LUNG CANCER-EARLY DETECTION-KEY TO A LONGER LIFE

LUNG CANCER - EARLY DETECTION
KEY TO A LONGER LIFE
A CHRONOLOGY OF A LIFE SAVED
by
Harold J. McLaughlin, Ph.D.

I am a 78 year old lung cancer survivor!

I haven't smoked in 51 years, haven't drank alcoholic beverages in 30 years, haven't drank coffee in 20 years; I've exercised regularly for more than 35 years, and took heavy doses of vitamin supplements for 35 years, and yet ... I managed to get lung cancer. How can that be?

Three years ago I caught a very serious case of bacterial pneumonia. It lasted for more than a week before it was treated ... in a hospital. During that short out-patient stay the doctors noticed a spot on my lungs and declared it to be scar tissue. Perhaps the cause of this was pneumonia? Since that time, I've been plagued with pulmonary problems.

During a period of three months beginning in December 2009 and March 2010, I managed to attract three severe cases of Bronchitis, each one cured through the application of "five day antibiotics" program prescribed by my immediate care doctor. He X-Rayed my lungs during one of these episodes and he saw what appeared to be scar tissue. His advice was to return in six months to have another X-Ray to see if the scar tissue changed.

I have a "self proclaimed very loving bitchy wife" of 55 years who tired of this nonsense and encouraged me to see a Pulmonologist, a specialist who deals with the body's respiratory system. I contacted my cardiologist's office for a recommendation. His staff gave me three recommendations, one of which was outstanding, Dr. Shahriyar Tavakoli, MD, and I was told I would not engage because he's always booked. As luck would have it, my friend and literally my neighbor is also a renowned cancer doctor, Dr. Davood Vafai, MD, and is a personal friend of this famed pulmonologist. He secured an immediate appointment for me.

Over a period of a month, Dr. Tavakoli had me take several breathing tests in his office and nearby Eisenhower Hospital. They proved normal. Next came a CT (CAT) X-Ray scan. That showed the lung "scar" tissue in the upper (of three) lobes in the right lung. Next he ordered a PET Scan which provides real life answers about cancer (breast cancer, lung cancer, colorectal cancer, melanoma, etc.). It is a nuclear medicine imaging technique which produced a three-dimensional image of functional processes in my body. A rradioactive tracer isotope was injected into my blood circulation. The tracer is chemically incorporated into a biologically active molecule. There is a waiting period while the active molecule becomes concentrated in tissues of interest; then I was placed in the imaging scanner. Before the scan I had to swallow a liquid nuclear medicine and wait about 45 minutes for it to distribute through my body. If there was cancer in my body of a given size, the medicine lights up in the area of the cancer.

On April 30, Dr. Tavakoli said my PET Scan was clear. No cancer elsewhere in my body. Becasue of the small size of my cancer it was not detected.

Dr. Tavakoli was not convinced I was cancer free. He conferred with Dr. VaFai, the cancer doctor as well as with other collegues. They superimposed the CT and Pet Scans for better definition of the scar tissue. Something was not right. Dr. Tavakoli then ordered a CT Scan guided lung biopsy.

Now lung biopsy's are not the most fun experiences in the medical world. I was admitted to Eisenhower Hospital as a patient, dressed in the usual hospital garb and taken to the radiation labratory. I laid on my stomach in the bed of the CT Scan machine and my back was numbed with the appropriate medication so the 20 inch long needles would not hurt as they were inserted through my back and into my lung. It was not painful, just a lot of pressure and a weird feeling as the doctor instructed, "take a deep breath - let it out and hold it" then he thrust the needle into my back and lung. My "bed" was then positioned into the CT Scan machine, presumably with the needle still in my lung and a "picture" was taken. I was rolled back out and the most recent picture was displayed on a monitor beside my "bed." That apparently showed the doctor if he aimed accurately. This process was repeated for 40 minutes. He eventually was able to extract about four samples.

On May 18th, Dr. Tavakoli called me in for the biopsy reports. HI suspecions were correct - stage 1 lung cancer. It was a 1X1.1 cm well differentiated Adenocarcionoma with Bronchioloalveolar features (describing certain variants of lung cancer arising in the distal bronchioles or alveoli that initially exhibit a specific non-invasive growth pattern - Wikipedia). He recommended immediate resection (doctor talk for removal).

May 19th was my first visit to my friend and neighbor, Dr. VaFai, the cancer doctor. He described how the effects of smoking effects the cells of the path between the mouth and the lungs and how some of the cells mutate into cancer. He also described how the combination of the CAT and PET scans identify the state and severity of the cancer cells in the lungs. He said my cancer is small, 1 X1.1 centimeters and is often dismissed by many doctors as scar tissue. Then, only a biopsy can ensure an accurate diagnosis. My biopsy identified the small growth as a stage 1 cancer. I was lucky. Only 1.5% of lung cancers are identified as stage 1.[1] Many of his patients come in too late and are in stages 3 and 4 and they only have year or two left to live. Mine is curable by removing it and I am expected to have a full recovery.

Even though nearby Eisenhower Hospital is rated as one of the best in the country, I wanted the best surgeon available for this operation. I did a Google search on my cancer and discovered Dr. Robert J. McKenna at Cedars-Sinai in Los Angeles invented a non invasive flexible bronchoscopy, video assisted thoracic lymphadenectomy operation and had performed more than 2,500 such operations. Additionally, he was rated the best surgeon in the country for this type of operation. By chance, another of my friends had used his services and I used him as a reference.

