Finding Heart Disease Through Lung Cancer Screening

You may know that lung screenings can detect cancer in its earlier, more treatable stages. However, there’s another benefit to these scans that you might not be aware of: They can identify heart disease.

In addition to identifying suspicious masses, lung cancer screenings (done with low-dose computed tomography scans) also can show atherosclerosis, or a buildup of fat and calcium, in the coronary arteries or the aorta.

“When we see atherosclerosis in the coronary arteries or the aorta, we know that the patient is at higher risk for having a heart attack or a stroke,” says cardiologist Deborah Sundlof, DO, with Lehigh Valley Physician Group (LVPG) Cardiology–Muhlenberg. “Atherosclerosis is often asymptomatic before causing a major cardiac event, so finding it incidentally during a scan gives us a chance to stop its progression.”

It’s more common to find during lung cancer screening than you might think.

“To be eligible for screening, you need to have an extensive smoking history,” says pulmonologist C. Gerard Petersen, MD, with LVPG Pulmonary and Critical Care Medicine–1250 Cedar Crest. “Along with being the biggest risk factor for lung cancer, smoking is one of the top risk factors for coronary artery disease. That’s why it isn’t surprising to find atherosclerosis in individuals who get screened.”

Treatment for atherosclerosis focuses on preventing additional buildup in the coronary arteries or aorta. This can be done by:

• Addressing risk factors by making heart-healthy lifestyle changes, like:
  • Eating healthier
  • Getting to and maintaining a healthy weight
  • Controlling your stress levels
  • Getting regular exercise
  • Quitting smoking
• Taking medications to lower your cholesterol and/or prevent blood clots

Treatment recommendations are different for everyone; however, lifestyle changes to improve risk factors will always be recommended.

To be eligible for a lung cancer screening, you must meet all the following criteria:

• Be age 50-80
• Have a 20 pack-year smoking history (determined by multiplying the number of cigarette packs smoked per day by the number of years smoked)
• Currently smoke or have quit within the past 15 years

During the test, you lie on a table while an X-ray machine uses low doses of radiation to create detailed images of your lungs and chest. The scan only takes a couple minutes and is completely pain-free.

At Lehigh Valley Health Network (LVHN), our radiologists have developed a system for grading the severity of atherosclerosis found during lung cancer screening. Depending on the level of calcification, family medicine doctors and pulmonologists will recommend additional testing, certain treatment options or referral to LVHN’s cardiology program.

“Our grading system categorizes the level of calcification as none, mild, moderate or severe,” says radiologist Kenneth Cavorsi, MD, Chief, Section of Chest Radiology for LVHN. “Patients at the farther end of the scale are at a much higher risk for heart attack and stroke. By knowing this, their care team can provide individualized recommendations for their care.”

If patients are found to have both a lung nodule and atherosclerosis, their LVHN clinicians will work closely together to evaluate both conditions and recommend a treatment plan that is best for their overall health.

“A major push among our clinicians is collaboration,” Sundlof, who also treats patients through LVHN’s cardio-oncology program, says. “Coming together from multiple disciplines allows us to address the full picture of our patients’ health and optimize their outcomes.”