Early detection reduces mortality and improves treatment outcomes
Cancer deaths are declining as early screening saves lives.
Since cancer remains the second leading cause of death in the United States, staying proactive about your health is essential. With more than 2 million new cases projected for 2025 in the United States alone, undergoing routine cancer screenings is more vital than ever.
According to the American Cancer Society, mortality rates have declined due to improvements in early detection, treatment and prevention – a trend that Charleston Oncology’s Nicholas Schmidt, MD, is excited to see.
Common cancers and screening guidelines
As a hematologist and medical oncologist, Dr. Schmidt regularly helps patients navigate their cancer journey. He explained that the most prevalent cancers in the United States are breast, lung, colon and prostate. “Each of these cancers bring with them a different age that would be an appropriate time to get screened,” Dr. Schmidt said. “For example, women are recommended to be screened for breast cancer at age 40 while colon cancer is now age 45, but it used to be 50.”
At Charleston Oncology, the most frequent new diagnoses are breast cancer in women and prostate cancer in men. Screenings vary by cancer type. A mammogram is the primary test for breast cancer, while a prostate-specific antigen, or PSA, blood test or a digital rectal exam are standard for prostate cancer. Since hereditary factors can influence risk, it’s crucial to know your family history because it may mean you need to start screening earlier.
The central role of radiology in cancer screenings and treatment planning
Radiologists play a critical and collaborative role in patient diagnosis and treatment planning. Matthew Brady, MD, chairman of the Department of Radiology at Roper St. Francis Healthcare, explained that his team’s work is fundamental to a patient’s treatment path.
“Patient cases are managed through a multidisciplinary team for different cancers, and radiology is a key component in those meetings,” said Dr. Brady. Completing the staging for cancer patients requires detailed imaging to determine the extent of the disease. This information is essential for creating an effective treatment plan and “ensuring we are operating down the appropriate paradigm for that patient.”
Radiology works in close partnership with medical oncology, radiation oncology and surgeons. This strong relationship helps determine the next steps, whether it’s targeted therapy, surgery or a referral to a specialist such as a vascular and interventional radiologist for minimally invasive procedures.
Another Lowcountry provider, the Charleston Breast Center at Novant Health East Cooper Medical Center, takes a specialized approach. It offers advanced imaging and biopsy services, including 3D mammography, breast ultrasound and breast magnetic resonance imaging. John Leahy, MD, a diagnostic radiologist with Charleston Breast Center, noted that while mammography is the most common tool for breast cancer screening, MRI may be used for women at higher risk.
Dr. Brady agreed, reinforcing that “Mammography will always be the first step in breast cancer screening.” However, some individuals who are considered to be high risk may need additional, or “adjunct,” screening such as an MRI. This is typically “based on lifetime risk profile or the density of the breast,” he added, pointing out that a woman’s OBGYN is the best person to help determine if she falls into a high-risk category.
A closer look: low-dose lung cancer screening
While mammograms have become a routine part of women’s health, another powerful screening tool remains significantly underused. “Low-dose lung cancer screening does not have the same traction that breast screening does,” Dr. Brady noted. “A large percentage of people who would be candidates for Low-Dose Lung Cancer screening are not taking advantage of it.”
This is a missed opportunity, because the screening can help find lung cancer earlier and dramatically improve survivability. “A lot of small lung cancers are clinically silent,” Dr. Brady explained. “You can find them and treat the cancer before the outcome is futile.”
The screening, often called an LDCT scan, is designed for specific populations, based on age and smoking history. Sometimes, known environmental or occupational risk factors also qualify a person for screening. For those who meet the criteria, the scan may be covered by insurance, and the process is simple and fast. “There is no contrast injected, a very low dose of radiation and the actual scan takes literal seconds,” said Dr. Brady.
The future of screening: innovation and technology
Medical professionals are looking toward a future of more personalized and precise screening. Dr. Leahy of Charleston Breast Center said, “Advancements in imaging, like our Breast Center’s contrast-enhanced mammography and 3D mammography, are helping us detect cancers earlier and more accurately, especially in women with dense breast tissue.”
One of the most talked-about innovations is artificial intelligence. Dr. Brady explained that AI-assisted technology is being developed to act as a “co-pilot to the radiologist. It never supplants the radiologist.” While Dr. Brady’s team is evaluating these rapidly evolving tools, there are important factors to consider. “It has great promise, but, ultimately, the radiologist must judge whether areas flagged by AI are real or false positives,” he said. The core question is always whether the improvement in quality outweighs any increase in cost. “We are close to the tipping point,” Dr. Brady concluded, noting that the root technology is constantly improving.
Your path to proactive health
Once a diagnosis is made, treatment begins. At Charleston Oncology, patients have access to targeted therapies, hormonal therapies, chemotherapy and immunotherapy. “Once patients get to us, a majority of the time they’ve gotten that diagnosis, so our approach is a multidisciplinary treatment for all kinds of cancer,” Dr. Schmidt said.
However, the journey starts long before treatment. It begins with prevention and early detection. Both Dr. Schmidt and Dr. Brady highlighted the critical role of primary care doctors and OBGYNs in this process. They are essential for educating patients about which screenings they need and when.
“Have the conversation,” Dr. Brady urged, particularly regarding underutilized screenings such as the LDCT scan for lung cancer. Dr. Schmidt echoed this sentiment: “Get the age-appropriate screenings. The sooner, the better.”
Don’t wait. Talk to your primary care doctor or OBGYN to understand your risk factors, confirm your eligibility for screenings and take control of your long-term health.
By Colby Denton
