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>> Well hello and welcome to HealthLine on this Tuesday evening.

I'm Jennifer Blomquist.

I'm so glad you joined us.

This is a great show.

I know we have many of you out there who are regulars and you already know it's a great show and that you're going to learn a lot.

But just in case you're new I guarantee you will learn a lot.

We are live in the studio and we have two guests tonight.

We have a medical oncologist we're going to be talking about lung cancer lung cancer awareness.

It is lung cancer Awareness Month things you can do for screenings, checks, things to keep that something that you never have to deal with hopefully.

So we're going to talk about that.

But the great thing is we welcome your questions any time during the show.

So we're going to keep the phone number up at the bottom of the screen actually we have two phone numbers because this past year we included an option to text in your question so let me quickly just for the new folks review all that so the phone lines are open right now.

The main phone number that you're going to call if you want to call in a question is (969) 27 two zero.

It is a free call if you're outside of Fort Wayne just put an 866- in front of there.

So when you call in we don't just throw you on the air.

You'll talk to a very nice call screener and you have the option of relaying your question to the call screener and then they'll give it to us.

We'll get an answer that way or if you like call stay on the line and ask the question live during the show.

I really like that because maybe our doctor who's our guest maybe she would need more information from you to give you a better answer.

So keep that in mind when if you're going to call in texting everyone knows how to text.

It's just a different phone number (969) 27 three zero.

If you feel OK with this, just give us your name, tell us where you're texting from and then relay your question to us.

I want to remind you that we keep your phone number private.

Nobody will see it so don't be worried about texting and having any privacy issues.

Let's go ahead and meet our guests tonight.

So sitting next to me is Dr.

Patricia Rich.

She is a thoracic medical oncologist and next to her she I think did she call you her life support for Teddy Bear?

>> She's actually a medical professional that is Jordan Madison and she is a registered nurse and works with Dr.

Rich.

>> So we want to focus on lung cancer.

November is lung cancer awareness.

We've got a brand new month.

Probably a lot of people if you don't smoke or use tobacco products a lot people probably think oh, I'll never get lung cancer.

>> But I was telling both of you before the show I am Patty this is years ago.

Never smoked a day in our life .

Took a care of herself, never used any tobacco products and ended up dying from lung cancer at a young age.

Forty five that was back see that was back in the late nineties.

So there was at that time I don't remember there being any screenings.

People didn't really talk about it but I was shocked from your notes, Dr.

Rich, that this is the most prevalent type of cancer.

>> It is so lung cancer still is and I want no one type of cancer that people that have cancer die of .

>> Yeah.

In your notes you said it's even like if you combine was it combining cancer, colon colorectal it's getting better actually reduce it by combining all of them and still more we're getting better which tells you that there's hope and there's progress.

Yeah.

And like you said, although tobacco smoking cigarets is the number one high risk of developing Lancaster, not everybody that smokes you know ,people that don't smoke can also get lung cancer and we see that other risk like second hand smoking, radon, some environmental and chemical exposures in and even some family history.

So we do see actually a growing number of non smokers.

>> I get lung cancer, you know, and people I you know, it's gotten better.

We you know I mean when I moved to Fort Wayne in nineteen ninety four I mean people could still you know like in the bars and stuff like that they could still smoke.

>> I mean it was horrible if you're you know people don't think about the secondhand smoke or living with somebody who smokes right.

>> That does pose a health risk and people don't think about that so much and it does you can smell it.

It's there and you're getting exposed and you were talking about screening in the 90s at one point way back when they were doing chest x rays, which is not the ideal nowadays and we're talking incredible progress now.

>> We do have lung cancer screening.

>> Yeah, a little bit different than from cancer here you have a woman a certain age.

Everybody gets mammogram over here there's a little bit more of a guideline.

Yes.

And the US task force and the American Cancer Society kind of have that guidelines.

So if somebody and that's important for for the audiences if you're between the ages of 50 and 80 years of age, if you have a 20 at least 20 pack of tobacco use under way to calculate that is how many years have somebody smoked and how many packs a day.

So for example, when they say 20 pack years if somebody smoked one pack a day for 20 years that constitutes a 20 pack years.

If somebody smoked two packs a day 10 years that 20 pack years.

So the guidelines say 50 and 80 at least 20 years the task force and the American Cancer Society have a little difference in this part because the task force says if somebody quit smoking in the past 15 years they qualify the American society does not make that distinction.

OK, but that's a group that is at highest risk and they would really benefit from the CT lung cancer screening and the city is very quick.

