What to Expect From Screening to Treatment

We have narratives and expectations for many life events, like getting married or having a child, but there is no widely understood set of expectations for being diagnosed with a disease like lung cancer. This blog post will describe some of the key stages of the journey for anyone who is being screened, has just been diagnosed, or is in treatment for lung cancer, so that you know what to expect. 

What to expect during screening

Lung Cancer Treatment

Not everyone who is screened for lung cancer will have lung cancer. But screening is an important first step in the lung cancer diagnosis process, and many people may not know what to expect. 

The most common method of screening for lung cancer is called a low-dose CT scan, or LDCT, which makes detailed images of internal organs. Although LDCT is very safe, there are some small risks to be aware of in advance. For one thing, LDCT does involve exposure to radiation, although it is a very low amount, comparable to the amount of natural or background radiation most people are exposed to over the course of six months. The radiation levels are slightly higher than those of other routine screenings, like mammograms. As with screening for other forms of cancer, there is also the risk that the test may show a false positive. According to the American Lung Association, 12-14 percent of screening scans yield a false positive, although that rate is decreasing as doctors learn more about who should be screened. Finally, there is a risk of incidental discoveries, in which the scan finds something in the scanned area that is not lung cancer, but that also requires medical treatment. 

Before the scan, it is a good idea to call the insurance company to make sure the scan is covered. On the day of the scan, there is usually very little preparation required, but you should let your doctor know if you are sick. When it comes time for the scan, you will have to remove any metal you are wearing. You may or may not need to change into a hospital gown. The scan itself will take less than a minute. You may need to hold your breath. 

Depending on what the scan finds, you may need more tests after the initial one, like a PET scan or biopsy. 

Emotions upon diagnosis

When the doctor recommends a lung cancer screening, many people may focus on the physical or logistical things that they need to do, but it is also important to consider the emotional aspect of receiving a lung cancer diagnosis (if there is one). When people are diagnosed, it is common to feel a wide range of emotions and reactions, including shock, angry, afraid, worried, anxious, depressed, guilty or lonely and feeling overwhelmed. In the face of these emotions, it may be helpful to learn more about lung cancer through research or asking questions. There are also many medical professionals who are there to support you, so you don’t have to weather the emotions alone. Finding a patient advocate who has experienced the process before may be useful in managing both the practical and emotional sides of a lung cancer diagnosis. 

Self-reflection can also be a valuable tool in managing the varied emotions that come with a lung cancer diagnosis. If you are diagnosed with lung cancer, you should consider what you most need at that moment and what you want to tell others. 

What to expect from surgery

For many people who are screened and catch lung cancer in an early stage, surgery may be the first step of treatment. Here are some things to expect before and during surgery. 

Before surgery you will need to have tests to see how well your lungs, heart and other organs are functioning, to make sure that they are healthy enough for surgery. You may need to walk a mile or do other physical activity every day to reduce the risk of getting sick after the procedure. If you smoke you will have to stop. Try to avoid getting sick with respiratory illnesses before the surgery. Immediately before surgery you may need to fast and take certain medications. 

There are four types of lung cancer surgery, and they each involve removing a different amount of the lung. Our lungs are divided into lobes, with the left lung having two lobes and the right lung having three. The lobes are also further divided into sections and wedges. In a wedge resection, surgeons take out just the tumor in the lung and some of the tissue around it. In a segmentectomy, they remove a segment. If surgeons remove a lobe, it is called a lobectomy. In rare cases surgeons can remove a whole lung. During lung cancer surgery, surgeons will also remove dime-sized lymph nodes near where they do the surgery to test for cancer. 

Lung cancer surgery is performed in two ways. In the older approach, doctors make a larger incision between your ribs to access your lungs. A newer approach is video-assisted thoracoscopic surgery (or VATS), in which surgeons make smaller incisions and insert a small camera, which they use to help them complete the procedure. 

What to expect when recovering after surgery

After the surgery, you will likely be in the hospital for two to seven days, assuming there are no major complications. Hospital staff will encourage you to move as soon as possible. You may have a breathing tube. The length of your hospital stay depends on which type of surgery you had and whether there are complications. In general, patients who have VATS procedures recover more quickly. If you have an entire lung removed, you may need to stay in the hospital for up to two weeks. 

When you are discharged from the hospital, you may still need a breathing tube as you recover and it may take a few weeks to a few months to return to normal. You may not be able to lift more than 10 pounds for a few weeks after the surgery. As a result, you may need help with everyday tasks like getting groceries. It may also be difficult to sleep for more than 3 to 4 hours, due to the pain, although this will get better over time. Some people also find that the incision site is sore or tight for a few weeks or months. 

Emotional recovery after cancer treatment 

Even if you successfully treat your lung cancer and go into remission or are declared cancer-free, you may still deal with the emotional effects of cancer treatment. With the end of treatment, you may be ready to return to a more normal life. But if you’ve built strong connections with your care team, you may also feel anxious about leaving them behind. 

When you finish treatment, you may be offered a cancer survivorship plan, which is a visit that includes a summary of your treatment and the likely side effects as well as a chance to discuss how you are feeling emotionally. The healthcare professional who does the visit may also be a good resource to stay in touch with going forward. 

Although people may expect to feel positively when they finish cancer care, cancer survivors may still deal with negative emotions in the aftermath of treatment. These include grieving or feeling angry about the time you had to spend in treatment or plans that you missed because of treatment, body insecurities due to scarring and physical changes because of surgery, fear and anxiety about cancer returning, stress, sadness or worry about finances, or a feeling of loneliness, as if no one can understand what you are going through. Cancer survivor groups may help to discuss these feelings and feel less alone. 

Sources

What to Expect from a Lung Cancer Screening | American Lung Association

Lung Cancer Surgery: Types and What to Expect | U.S. News (usnews.com)

Lung cancer surgery: Types, recovery and survivorship | Mayo Clinic Comprehensive Cancer Center

How Long Does it Take to Recover from Lung Cancer Surgery? | healthline.com

Coping With Emotions From A Lung Cancer Diagnosis | Lung Cancer Research Foundation

Emotional recovery after cancer | Mayo Clinic Health System