Report: W.Va. Has Highest Rate Of Smoking

A recent report from the American Lung Association shows West Virginians have some of the highest rates of lung disease and circumstances that cause it.

West Virignians are more likely to have a smoking habit than those living in any other state, according to the association’s 2021 State of Lung Cancer report. Almost a quarter of adults in the state smoke cigarettes.

That’s one reason why so many people are being diagnosed with lung cancer, says Molly Pisciottano, who serves as the West Virginia and Pennsylvania director for advocacy at the American Lung Association.

“While you don’t have to be a smoker to get lung cancer, it is the primary cause,” Pisciottano said.

West Virginia is second to only Kentucky in the rate of new diagnoses. The current age-adjusted rate of new lung cancer cases is 79 for every 100,000 West Virginians. The national average is 58.

The new research findings may not be surprising to West Virginians. The state consistently ranks towards the bottom of many health indices.

However, over the five years that Pisciottano’s organization has filed this report, she said there’s been some positive changes. More people are surviving the life-threatening disease five years after their initial diagnoses.

“Even though we’re 40th in the nation for survival rates … we still have seen a 15 percent improvement over the past five years,” Pisciottano said.

Also, 30 percent of those West Virginians who have been diagnosed are getting the essential cancer treatment they need.

“So that was a little bit of good news, too,” Pisciottano said.

To prevent the worst outcomes of lung cancer, doctors urge people to get regular cancer screenings. That goes for West Virginia and the whole country. The report found, nationally, only six percent of at-risk people were screened in the past year.

There’s at least one reason for that, said Dr. Kyle Chapman, a pulmonologist at Ruby Memorial Hospital.

“Lung cancer in its early stages oftentimes doesn’t cause a lot of symptoms,” Chapman said.

That means people might wait until they’re coughing up blood to go to the doctor. At that point, the cancer may have grown, spread through the lungs, or even advanced to other organs.

“So the downside of finding a cancer later, particularly lung cancer, is the treatments are going to be more invasive and harder on the patient and potentially not curative,” Chapman said.

But with regular early screenings, Chapman hopes more West Virginians can receive their diagnosis while the cancer is still small, localized and could be removed through life-saving surgery.

Efforts to expand screening are happening nationwide and locally. In March, a panel of national experts expanded criteria for who should get screened annually. That now includes those 50 and older who’ve spent about 20 years smoking.

In West Virginia, doctors like Chapman are offering more opportunities to screen people, even taking their practices on the road. The WVU Cancer Institute launched a mobile lung cancer screening program in August to serve 42 of the state’s most rural counties. It was the first of its kind in the nation.

“It’s one way that we’re trying to address the lack of access and lack of screening is by having this mobile screening platform,” Chapman said

It was modeled after the institute’s mobile Bonnie’s Bus, which offers mammograms. While breast and prostate cancers are the most common in West Virginia, lung cancer is by far the deadliest, according to a 2019 WVU and state report. The report showed 7,300 state residents died annually with the disease. The next deadliest cancer was colon cancer at 2,265.

To learn more about lung disease and if you should receive a screening, visit lung.org or wvucancer.org.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Nicotine May Help Treat a Particular Type of Lung Disease

Lung experts at Ohio State University Medical Center are testing whether nicotine can help people with a particular type of chronic inflammatory lung disease called sarcoidosis. If left untreated, sarcoidosis can cause severe lung damage and even death.

It is not completely understood why patients develop the disease, but some experts think it may happen when your immune system responds to a trigger, such as bacteria, viruses, dust, or chemicals.

Unlike most lung diseases, the main symptom isn’t shortness of breath, but debilitating fatigue. Current treatments for the disease have side effects such as osteoporosis, cataracts, diabetes or high blood pressure that experts say are often worse than the disease itself.

So doctors are testing whether nicotine patches, normally used to help people stop smoking, may be a potential treatment for the disease. Research published in the early 2000s found that nicotine itself is anti-inflammatory and that smokers are less likely to get sarcoidosis than non-smokers.

Researchers say the initial, small study of using nicotine patches to treat sarcoidosis showed some promise. Now, Ohio State, in collaboration with the Cleveland Clinic, is conducting a larger, randomized trial in hopes of producing more definitive data.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation, Charleston Area Medical Center and WVU Medicine.

New COPD Clinic Opens In Lincoln County

Today marked the ribbon cutting ceremony for a pulmonary rehabilitation center in Lincoln County. Named after Grace Anne Dorney – a COPD patient and wife of longtime Nightline anchor Ted Koppel – the new clinic will provide exercise, education and support to help patients learn to breathe better.

Advocates for the program call it “life changing” and working to open new centers around the state.

Chronic obstructive pulmonary disease, or COPD, affects more than 10 percent of West Virginians. It is the third leading cause of death in the United States.

Despite the high numbers, few programs exist to help rehabilitate COPD patients.This is the fourth Grace Anne Dorney Center in West Virginia. The others are at Cabin Creek Health, New River Health, and Boone Memorial Hospital.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Terminally Ill and Want to Die at Home? Fill Out This Form

People who have a terminal illness often prefer to spend their last days at home, rather than a hospital. WVU published research this month showing there’s a way to make it easier for those people to do so. In reality, it all comes down to paperwork.  

Janet Black looks up from her bed. She is terminally ill with end-stage lung disease and is due to be discharged into hospice care any day.

Credit www.POLST.org
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www.POLST.org
West Virginia POST Form

“I can’t stay in a hospital forever so we had to look at alternatives to get me out of the hospital and to get me to where I could get the help I needed,” she says.

Janet Black is 73 and has known she was sick since September. Doctors give her about six months to live, although she matter-of-factly stated she thinks she has less time left than that. Her daughter Tammy was in the hospital with her.

“Coming home, that’s her decision,” says Tammy. “That’s what she wants and that’s what we’re going to do.”

Janet stresses she wants to be comfortable when she passes from this world, and that she doesn’t want emergency medical personnel to try and save her.

“I don’t want no CPR or resuscitation when it comes down to that point where there is nothing they can do – just let nature and God take its course and do what is supposed to be done,” she says.

So under her physician (Doctor Alvin Moss’) direction, she filled out a POST form. This form makes Black’s end-of-life wishes absolutely clear and, most importantly, the POST form is registered online where caregivers can easily locate it.Moss is coauthor of a study published this month in the Journal of Pain and Symptom Management, which found that 92 percent of West Virginians prefer to die outside the hospital, yet only about 60 percent are able to do so.

“You just want to be home where you can get the care and the love you need, so you can give care and love to them as well.”

Janet also has an Advanced Directive in place. That lets medical personnel know who she wants to manage her care. Signed forms are important. Moss’ study also found that 57 percent of patients who have signed an Advanced Directive, but no POST form, die at home, while the figure jumps to 76 to 88 percent for those who signed both of those forms.

The POST form has been available in West Virginia since 2002 – one of six states to pioneer the idea. Now 43 states either have a POST form or are in the process of developing one.

West Virginia is also one of the only states in the country with an electronic registry.

“We are the most comprehensive registry in the country,” says Moss. “Thirty-seven forms a day, 1,000 forms a month ­– up almost 200 percent since we started doing this three years ago.”

Moss says that prior to the forms being accessible online, about 25 percent of all forms – both Advanced Directives and POST forms – were lost, meaning that patients like Black often received end-of-life care, such as CPR or a tube down their throat, that they didn’t want.

“We actually even know that 550 times a month, physicians go online and find the form on a patient they want, so it’s working.”

Moss said that in the end, most Americans say they want to live as long and as well as possible and to die gently. The idea behind the form is to help people die with dignity.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

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