Catching lung cancer early a blessing

"My third scan saved my life," says Janet, who participated in an annual low-dose CT lung screening twice before the March 3 scan that found a suspicious soft tissue mass on the third lobe of her right lung. Five days later, a PET scan identified a 2.3 cm hypermetabolic pulmonary nodule.

After undergoing pulmonary function testing, an MRI and cardiac clearance, she was ready for surgery. On March 31, cardiothoracic surgeon Brett Grizzell, MD, medical director for the lung screening program, performed a robotic resection of the lobe, removing along with it the fast-growing neuro-endocrine cancer.

All her margins were clean and her nodes were negative, so it was determined to be an early stage cancer that would require more frequent monitoring, but not chemotherapy or radiation.

“I am now lung cancer free,” says Janet, who after 40 years quit smoking prior to her surgery. “To me it was a miracle that we caught it before it could spread to my lymph nodes or brain.”

Janet was among the 1,327 patients for whom Lori Hurst, an oncology nurse navigator at the Ascension Via Christi Cancer Center, arranged a low-dose CT lung screening last year.

Of those patients:

• 23 lung cancers were diagnosed and treated using surgery, chemotherapy, radiation or a combination of the three;
• 221 required some form of follow up;
• 134 continue to be under close monitoring;
• 64 were recommended for yearly scanning and follow up based on their risk factors.

Other cancers, including esophageal, breast, thyroid and colon were identified and referred for further diagnosis and treatment, and other conditions, such as aneurysms, hernias and cysts also were detected.

“More than 1,300 screenings may seem like a lot for one calendar year, particularly with the overall number of cancer screenings being down due to the pandemic," says Dr. Grizzell. "However, there are so many more patients who meet the criteria and are unaware of the need or availability of this effective, but vastly underutilized tool, which typically is covered by insurance at no cost to patients who meet the screening criteria."

Only about 15 percent of the 8.6 million Americans eligible for lung cancer screenings are aware they should get them.

"Low-dose CT is the only screening tool that can reduce a person's risk of dying from lung cancer by catching it in an earlier and more treatable stage," says Hurst, one of two Ascension Via Christi lung cancer nurse navigators who help educate patients, assess their risk and schedule treatment according to their personalized plan.

Janet is hoping her story will inspire others to take advantage of this potentially life-saving opportunity.

“It’s given me a second chance at life and time with my two grandbabies,” says Janet.

Her advice to others who meet the criteria: “Do it every year because it can save your life. It did mine.”

Low-dose CT lung cancer screening is open to current smokers and former smokers who have quit within the past 15 years and are between age 50 and 80.

In February, the Centers for Medicare & Medicaid Services expanded its eligibility guidelines for low-dose lung cancer screening for Medicare recipients, lowering the age from 55 to 50 years and its smoking usage criteria from 30-pack years to 20. The expanded criteria was designed to address racial disparities associated with lung cancer, given evidence that one in three Black patients with lung cancer are diagnosed before age 55.

Taking part in the screening is easy. Patients complete a brief respiratory assessment and questionnaire to make sure that they meet the screening criteria. They then meet with the nurse navigator, who makes arrangements for them to have a low-dose CT at one of four Ascension Medical Group Via Christi Imaging locations. The CT is read by a radiologist and the results are reported to the referring primary care physician.

Starting next month, patients whose results indicate a need for follow up will be referred to Ascension Via Christi's new Lung Nodule Clinic, where a multidisciplinary team of lung and cancer specialists will meet with them to develop a care plan so they can begin treatment within seven to 14 days.

"Our goal is to find cancer early and give patients and their families the peace of mind that comes with having a plan and putting it into place as soon as possible to ensure the best possible outcomes," says Dr. Grizzell.

That certainly was the case for Janet, who says that although her diabetes is well controlled and her multiple sclerosis has been in remission for 10 years, “I’m not sure my body could handle chemotherapy.”

“I just feel really blessed that we found it, it was little and it was removed,” she says. “Somebody was watching out for me.”