Low-dose CT scan at Region hospitals can find lung cancer sooner, improve results

Dr. Eias Jweied at St. Anthony Hospital in Crown Point is a hearty advocate for lung cancer screening. Photo by Tony V. Martin

Tony V. Martin, The Times

Sandy Roth, a nurse at Franciscan Health hospital in Crown Point, thought she had the flu.

“It was very early in 2017,” she said. “I was sick for about a week: light-headed, that overall feeling that something’s not right. Just trying to push through it.”

Something was definitely not right.

She was with her daughter, also a nurse, when she passed out. A trip to the emergency room and subsequent tests discovered pulmonary embolism — blood clots in the left lung.

A CT scan found a mass in her upper left lung. The results of a PET scan raised the suspicion that the mass might be more than an infection.

That was when Roth met Dr. Eias Jweied, a Franciscan-affiliated cardiothoracic surgeon and member of Cardiothoracic & Vascular Surgical Associates.

“Dr. Jweied walked me through every step,” she said. “His bedside manner was incredible. I was very nervous, but he kept me calm and focused.”

Roth, 55, had stage-one lung cancer.

Many Americans have had disease

In 2016, more than 224,000 cases of lung cancer were diagnosed in America. That represents 13 percent of all new cancer diagnoses. About 415,000 Americans alive have been diagnosed with lung cancer at some point in their lives.

However, those statistics do not mean lung cancer is a death sentence. Jweied touts advancements in early detection and treatment that promise to make lung cancer less lethal.

In Roth’s case, Jweied performed a lobectomy to remove the upper left lobe, one of two lobes in the left lung. The right has three.

The surrounding tissue and lymph nodes were tested, and all came back clean. Roth’s tumor was isolated.

“I did not need any follow-up chemo or radiation,” said Roth, who had started smoking as a teenager. “I quit for eight years, but …

“In six weeks, I was allowed to go back to work and resume a normal life. I just need follow-up CT scans every six months.”

Jweied calls early screening such as Roth's vital. “If we can catch lung cancer early, in stage one (in which the lymph nodes are not affected), we have the chance to place 75 percent of our patients in remission," he explained.

Screening can save lives

The screening, a low-dose CT scan of the lungs, can detect a tumor as small as 1 centimeter, about the size of a pea. And though there is great variability in the types of lung cancers, Jweied said most tumors that small have not spread to the lymph nodes or other organs.

“Lung cancer patients usually display no symptoms until the disease has advanced,” he said. “A few years ago, early detection wasn’t possible. That’s one main reason the death rate is so high.”

Researchers from the American Cancer Society have found that screening former and current smokers who fall within guideline recommendations (see accompanying box) could prevent 12,000 lung cancer deaths each year in the U.S.

“If you are at risk, getting a screening (annually) is just as critical as a colonoscopy, a prostate exam, or a mammogram,” he said.

Not all insurance plans will pay for a lung cancer screening. However, several local medical facilities offer the CT scan for less than $50.

Not always cancer

Even when a scan looks suspicious, Jweied reminds that not all "spots" are cancer.

“There are various lung infections that show up on a scan,” he explained. “They can be treated with medications.”

But when something shows up on a scan, a PET scan and needle biopsy follow. That scan looks for tumors in other areas of the body, while the biopsy checks for malignancy. A positive biopsy means treatment is necessary. 

At this point, a team composed of a pulmonologist, oncologist and surgeon work together to determine the best course of treatment.

“If the tumor is small (less than 3 centimeters, which is about the size of a strawberry) and appears to be local, we frequently opt for a lobectomy,” Jweied said. "It’s a very different procedure than a complete lung removal. By not spreading or cutting the rib cage, we reduce the pain, hospital stay, and risk of infection. It’s still surgery, but much less drastic than past practices."

Roth, the Crown Point nurse, realizes how blessed she is. “I have two beautiful grandchildren,” she said. “I get to be a part of their lives."

“I am living proof of the importance of getting screened — literally," she added.