On May 24th,l telephoned Dr. Robert McKenna's office and his assistant wanted to know when I'd like to arrive. She said he's in on Monday and Wednesday and operates on Tuesday, Thursday and Friday. I made an appointment with him for 2:00 p.m., on Wednesday, May 26. I could be operated on Thursday May 27 providing he thinks I'm a good candidate. I needed all of the CDs, records of my CT & CAT Scan tests. I had the CDs but had to pick up the test and pathology reports. I subsequently did that later in the afternoon. He also needed my breathing test results. I had Dr. Tavakoli's assistant FAX them to her that day. Also needed was a recent EKG. I had my cardiologist's office FAX it to her. I also said I'd stoped taking Coumadin (blood thinner). The last time I took it was Sunday afternoon. I telephoned my cardiologist's office to tell them what I was doing and his assistants called back and said what I'm doing is OK. I asked Dr. McKenna's assistant if my wife can stay in my room on a cot. She can. I telephoned Cedars-Sinai Admissions and asked what the extra charge to have my wife stay in my room and there is no extra charge.

My wife and I hired a driver to drive us the 125 miles to Cedars-Sinai and stay with us through our initial Dr. interview to see if I was going to be accepted as a surgical patient. The interview went well and I was accepted as a patient. I would be admitted and operated on the next day. We sent our driver home and my wife and I Checked in to the nearby Le Parc Suite Hotel for the night.

The next morning we checked into Cedars-Sinai Hospital and I was prepared for my operation. It lasted for about an hour and a half, I was sent to recovery for a couple of hours then back to my room which was to be home for six days.

Since it was a "non invasive" operation, no ribs were broken. The top lobe of my right lung and lymph nodes were removed for good measure. The pathology report on my lung lobe confirmed what the biopsy showed and the lymph nodes showed no sign of any cancer.

The worst part of the operation was having two 3/4 inch drainage hoses sticking our my right side which had to follow me when I used the bathroom. Removal of those hoses as well as a catheter from my penis and an enema all administered by a beautiful young nurse proved to be not the most enjoyable experience. However, the hospital staff was wonderful to both my wife and myself. Interestingly, I gained 12 pounds during my stay even though I only ate two small bowls of Oatmeal and two pieces of toast during my six day stay. I'm sure the food was tasty but I had no appetite. The weight gain was due to the fluids being dripped into my arm. Water weight.

Dr. McKenna visited me many times and was polite, thorough and professional. He said I could check out on Tuesday, June 1, which we did. Our driver picked us up and we were on our way home by 11:00 a.m. That night I had my wife call 911 and was transported to nearby Eisenhower Hospital because of shortness of breath. That subsided and I was sent home during the early AM hours the next day.

June 8th, one week after discharge, our driver returned us to Dr. McKenna's office for a follow up visit. He said everything looks good. Medically I can do anything I want, go to the gym, fly, drive etc. He knew however, I was incapable of doing much of anything for at least two weeks. I think he was spoofing me a bit.

Exercise I did by plotting a 135 foot course through the house and walking around it 10 times at least 5-6 times a day. I think i wore a path into the carpeting doing this. I also had to inhale on a device with three balls in their individual cylinders and to suck them to the top of the device. This was to exercise my lungs.

Because of the healing small incisions in my right side, and the pain they caused, I was unable to sleep in my bed for about 10 days. I slept in my family room recliner which was fine because I didn't wake my wife when I was up at 1:00 a.m and 4:00 a.m., doing my walking exercise.

On June 10th, I visited my cardiologist to make sure that department was working properly. It was! He told me an interesting fact. I had given him a copy of my biopsy and operation pathology reports and he said my type of cancer often grows out of scar tissue. Interesting! I'm going to avoid my lung scar tissue in the future.

To get better faster, more exercise is needed. So on June 14 I walked outside in the cool early morning hours and walked 1/2 mile. The next day, I doubled it and walked a mile and did it again the next day and continued each day.

Healing continues. My surgeon told me "total" recovery will take six weeks. I'm a high activity type of person and as of June 17th, I'm entering my third week since my operation and I'm beginning to believe the surgeon about his six week estimate.

Was the early detection and correction worth the inconvenience, and pain? If you have a happy full filling enjoyable life - YOU BET IT IS! If you don't, that is your call. I have my Higher Power, whom I call GOD, to thank for putting all of the small incidents and wonderful people (especially my self proclaimed Bitchy wife) and personal friends, together to make this happen in the manner and time it did. I am forever grateful to all of them for their concern, help and kindness.

Six month follow-ups with my Drs. Tavakoli and VaFai, and cardiologist are necessary to ensure this nasty disease does not return but that is a small price to pay for THE GIFT OF EXTENDED LIFE!

REFERENCES
[1] New England Journal of Medicine, 2006, Oct 26.Survival of patients with stage 1 lung cancer detected on CT screening.
International Early Lung Cancer Action Program Investigators, Henschke " ... we screened ... using low dose CT ... 27,456 repeated screenings were performed 7-18 months after the previous screening. ... Of these participants 412 had clinical stage 1 lung cancer ... Among 302 participants with clinical stage 1 cancer who underwent surgical resection within 1 month after diagnosis, the survival rate was 92%. The 8 participants with clinical stage 1 cancer who did not receive treatment died within 5 years after diagnosis. Conclusions: Annual spiral CT screening can detect lung cancer that is curable."
http://www.ncbi.nlm.nih.gov/pubmed/17065637