One Patient, One Screening, One Life Saved At St. Clair Hospital
On Thanksgiving of 2015, Linda Vance celebrated a memorable holiday with her family and her friends. They had good reason to celebrate and give thanks that November. Just a week before, Linda was in an intensive care unit at St. Clair Hospital, recovering from surgery to remove a tumor – a tumor that very easily could have taken Linda’s life, if it wasn’t discovered in time. Now, almost a year later, her life has been changed for the better.
A Deadly Disease
Linda’s tumor was caused by a very serious diagnosis: lung cancer. Responsible for over 28% of cancer-related deaths, lung cancer is the most deadly type. It affects 1 in 13 of all men, and 1 in 16 of all women; in 2014, this disease claimed 159,260 lives.
There are a number of reasons that lung cancer is so deadly. It takes years to develop, and tends to be asymptomatic until it has reached its advanced stages. Additionally, until very recently, there was actually no screening test for lung cancer. As a result, many tumors were not spotted until they were discovered on an X-ray – long past the early stages of the disease.
Today, however, patients such as Linda have another option for diagnosing this deadly disease. CT scans that utilize low doses of radiation can now be used to create detailed images of patients’ lungs. These scans provide better quality imaging – and more information – than any X-ray.
Diagnosing Linda
While low-dose CT scanning is the only screening test for lung cancer, the test is not for everyone. Instead, it’s prescribed to those who are high risk and meet specific criteria:
1) Have a history of heavy smoking; “heavy” being defined as 30 or more “pack years” (Note: a single pack year is roughly defined as “smoking an average of one pack per day, for one year” – However the equation can be adjusted for those who smoke multiple packs)
2) Are smoking now or have quit within five years
3) Are between the ages of 55–77
It just so happened that Linda met all these criteria. As of 2015, she was a self-proclaimed “closet smoker.” But she never had problems related to smoking. She was in general good health. She felt fine. And her personal and work life kept her quite busy.
Until her retirement, she served as a nurse manager for St. Clair’s Coronary Care Unit, and was on the St. Clair nursing staff for 44 years. An expert manager and clinical nurse, she took pride in giving patients skillful, compassionate care.
However, Linda had never become a patient in need of major care herself. She hadn’t had a chest X-ray in all her years of smoking. As a result, in 2015, Linda’s primary care physician suggested getting a low-dose CT scan to check her lungs.
So, in September 2015, Linda underwent a screening CT scan at St. Clair. It revealed a nodule in the lower lobe of her left lung.
Treating Linda
After her diagnosis was made, Linda was referred to a pulmonologist with Pittsburgh Chest Physicians. “Dr. [Zachary] Young saw me and explained all my [care] options,” Linda remembers. “He spent forever with me, talking to me in depth, answering every question.”
It was during these discussions that Linda was told she needed to have a biopsy. She was referred yet again to another care expert: Richard H. Maley, Jr., M.D., a thoracic surgeon at St. Clair Hospital. Thanks to the detailed test information from Dr. Young, and the experience of Dr. Maley, a plan was quickly developed that would allow them to determine exactly how to get Linda on the road to recovery.
In mid-November of 2015, Linda had a thoracotomy and a left lower lobectomy, with biopsy. She was admitted to an intensive care unit with a chest tube inserted in her left lung after the procedure, to drain and re-expand it. And she was discharged on the third post-op day, after a nearly pain-free experience.
The biopsy delivered the best news a family could hope for as they went into the holiday season: Linda’s tumor was a Stage I adenocarcinoma. Her cancer was also well contained; there was no lymph node involvement. She did not need chemotherapy or radiation. Instead, her doctors could simply monitor her lungs with CT scans for the next five years, to ensure her cancer does not return.
Linda’s Message
Today, Linda is healthy and active. She has retired from her work with St. Clair – but her memory as a patient at the hospital is strong. “I have a lot of nursing experience, but this was my first experience as a patient,” she says. “I was impressed by the teamwork — every specialist was on the same team, my team. The communication was flawless, and the care felt extremely personal.”
Perhaps even more importantly, Linda is now an advocate for lung cancer screenings – wanting to connect with the potential patients who may be afraid to find out the truth about their own lungs.
“I want people to know that there is nothing to fear,” she says. “I was well cared for and my experience was essentially painless. My cancer was asymptomatic; CT screening saved my life. If you meet the criteria, talk to your PCP and get the screening — if there is something there, the sooner they find it, the better off you will be. Delaying only will make things worse.”
If you are worried about your own history and potential health issues, we invite you to have a conversation with your primary care physician about having a low-dose CT scan. Your primary care doctor must give you an order for the test; an appointment with them will also give you an opportunity to discuss your risk factors in more depth. St. Clair Hospital offers low-dose CT scans at both of its Outpatient centers, in Bethel Park and Peters Township.