It doesn't use I.B.

contrast, OK that a lot of people hate that so that's good.

So and then she gets that a lot and so sure.

>> Yes.

And so I think it's important that the awareness is there that if you don't be afraid to get that seat because when you look at the statistics more people should be getting screened and the reason we say that as we see it every day and is that it does save lives because you catch it early, you can cure it.

>> That's just it.

You know, I think you know, I think I was out of lung cancer kind of in the same realm as pancreatic cancer because I always heard you know, if you've got symptoms you're probably odds of beating it are probably pretty low because it's one of those sneaky ones that doesn't really present itself until it's advanced, I would say and a lot of our patients kind of the way that we find these masses or lesions are incidental findings and that's kind of what prompts a a further workup.

>> You know, somebody gets in a car accident and go to the E.R.

and get CT scans and we find a lung nodule so again, just really a benefit to screening and screening early.

>> Yeah.

And not to you know, I hope this doesn't come off the wrong way but you know, it's very sad that Polio's had to deal with this.

But what if there's a national figure or a global figure and they have a health issue like that?

I think it does make some people at least think about it or maybe even think about a loved one like hey because he's in his 70s but he looks like a pretty healthy guy, you know?

And obviously, you know, probably wasn't on his radar, you know, that he was going to get lung cancer.

He said he hadn't used tobacco products but so hopefully that will draw some awareness to it and I hope so because of course prevention is the mainstay.

But yeah, lung cancer is some of the other early early cancers.

There are no symptoms so so would you even feel pain at some point though from like a nodule or a lesion or you could at some point OK some of the symptoms and although they are a little bit of the general type symptoms but all of a sudden increase fatigue, a cough that developed and begins to change coughing up blood that's definitely a flag involuntary weight loss.

It's very easy to lose weight all of a sudden regardless of what it is.

I think that that merits a conversation with the family physician because something is different, something's happening and sometimes those are the first symptoms that we that we see OK, but a lot of times early stage has long have a lot of space.

You know it yeah.

We don't have they don't have any symptoms and uh so that's why at least the group that they are high risk I really really encourage the screening because we see it every day and it does make a difference and we can cure patients.

It doesn't have to be a death sentence.

No.

Well, I want to remind everybody we have lots that we can talk about but we'd love to hear from you guys.

So if you have a question I mean you can't beat free advice.

You know, maybe there's just maybe it's about yourself or maybe about somebody in your family, maybe just a friend.

Just why don't you give the text, you know, shoot us a text message with a question.

You can call the phone number again.

We keep those numbers up at the bottom of the screen (969) excuse me 27 two zero that's our phone number if you want to call it in text (969) 27 three zero if you are getting this screening and if it looks OK but maybe you're a tobacco user.

I didn't know how how often then would you need to get another screening if you have the colonoscopy and it's OK I think they say what seven to ten years so how do you handle it with the one screening so the lung screening in general is done once a year?

>> Oh it is OK so kind of like a mammogram.

>> Exactly.

OK so and then and at one point you know if you have your eighty five years old that may stop or after eight you may four but normally it's once a year ok that would be for somebody at risk that said that to somebody that's already being screened that's OK.

So the screening is for somebody that's at risk and the screening is not for diagnosis.

So if somebody is there's a risk that there's a concern or a finding that's a different workup.

OK, all right.

Well somebody answered or once a question answered so Marshall called in, wanted me to ask the question for and so he has is this is it granuloma granulomas?

>> OK, so he has granuloma on lungs and he wants to know if that's going to turn into lung cancer.

So what is a granuloma?

So I granuloma is like a small round scar in the lung in general they don't the the some of the best thing to one of the things that some places have lung nodule clinics so if there is that granuloma or if you like Marchelle has seen a pulmonologist that they can kind of take a look at it and see if they need to follow it or not.

That in general, Askhat, that's not that granulomatous is not OK.

But if you have never had a follow up maybe just to to ascertain that it is a granuloma, is it something does it ever go away or is it once it's there just stays no granuloma that still stays there.

It's like having a scar.

It just doesn't go OK.

I've not heard of that so.

All right.

Well, Marshall, thank you so much for your question.

You can do it.

Marshall did he just called it in.

He talked to our lovely call screener and she took down his question and they by magic they put it on our screen out here and we got it answered that way.

So feel free to call in.

You can ask your question love.

You can at the way Marshall did asking it offline or text.

So we're going to keep talking about lung cancer screenings, lung cancer awareness but feel free to interrupt it any time.

