A Place For Smokers To Find Out: What Has Smoking Done To My Lungs? How Can I Quit?
A unique, multidisciplinary clinic
designed for current and former smokers to help them assess the condition
of their lungs and to get them started down the road to quitting will open
this Friday at the Seattle Cancer Care Alliance. The clinic also is for
current and former smokers diagnosed with a precancerous lung nodule that
needs further assessment and treatment.
Early detection of lung disease and cancer, and ultimately quitting
smoking, is key to preventing and reducing the incidence of lung cancer
while giving smokers a healthier life, according to Jason Chien, M.D.,
M.S., a pulmonary and critical-care specialist at the SCCA who directs the
new clinic. He is also a clinical researcher at Fred Hutchinson Cancer
"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."
The weekly clinic on Fridays will serve two patient populations:
"worried well" current or former smokers who are concerned about their
health, their risk of lung cancer and who want to quit, as well as patients
whose primary- care doctors have discovered a lung nodule during a routine
What makes this service unique for both groups is that every patient
will meet with a physician for a thorough pulmonary assessment and smokers
who want to quit will be referred to the SCCA Smoke Free Life Program,
directed by Abigail Halperin, M.D., director of the Tobacco Studies Program
at the University of Washington, and co-medical director of Free & Clear,
the nation's largest smoking-cessation program.
Quitting smoking stops the risk of developing lung cancer from rising
any more than it already has. However, former smokers always have a risk of
lung cancer; this risk is fixed at the time they quit and actually
increases as they approach the age of 70, Chien said.
The evaluation of otherwise healthy smokers will include a lung
function test and if determined clinically appropriate, a CT scan of the
lungs. Since it is not yet established that CT screening will extend the
life of lung cancer patients, the SCCA program will not automatically
recommend a radiology exam unless it is truly needed. The use of CT scans
for lung-cancer-screening is not standard practice; avoiding unnecessary
scans prevents radiation exposure and lowers costs. The evaluation exam is
not covered by insurance.
It's more likely that smoking-related respiratory diseases such as
emphysema will be found during an exam than cancer, Chien said. Additional
care for any diagnosed illness such as emphysema, COPD, chronic bronchitis,
or asthma likely will be covered by insurance.
Patients who are referred to the clinic to have lung nodules assessed
will be evaluated by a multidisciplinary team consisting of a
pulmonologist, thoracic surgeon, chest-CT expert and nuclear-medicine
specialist. If a malignancy is diagnosed, the team will also facilitate the
next course of action for the patient, such as meeting with an oncologist
or a surgeon. Such follow-up treatment is likely covered by insurance.
"We envision this service as a comprehensive center for primary-care
physicians to refer their patients so that they can have their nodules
thoroughly evaluated and diagnosed," Chien said.
About the Seattle Cancer Care Alliance
The Seattle Cancer Care Alliance, established in 1998, unites the adult
and pediatric cancer-care services of Fred Hutchinson Cancer Research
Center, UW Medicine and Children's Hospital and Regional Medical Center. A
major focus of SCCA is to speed the transfer of new diagnostic and
treatment techniques from the research setting to the patient bedside while
providing premier, patient-focused cancer care. Patients who come to SCCA
receive the latest research-based cancer therapies as well as cutting-edge
treatments for a number of non-malignant diseases under development by its
partner organizations. SCCA has three clinical-care sites: an outpatient
clinic on the Hutchinson Center campus, a pediatric-inpatient unit at
Children's and an adult-inpatient unit at UW Medical Center. For more
information about SCCA, visit