DEAR DR. ROACH: My husband and I are over 65. We got the respiratory syncytial virus (RSV) vaccinations two years ago. I\u2019m reading mixed reports on how often we should be getting them. — N.W.<\/p>\n
ANSWER: Along with influenza and COVID, RSV is yet another virus that causes respiratory disease in adults — one that is especially dangerous for young children and older adults. It is recommended to be discussed for those who are over the age of 60.<\/p>\n
People younger than 60 with moderate to severe immune system diseases, such as those that deal with an organ (especially lung) or a stem-cell transplant, should also consider vaccination. I recommend the vaccine to all adults over 75 and to those over 60 who have risk factors such as chronic heart or lung disease, complicated diabetes, or hemodialysis.<\/p>\n
At the current time, booster doses of the RSV vaccine are not recommended. This may change; although there is evidence that immunity wanes after a year, repeat doses were not found to be helpful.<\/p>\n
DEAR DR. ROACH: When I was about 6 years old in the early \u201940s, my 16-year-old brother was sent to a sanitarium for tuberculosis patients. He was there for 18 months and was a survivor.<\/p>\n
During this period of time, we (the family) went regularly for chest X-rays and some kind of test that involved a needle in my forearm. Why aren\u2019t X-rays done today — not to detect tuberculosis but to look for cancer? CT scans are expensive and sometimes involve a long wait, so why not do a simple X-ray for starters? And then if they see something, perhaps they can do a CT scan? — N.C.<\/p>\n
ANSWER: Many physicians and scientists at Johns Hopkins, Memorial Sloan-Kettering, and other first-rate institutions have sought to answer the question of whether annual chest X-rays led to a reduction in the risk of dying from lung cancer. But unfortunately, the consensus of opinion is that chest X-rays do not lead to an improvement in lung cancer mortality. There were tens of thousands of participants in these studies.<\/p>\n
You are also right to think that a CT scan might be more useful. Studies have shown that for a subset of people who are at a high risk, screening with a CT scan does lead to a reduction in lung cancer deaths. Specifically, lung cancer screening should be considered for people between the ages of 50-80 (Medicare will pay up to age 77) who are in generally good health; those who have smoked at least 20 \u201cpack years\u201d (such as a pack a day for 20 years, two packs a day for 10 years, or a half pack a day for 40 years); and those who currently smoke or have quit within the past 15 years.<\/p>\n
The benefit from lung cancer screening is modest; it takes about 250 people to be screened annually for three years to prevent one lung cancer death. Still, this is significant, and I do discuss lung cancer screening with my eligible patients.<\/p>\n
Finally, the best way by far to prevent lung cancer is to quit smoking as soon as possible. If you are a smoker, your doctor has many ways to help you quit. Calling a quit line, such as 800-QUIT-NOW, will connect you with your state service. You can also text QUITNOW to 333888, and there are web-based programs such as Smokefree.gov and apps like quitSTART from the National CANCER Institute.<\/p>\n