>> So if you if you're at risk and you have these screenings at that point, is it you know, suppose you're a heavy smoker, does it even matter if you stop at that point or is the damage already been done like do you benefit because some people hear some people say oh, smoking for 40 years is not going to change anything now and we hear that yeah, it does help.

>> Does it quitting you know, at any point help even quitting when somebody gets diagnosed with lung cancer?

OK, it does help with tolerating treatment with a treatment working better if somebody has emphysema and has some lung damage sometimes that the lung does not regenerate.

But if you stop smoking it stops damaging the lung.

Yeah, and that's a positive.

OK, so there is no better time to quit.

>> Yeah, I'm glad you said that because I I've heard people say the same thing.

I have some relatives on my mom's side in particular that just you know they just love smoking you know and so and it was looked at differently years ago you know growing up my grandparents you were cool.

I mean that was like it was like so very socially acceptable.

You know, people really thought that that was I mean my grandma my grandparents are passed away of course.

But like my grandma was born in nineteen seventy, you know and as a teenager she said all of you didn't smoke.

>> You were like an outcast.

You know it was very socially important.

It became the cool thing.

Yeah.

So breathing that changing that it takes time and I think we're getting better and getting there I always tell my patients nobody quits because they don't like it.

Yeah but they have to quit because it's healthier and it's the right thing to do well and Jordan I know you have young children so it's fun.

>> It's funny because my kids are older now they're in high school and college but even when they were growing up and they would see somebody smoking they would say oh great.

They I mean it was very negative.

So I am hopeful, Dr.

Rich because when I saw my children's reaction like oh that guy's smoking, that's terrible.

I think with our young people hopefully it's it's switching the thing with a with a younger younger people is they're vaping, you know and the talk about that because I feel I feel like some people say oh it's not bad, it's the safer way to smoke supposedly it's still smoking.

Yeah.

It's so we don't have decades of information to see the level of risk what risk there is for lung cancer.

Yeah, but it doesn't reduce to the lung chemicals that are damaging to along so my advice is if you smoke stop smoking vaping, stop vaping.

If you haven't done it don't start.

Yeah one thing I know it is and this is my experience on some of the patients that did stop smoking and took a baby cough and got worse.

Oh that was interesting.

>> I don't know if you saw that and it is a problem in the high schools I will say because my children and in fact my older boys who are in college now they wouldn't use the bathroom and in high school and I picked them up they were always dying to go to the bathroom.

>> We had to drive home so fast because of the we don't yet.

>> Why is it why don't you use the bathroom?

They say I'm not going in there.

People are always vaping and it's a little alarming if you if I had not really known anybody personally who vaped but there was a boy walking down the street after school got out and it's this big plume of smoke like you can't even see them and I I'm just surprised that so many people do it.

>> I mean I there's nicotine involved but you know and I think as time goes by and we gather more data and and the Anabella analyzing the chemicals that are in there so I still think it's it's an irritant to the lungs term.

Sure.

Sure.

Well yeah.

Like you said, just don't just don't start you know, do something else.

I think a lot of people who smoke they'll take up other they'll do other things to keep their mouth occupied.

I mean like I used to babysit for a family of the mom she is pregnant and had to stop.

She just went to popsicles that was like her instead of smoking she had a popsicle or her people you know, licorice or a lollipop or something chewing on a straw or.

>> Yeah, doing I mean is that what you guys advise patients sometimes when they're trying to quit?

So what what would we advise is it's a combination so they are methods.

It's combining you can do far more pharmacological.

Sure.

You know but also using the counseling there's no I always say I wish I had the magic wand I would be using it but there is it takes a person's work and willpower to do it.

These are twice, you know, like nicotine patches and such so that they are to to assist.

But unfortunately the word comes from the person who has to quit.

Sometimes it takes that devastating diagnosis I would think, you know, to have to get the willpower.

We do have somebody who want to ask your question live.

So that's great.

Phyllis, are you there?

Yes.

Oh, thank you for waiting.

>> Go ahead and ask Dr.

Rich and Jordan your question.

OK, nine months ago I had a lobectomy done and it was they had to remove my upper lobe.

I oh Phyllis go ahead and turn the sound down on your TV because there's a delay so it would get confusing for you I'm sure.

>> OK, let's see.

>> I think she's right.

>> Go ahead Phyllis.

Yeah OK I did OK so what happened after you had that so so anyhow I was just wondering as Dr.

Rich and another thing she is my oncologist.

She's following me up since I have the cancer.

So what I wanted to know what I wanted to know was is there a possibility that there so that's Phyllis got out go go ahead.

