Dear Dr. Roach: In my local community, there is an offer for an X-ray test ($99) to see if a past smoker is developing lung cancer. We both quit in 1996. Our doctor says we don鈥檛 qualify for the test because of how long it鈥檚 been since we quit smoking. Is he trying to say that since we quit in 1996, we will never get lung cancer? What is your opinion?
B. and G.
The test is called a low-dose CT scan. It can find lung cancers, but the real cost of the test isn鈥檛 the $99 鈥� it鈥檚 the possibility of a false-positive test: something that looks like cancer but turns out, after biopsy, to be a benign tumour.
The higher a risk someone has, the more likely that any abnormality the test finds is true cancer and not a false positive result, which is why the test is recommended only for those at high risk.
In the study that got the screening test recommended by large groups, like the U.S. Preventive Services Task Force, about 25 per cent of all participants had a positive test, 95 per cent of which were false-positives.
Your doctor can鈥檛 say that you won鈥檛 ever get lung cancer. He seems to agree, as do I, with the current recommendations that a person needs to have smoked at least one pack a day for 30 years (or equivalent, such as 1 1/2 packs a day for 20 years) and either still be smoking or have quit within the past 15 years to benefit from screening.
Doing the low-dose CT scan on people at lower risk makes the risk of false-positives much, much higher than the risk of finding a true case of lung cancer. A false-positive means you would need a lung biopsy, and these can have major complications.
Dear Dr. Roach: I work a swing shift and do lots of overtime, in addition to being a busy father and husband. I am very stressed. My friend recommended the herb rhodiola to reduce my stress hormones and provide better mood and energy. However, I have high blood pressure (well-controlled on lisinopril), and the bottle says not to take it if you are at risk of or being treated for hypertension. Is this a good supplement for me?
S.F.
Rhodiola supplements, taken as an extract of the root Rhodiola rosea, have been shown in several studies to have benefits, especially in reducing fatigue in people with stress.
It was also found to have some benefit in people with anxiety and depression. Most studies used doses between 100 and 400 mg of the SHR-5 extract.
Like any medication, this has the potential for side-effects. It can be dangerous to take in combination with an antidepressant, and with a long list of medicines that are metabolized by a common system (called the CYP3A4) 鈥� your doctor can help you.
As far as blood pressure goes, some blood pressure medicines (not lisinopril) are affected by this medicine, but it can make blood pressure go down in some people.
Finally, I was unable to find a rhodiola supplement online that was verified by an independent third party, so if you buy it, you are relying on the manufacturer鈥檚 word that it actually is rhodiola.
In summary, there is better evidence for effectiveness and safety of this supplement than most. It might help you, but it still has a small risk of side-effects.
听
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
