If Australia’s new lung cancer screening program had been around earlier, Anne Fidler thinks she might have had a lot longer to live.
“They probably would have caught it at stage 1 and not now at stage 4,” the 62-year-old said.
“In my case, it’s incurable … it’s just a matter of how much time I’ve got now.”
The Brisbane-based real estate agent, who used to smoke, went for an unrelated scan.
That was when her lung cancer was picked up.
“It was quite bizarre, really, because I had gone to the doctor for a gynaecological reason,” she said.
“I was super fit, I was going to the gym … I had no evidence, no cough, nothing.”
The new national screening program starts next month and is open to people with a significant history of smoking.
Ms Fidler said she hoped others would not miss out on early detection.
“I’m very passionate that nobody moving forward has to go through what I’ve gone through,” she said.
“Nobody deserves to have lung cancer. Whether you’re a smoker or a past smoker or a non-smoker, nobody deserves it.”
Turning the tide on lung cancer statistics
Radiation oncologist Shalini Vinod said more women died of lung cancer than breast cancer and more men died of lung cancer than prostate cancer.
She said not only was lung cancer Australia’s deadliest cancer, killing almost 9,000 people a year, but the five-year survival rate for lung cancer was just 26 per cent, compared to breast cancer, which was 92 per cent.
“When patients are diagnosed, about half of them will present with advanced disease … and that means the lung cancer is incurable and survival is poor,” Professor Vinod said.
“The idea of lung cancer screening is to try and detect these cancers at a much earlier stage where they can have curative treatment.
Lung Foundation Australia chief executive Mark Brooke said he was optimistic the program would bring hope for lung cancer patients by achieving similar results to the screening programs already in place for colorectal, cervical and breast cancers.
“Cancer screening programs have transformed those cancers to where most are now diagnosed at early stages … and that’s our fervent hope for lung cancer,” Mr Brooke said.
New wave of lung cancer diagnoses
On top of the 15,000 cases of lung cancer already detected each year, respiratory specialists expect an extra 1,500 cases will be picked up in Australia annually through the screening program.
It is hoped it will save 12,000 lives in its first 10 years.
“We have a whole range of treatments that can absolutely turn around and improve your chances,” Mr Brooke said.
He said that while the increase in diagnoses of early-stage lung cancer would increase pressure on the health system to treat more patients, it would ultimately cut costs.
“It costs nearly $60,000 per patient to diagnose them at stage 4 and up to $17,000, depending upon the treatment, for patients being diagnosed at stage 1,” he said.
The screening program will offer a bulk-billed low-dose CT scan for the 930,000 people estimated to be eligible for the program in the first year.
Mr Brooke said the eligibility criteria targeted a demographic of people who grew up at a time when smoking was much more common than today.
“Growing up in the 70s and 80s, when smoking rates in Australia were up around 60 per cent … [these people will] be in their 50s and 70s as this program is introduced,” he said.
“It was less than 30 years ago that we were allowed to smoke in our workplaces, in our motor vehicles, in our own homes, indoors in pubs and nightclubs.”
You’re eligible for the screening program if you:
- are aged between 50 and 70 years old
- show no symptoms of lung cancer and
- have a history of cigarette smoking equivalent to smoking a pack of cigarettes a day for 30 years
- are currently still smoking or have quit in the past 10 years
The program will focus on First Nations communities — which have a higher incidence rate of lung cancer — as well as people from culturally and linguistically diverse backgrounds and rural and remote areas.
Vans fitted with screening technology will travel to remote areas to ensure people have convenient access to the service.
“This is the first-ever screening program that has been co-designed with Aboriginal and Torres Strait Islander communities,” Mr Brooke said.
A third of lung cancer cases are not linked to smoking.
Professor Vinod said for now, the screening would only be open to people who had smoked, but she hoped eligibility might widen at a later date.
“It doesn’t mean we don’t care about those who don’t smoke, but I think we have to get started somewhere,” she said.
Breaking down the shame around lung cancer
While Anne Fidler’s cancer is incurable, for now, she is in a good place, enjoying time with her adult children, her grandchild and ticking things off her bucket list, such as overseas travel.
“I’m extremely grateful that I am very well and my cancer is very stable at the moment,” she said.
Ms Fidler said she wanted those eligible to take advantage of the new program and for it to break down some of the shame and stigma around lung cancer.
“I think the problem with lung cancer is that everyone goes, ‘Oh well, you’re a smoker, right?’ Like it’s your own fault, [like] you deserve it.
“That’s just not on. It’s unfair. We have no right to do that to people.”
People who have lung cancer with no history of smoking also experience the shame associated with the illness.
Mr Brooke said Lung Foundation surveys showed one in three respondents believed if someone was diagnosed with lung cancer, it was their own fault.
“That stigma of lung cancer has held back community empathy, fundraising, research, investment and, in some cases, the quality of care that patients receive.”
And, for some, it is potentially deadly.
“We know from talking to patients that they have withdrawn from care or not sought care because they feel guilty about being a person who currently smokes or who has previously smoked,” Mr Brooke said.
For people who already have potential symptoms of lung cancer, and are therefore ineligible for the screening program, the Health Department recommends consulting with their GP about more in-depth lung testing.
Symptoms of lung cancer include changes in coughing, coughing up blood, shortness of breath, fatigue, weight loss or persistent chest or shoulder pain.
By national health equity reporter Rachel Carbonell and the Specialist Reporting Team’s Alison Branley