>> I know I can hear that.

I can still hear an echo in the background.

Oh, OK.

so I've got it turned down as low as I can go I think.

>> OK, arborists OK do you want me to start over or just well so you're so now you've had this procedure are you concerned you have concerns about something or maybe a concern is now that I've had to lobectomy is there a chance that I have another nodule on the right hand side?

Could it be possible that I could get could the cancer even though they got it all out of me could it go on the other side in that nodule so that I thank for your question?

So when you had the lobectomy and they tell you whether you were a stage one.

>> Yes, stage one.

OK, so I stage one with Allovectin is considered curable.

But having said that we do follow with a scamps and normally after a surgery we do the test every six months for about two years and then we can do to once a year and then we go to like the screening test without that without the contrast if because there's always a remote chance that that a lung nodule may grow again if there is a lung nodule that wasn't there and has showed up then we need to see where it is, how big it is.

Do we need to follow it with another kind of imaging to evaluate it normally we don't ignore it.

OK, all right.

Thank you so much, Dr.

Rich.

>> Oh, you're welcome.

Thanks for calling Phyllis.

That's it.

I love when people call in because they look at you had to ask her some questions to give her a better answer so that's a great way.

We could still take a few more questions too.

We've got a little under five minutes.

The time of the show goes quickly but feel free to give us a call or text.

Right now we're getting a text.

We just got a text from somebody named Wesley.

So Dr.

Richard Jordan he Wesley says can second hand smoke or the smells from it make your asthma worse so that it will be a better question for a pulmonologist because OK, his asthma is it's a it's a it's a lung disease and I don't treat asthma.

I know that anything that makes it reactive airway so airway to react to close can give you an asthma attack.

I believe second hand smoke could do that because of your own cigarets.

It could irritate your airways but you do have asthma.

Two things talk to your primary care and seek advice from pulmonary.

>> OK, I agree.

Yes.

Yeah no I like it.

I'm glad you're talking about the second hand smoke because a lot of people don't think about that how impactful it can be.

Years ago we from the we have a nonprofit group McMillan Health Center in Fort Wayne .

They do a lot of health education for children and one of the representatives and they're brought in they were lungs that had been coated you know, they they had preserved the organ.

So she showed us a pair that I mean I was thinking it was from a nonsmoker and I was thinking they would be whiter but they were a little beige and she's like that was probably just from pollution and maybe some secondhand smoke, you know?

But then I could not believe how horrible the smoker's lungs looked.

They were really shrunken and I mean it looked like like if you overcook a turkey or something and it was all shrunken and and yeah she said basically when she said when they're talking to the kids we tell the kids if you want to smoke you might as well be taking your lungs and putting them in the oven every day and and baking them and you know, if you over she said think about what if your mom burns some cookies or something?

>> They get all yucky and crunchy.

And so that's like I was saying, you know, when you walk emphysema is destruction of the lung tissue as you smoke and it's it's hot smoke and it has so you're right as time goes by and it's more like destruction, distraction kind of yeah.

>> Because you're losing lung tissue sometimes you just have to say you know I think I know that was you know gosh when I first started doing the show so at least 18 years ago and I have never forgotten that it really had a big impact.

So yeah, something something to think what do they say a picture of yeah.

It was more was the actual thing but you know we were showing it to on the air and hopefully you know made an impact on people watching so it is quite impactful when you see it we only have maybe a minute and a half so I don't know if either one of you could quickly just maybe give some advice to people about things to do to obviously don't smoke or use tobacco products and there are other things you can do to try and avoid getting lung cancer.

>> Kind of what we touched on earlier just really if you are a smoker really it's impactful to to get that early lung cancer screening done that was starting at age fifty, right?

>> Yeah.

Yeah, yep.

And like Dr.

Rich said, if it's early stage it's it's curable and that that's really impactful so sure.

>> And the same thing I know with a little with this conversation I hope you see what your risks are, what some of the symptoms could be.

The other thing that we did not touch upon is that it's you or somebody you is diagnosed with lung cancer.

There is hope there has been quite a bit of progress in the last ten fifteen from since and some fifteen years ago or twenty plus since I started.

But reach out ask and get informed.

I guess that that is critical to a healthy life can be a life saver.

So thank you both so much.

I love when we have more of one guest doing a lot of fun so we kind of we kind of had a bed Jordan but she did it so so Jordan Madsen, Dr.

Patricia Rich, thank you.

Thank you.

Thank you.

And we will be back next week so join us next Tuesday seven thirty PM take care.

>> Have a great night.

Bye bye