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New lung disease clinic reaching out to current, former smokers

Weekly program hopes to raise awareness, focuses on early detection

By CHERIE BLACK

P-I REPORTER

A new clinic at Seattle Cancer Care Alliance is looking to help current and former smokers test for possible lung problems or disease in an effort to begin early detection and awareness about lung cancer.

The weekly clinic, which opened Friday, also offers screenings for bronchitis, cardiovascular disease and oral cancers. It is the first clinic of its kind in Seattle dedicated to lung disease and prevention, said Dr. Jason Chien, a pulmonary and critical-care specialist at SCCA who directs the new clinic. He said more than 60 percent of lung cancer cases in Western Washington occur in former smokers.

Dan DeLong / P-I

Janet Cothrell and Dr. Jason Chien, background, observe a patient as she breathes into a spirometer to measure her lung capacity Friday at the Seattle Cancer Care Alliance.

Lung cancer is the second most common cancer in both men and women, but is the leading cause of cancer death among both, according to the American Cancer Society. More people die of lung cancer than of colon, breast and prostate cancer combined.

"The need (for this clinic) is simple -- people getting lung cancer are people who otherwise think they are no longer at risk for the cancer -- former smokers," he said. "When a smoker quits, the absolute risk will never decrease. It's fixed at the time they quit smoking."

At the clinic, patients meet with a physician for a complete exam, including a lung function test and, if necessary, a CT scan of the lungs or additional tests for bronchitis or heart disease. The exam costs between $600 and $900, and may be covered by insurance depending if the patient has obvious smoking-related lung symptoms before the exam.

Smokers coming to the clinic who want to quit are referred to the SCCA Smoke Free Life Program. Patients whose primary-care doctors have discovered a lung nodule during a routine chest X-ray can also be seen for further tests.

A team including a pulmonologist, thoracic surgeon, chest-CT expert and nuclear-medicine specialist will evaluate patients referred because of lung nodules. If a tumor is diagnosed, the team will help with the next step, such as meeting with an oncologist or a surgeon.

Chien said it is more likely that smoking-related respiratory diseases such as emphysema will be found during an exam than cancer. But he said a main goal of the clinic is early diagnosis. There are no standard methods for early detection of lung cancer, unlike for breast or prostate, and 90 percent of those diagnosed die within five years because they were diagnosed too late, he said.

There also aren't a lot of research dollars going toward lung cancer research, partly because of the stigma that smokers bring the disease upon themselves, Chien said. The Seattle clinic will devote some of its resources to research, using patient volunteers as they visit the clinic.

"Based upon what we know about early versus late stage lung cancer, we believe that early detection of lung cancer should extend life. If you are looking for biomarkers that can detect early stage lung disease, who do you study? People who smoke," Chien said.

"The only way to end the majority of lung cancer cases that we see today is for everyone to stop smoking. Realistically, that's unlikely to happen, and even if it does, lung cancer will still be a major health problem in the foreseeable future because former smokers remain at risk for lung cancer.

"So the alternative is to reach people at high risk much earlier to try to identify the cancer earlier, or identify people at highest risk for the cancer."

IF YOU GO

To make an appointment for the Lung Cancer Early Detection and Prevention Clinic, call Seattle Cancer Care Alliance at 206-288-7222. The clinic is at 825 Eastlake Ave. E.

P-I reporter Cherie Black can be reached at 206-448-8180 or [email protected].

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