarette. That's kind of scary in a way."

Eileen's boss, cancer specialist Terry Mulvey, would like Eileen to quit smoking, of course. But she's a booster of the spiral CT. It uses x-ray detectors that spin around the patient's body, making a spiral image of the patient's inner geography. More than half of the hospitals in America use it for a variety of diagnostic tests.

Many experts are highly skeptical as to its ability to detect early cancers. But supporters like Dr. Claudia Henschke are working hard to defeat that skepticism. She's working through the lung scans of 10,000 New Yorkers, hoping to have them all scrutinized by year's end.

A study she published two years ago attracted international attention by suggesting that spiral CT catches cancer early. Among 1,000 smokers and ex-smokers, she found 27 with early-stage lung cancer. Many of them had successful surgery and remain cancer-free today (she won't give a precise number until she's followed them for a few more years).

But Dr. Ned Patz, a professor of radiology at Duke University Medical Center, says spiral CT still needs to be proved. "It's premature that we are promoting it and we're suggesting patients have a test which has not been validated at this time," he says.

As with much that happens in medicine these days, especially where a major, deadly disease is concerned, marketing is playing a big role in spiral CT - however effective it may be. One recent newspaper ad for a Connecticut hospital plays on public fear: "Put your mind to rest with a simple test."

To learn more, and to find out if Eileen's mind was put to rest, give a listen to Knox's story.

Other Resources

The Early Lung Cancer Action Program