Scranton Patient's Case Underscores Importance of Lung Cancer Screenings, Early Detection

11/15/2023

Courtesy of Scranton Times-Tribune

Claire Davis had recently moved to Scranton from New York state when she arrived for a physical with a cough and other concerning symptoms.

It prompted a referral to Dr. Brian Mott, a cardiothoracic surgeon at Commonwealth Health’s Regional Hospital of Scranton, who in June used a procedure known as robotic-assisted navigational bronchoscopy to biopsy a cancerous nodule in Davis’ lung.

Davis, 61, who smoked for about 40 years before quitting four years ago, underwent successful surgery in July to remove the cancer. Now, during Lung Cancer Awareness Month, Davis, Mott and Commonwealth Health are using her case to underscore the importance of early detection and lung cancer screenings.

“Sometimes we get scared of what the doctor might find, but the way I see it is early detection can prevent a lot of unnecessary death,” Davis said. “If we can catch it in time then we can do something.”

The aggressiveness of a form of cancer and the stage at which it’s discovered are key factors when it comes to successfully treating the disease, said Mott, who also emphasized the importance of early detection.

Lung cancer screening is designed to screen asymptomatic patients with significant smoking histories using low-dose CT scans, similar to how doctors use mammograms to screen for breast cancer. When a lung cancer CT scan finds something abnormal, Mott said doctors assess whether it should be biopsied for a tissue diagnosis to identify potential cancer.

“The technology that we’ve had up until now did not allow us to diagnose or biopsy very small nodules,” he said. “We were only biopsying things that were quite big that you could put a needle in and CT scan through someone’s ribs, or taking somebody to the operating room and cutting out a piece of their lung to see if that nodule is cancer or not.”

That’s changed with robotic navigational bronchoscopy, a high-tech procedure that uses a 3D map of a patient’s lungs and GPS and robotics technology to help doctors locate and biopsy potential lung cancer in a minimally invasive way. It allows doctors to biopsy tiny nodules as small as about 8 millimeters in diameter — roughly the size of the nodule in Davis’ lung.

It was so small that, in the past, doctors likely would have told Davis to come back for another set of pictures in a year, Mott said. But a year can be a long time for some aggressive forms of cancer.

“You could be behind the eight ball and it’s too late,” he said. “You may have missed the chance to cure her.”

But with the new technology Mott was able to act fast. He removed the cancer in July using a separate robotic surgical system. 

A grateful Davis said she hopes her story inspires others to get regular physicals and pursue screenings when eligible.

“I just hope it helps somebody else,” she said.

The U.S. Preventive Services Task Force recommends annual lung cancer screenings for people ages 50-80 with a 20 pack-year smoking history who are active smokers or who’ve quit within the past 15 years.

A pack-year is smoking an average of one pack of cigarettes per day for one year. A person could have a 20 pack-year history by smoking a pack a day for 20 years or two packs a day for 10 years, according to the U.S. Centers for Disease Control and Prevention.

The American Lung Association’s 2022 State of Lung Cancer report showed that only 8.8% of eligible Pennsylvanians had been screened for lung cancer. That was still above the national average, but below what Mott and other doctors want to see.

“We can have all the technology in the world that can diagnose and treat people, (but) if we don’t know they have it early on, what’s the point?” Mott said. “The thing that’s limiting the success of all these things is just finding the patients who are out there with asymptomatic cancers.”

“Right now we’re screening a very low number of potential candidates,” he said.

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