Early Detection of Lung Cancer Saves a Life

When Bonnie Mandarich’s doctor saw a spot on the CT scan of her lung, he figured it was nothing to worry about. Benign nodules commonly appear on CT scans. Bonnie was physically fit and had no history of cancer in her family.

Several weeks later, when Bonnie saw National Jewish Health pulmonologist Donald Rollins, MD, for a sinus problem, he recommended a CT scan of her lungs as well as her sinuses.

He, too, saw the spot on her lungs, but decided to investigate.

National Jewish Health radiologist David Lynch, MD, compared the new scans with ones done a few months before. Using sophisticated software that allowed him to reconstruct a three-dimensional model from the two-dimensional CT scans, Dr. Lynch discovered that the nodule had grown. Red flags went up, and Dr. Rollins referred Bonnie to National Jewish Health oncologist James Jett, MD.

After additional testing, Dr. Jett was convinced that the nodule was probably lung cancer. The nodule was still small and likely to be at an early stage if it were cancer. Bonnie could have waited a few months to see if the nodules continued to grow.

“If my wife had that nodule, I would tell her to see a surgeon and have it removed,” Dr. Jett advised Bonnie and her husband, David.

Both Bonnie and her husband were quiet on their car ride home that afternoon as they tried to make sense of it all. “It was devastating,” said Bonnie. “I was sure I was going to die.”

After a few days, Bonnie and David decided to follow Dr. Jett’s advice. Within a week, Michael Weyant, MD, removed a small portion of Bonnie’s lung that contained the nodule. Pathologists confirmed after the operation that the nodule was indeed a cancer. It was Stage IA, an early stage.

Within a few weeks, Bonnie recovered from the minimally invasive surgery and has resumed exercise, including skiing. She has an excellent prognosis.

“The doctors at National Jewish Health were so thorough and so professional and so compassionate, that I felt I was in the best hands possible,” said Bonnie. “I have referred several of my friends to National Jewish Health since.”

Bonnie was fortunate. Her cancer was detected early, before she had any symptoms and before it had spread. Most lung cancers are detected only after people begin to develop symptoms when the cancer is at an advanced stage and survival odds are much worse. Overall five-year survival for lung cancer in the United States is only about 15 percent for all stages. The survival rate is only about 4 percent for cancers detected after they have spread beyond the lung. Bonnie was also fortunate because her cancer was detected somewhat by chance, as a part of her evaluation for sinus problems.

Dr. Jett and his colleagues are working to make early cancer detection more common and less dependent on chance. Recent research from the National Lung Cancer Screening Trial indicated that using CT scans to screen people with no symptoms of cancer but who are at high risk of developing the disease can reduce deaths by 20 percent. Dr. Jett is now conducting two trials to improve screening techniques to further improve detection of lung cancer at early stages.

In one study, he is combining CT scans with biomarkers in the blood, some of which may appear as early as five years before symptoms develop. In a second trial, Dr. Jett is building on the reported ability of dogs to detect lung cancer in people’s breath, seeking to discover a chemical profile that identifies the breath of lung-cancer patients and those at high risk for lung cancer.

“Detecting lung cancer before it causes symptoms is the most promising strategy for reducing the terrible toll the disease takes,” said Dr. Jett.