Why ALL former smokers should have this test (...if they're brave enough!)



Chest test: The procedure examines and 'vacuum cleans' the lungs

When I gave up smoking almost four years ago I was living in America, where 'smoking cessation' is taken much more seriously than in the UK.

I wasn't having any health problems but, at 31, with our first child en route, I wanted to quit while I was ahead.

When I told my doctor I wanted to give up smoking, I was sent for a chest X-ray.



Then when I went back to my doctor a few days later, she talked me through the X-ray on a lightbox on her wall.

It was pretty grim viewing. The whole thing was dark, shadowy and, even to my untrained eye, appeared ominously clogged up by tar.

Not surprising, since I'd started smoking at 16 and, for the past ten years I had been a 30-a-day man.

But the good news was I didn't have any unusual growths which would indicate cancer; if I stopped smoking now, the tar would clean itself out over time.



Then the doctor told me something that struck an unwelcome note of fear. Lung cancer, she said, is the most deadly of all cancers.



In the UK, 22 per cent of all deaths from cancer are caused by it.

This is not because it's harder to treat, but because of late presentation.



A large number of people smoke heavily for years, quit - then assume they are no longer at risk.

In fact, the carcinogens in the cigarettes may have caused a precancerous growth to start developing or one can form after you quit.

My doctor advised me that, three to five years after my last cigarette, I should have an X-ray or scan to see if there were any nasties lingering which could be zapped if caught early.

Giving up smoking was one of the toughest things I have ever done, but fatherhood, that X ray and copious amounts of nicotine gum did it.



The three years came up six months ago. I no longer live abroad, so I went to my GP and asked to be referred to a lung specialist.

My GP insisted lung cancer deaths were rare in ex-smokers, but agreed to refer me to a private consultant.

The specialist I was referred to, Dr John Faul, took the idea of preventative lung cancer screening in heavy ex-smokers, and thinks more people should demand it.

'We often don't see people with lung cancer until it's too late,' he said. 'By then they are coughing up blood, or in pain, and there's a thing the size of an apple.'

As we chatted, I did a series of lung capacity tests, which involved blowing into tubes to see how damaged my lungs were. Mine were about 95 per cent of where they should be.



DID YOU KNOW?

Placebo cures work by stopping pain signals going from the spinal cord to the brain. When you expect something to work, the area of the brain responsible for pain control releases endorphins. These 'happy hormones' travel down the spinal cord, suppressing the pain signals coming up the other way.

Dr Faul thought I'd need not just a CT scan, a form of X-ray, but also a bronchoscopy, in which a camera is inserted into your lungs to look for unusual-looking growths.

A bonus of having a bronchoscopy was that Dr Faul could give my lungs a spring clean - using a miniature vacuum cleaner to suck out any mucusy tar accumulated in the past few years.



This is old tar from the cigarettes which is forced out over the years by tiny hair-like cells in your lungs called cilia.

Although these can handle day-to-day pollution, a cigarette habit is too much for them and they get clogged up and stop working, stirring back to life when you quit.



Ultimately, you'd cough most of it out anyway, but a vacuum speeds things along, and the mucus can be analysed for signs of cancer.



I was quite gung-ho about the procedure, even though it was going to cost about £650, but my wife was less enthusiastic - what if something went wrong?

It was only when I was waiting on the trolley that I started to have doubts. But within minutes, a needle was inserted into my arm, and the next thing I knew I was coming round back in the ward a few hours later. Dr Faul told me he'd been able to suction a lot of sticky mucus-tar out of my lungs.

'How much?' I croaked.

'About half a cup,' he replied brightly.

And I hadn't smoked for three years. It was the first time all day I had really felt sick.

I had to wait four weeks to get the full results of my bronchoscopy, and the one thing I'd say to anyone contemplating this procedure is that it helps if you are a relaxed, nonhysterical person. Unlike me.

Waiting for results is always painful, but in my case it was made worse by the fact that I was waiting on a life insurance policy to come through to process my mortgage. The insurance firm refused to issue the insurance until the results were in. It was incredibly frustrating.

Finally the day arrived. Sitting in the Dr Faul's lobby, I prayed that the results would be negative-What if he told me I had lung cancer? I went in to his office, guts swirling with nerves. But, thank God, the results showed no 'unusual lumps, bumps or cancers'.

What a relief! The only anomaly was a very small nodule. Dr Faul recommended I get the tar vacuumed out again in a year or two and then he'd check the nodule hadn't changed in size.

It is something of a myth about the lungs of ex-smokers returning to 'normal': mine will always be 95 per cent capacity.

What is true is that lungs rid themselves of much of the tarlike mucus within a decade, and after 15 years of non-smoking your chances of dying of lung cancer are about the same as that of a non-smoker.

So would I recommend all exsmokers put themselves through this? The answer is yes, because it could save your life. I was lucky enough not to discover any nasties, but thanks to the memory of that half cup of tar, the idea of sneaking 'one quick puff' has never looked less tempting.



