Still on board

By Mike Taibbi, NBC News correspondent

The email from the office Tuesday afternoon was a heads-up:  my colleague Robert Bazell, NBC's chief science correspondent, was going to have a report on that night's NBC Nightly News with Brian Williams about a medical controversy I'd want to know about...allegations that a study about a procedure for the early detection of lung cancer had been partly funded by tobacco companies.  And, the email went on, Bob's report would include a reference to me since I'd volunteered for the medical procedure at the heart of that controversy.

Ironically, just the day before, I'd kept a doctor's appointment I'd cancelled and rescheduled twice before that procedure-- actually a follow-up CT (Computer Tomography) Scan for lung cancer--  as part of an ongoing study by Dr. Claudia Henschke at the Weill Cornell Medical College in Manhattan.  I'd had my initial scan in November 2006, a decision I'd made after thinking hard about it and reading as much as I could about Dr. Henschke's research. 

For 40 years I'd smoked a pack of unfiltered cigarettes a day, finally quitting when my former colleague Peter Jennings died and I looked with fully open eyes for the first time at the unquestioned connections between lung cancer and cigarette smoking.  My decision to submit to the one test that seemed to screen effectively for lung cancer was based on a simple conclusion I'd taken another year to reach:  I wanted to know (and not simply wonder and worry) if my decades of smoking had set a time bomb in my chest that was about to go off… or already had.

I was nervous before that first scan but I came out clear.  No nodules, no hint of emphysema or arterial plaque.   Dr. Henschke explained that a decade of experience with these state-of-the-art scans had taught experts such as herself to identify those lesions that were most likely to be aggressive and dangerous and worth the risks of biopsy or other surgical intervention.  Since I was doing a story about my own test for NBC's Nightly News I solicited the opposing view, from another cancer expert, that Dr. Henschke's research, lacking a blind study for comparison purposes, had not proven her premise.

But personally I considered that early detection had proved a dramatic benefit in the mortality rates from breast and prostate cancers;  why wouldn't it prove equally beneficial in detecting lung cancer in its early stages?  So I took the test, accepted those first healthy results as only being a baseline for future tests, and agreed to return this year (and every year as part of my annual physical).

"No change," Dr. Henschke said, slightly out of breath after leaving a meeting to go over my scan results with me.  "The same good news as last time…"  She said something about some other issues she was wrestling with and I mumbled something about having heard or read about continuing criticisms of her research program.  She said something back that I didn't quite pick up… I was already reaching for my coat to leave…but all I'd really wanted to hear were those first words she'd spoken to me:  "Good news.  No change…"  I thanked her and returned to work.

So imagine my surprise when I opened the paper the next morning to learn the "other issues" Dr. Henschke was dealing with on the day I'd gotten my second scan had to do with dramatic allegations that millions in funding for her project had been provided by a cigarette manufacturer, and that she and others had set up a foundation through which those funds were paid as a way of making the financial support for her project less than transparent.

The press accounts of the controversy included suggestions by critics that the mere fact that funding had been provided by cigarette makers suggested those tobacco interests had a dark motive:  to imply for smokers that they could simply keep smoking until regular scans showed a problem was beginning, at which point they could nip it in the bud.  Both Dr. Henschke and her colleagues and the spokesman for the cigarette groups insisted vehemently that those groups "had no control or influence over the research."

My colleague  Bob Bazell's report on the controversy on last night's edition of NBC Nightly News with Brian Williams did in fact make an appropriate reference that I'd volunteered to be scanned last year.  Fair play, and so is a full examination of the connection between cigarette makers who provided millions in funding and the work of an esteemed researcher who has worked for years to reduce the horrendous mortality rates from lung cancer. 

For my part… I'm a man in my 50s who smoked for four decades, and I want to live as long as I can.  I know that male smokers are 20 times more likely to develop lung cancer than are male non-smokers.  I know they live an average of 14 years less than non-smokers.   I know the 5-year survival rate for diagnosed lung cancer patients remains abysmal, the treatment options limited and largely ineffective.

So, yes, I'll be curious to see how the controversy over the screening program plays out;  but the early detection provided by the screening technology is picking up support around the country and around the world.  Once a year, unless I'm convinced there's no benefit, I'll slide into the machine again and hope that afterward Dr. Henschke or some other expert will look at the images and repeat those words:  "Good news.  No change…"