Dr. Dan Woolery is a new pulmonologist who recently started practicing in Sedalia at Bothwell Pulmonary Specialists. In addition to seeing new patients, Woolery is working with the Bothwell Foundation to raise funds to purchase an Endobronchial Ultrasound (EBUS) bronchoscopy system that will increase the speed and efficiency of lung cancer diagnoses for Bothwell patients.
Lung cancer is the No. 1 cause of cancer deaths in the United States. More than 228,000 people will be diagnosed with the disease this year, with a new diagnosis happening every 2.3 minutes.
A lung cancer diagnosis is obtained by a tissue biopsy, either by a bronchoscopy (tube down the throat) or by CT-guided biopsy (needle into the lung outside the body). Woolery said the EBUS equipment provides real-time imaging and diagnoses and stages cancer in one visit, which translates into faster treatment.
“An EBUS procedure will tell us if cancer is present and how severe it is,” he said. “We can also test lymph nodes at the same time to determine if the cancer has or hasn’t spread, which speeds up the process of surgically removing lung masses and beginning treatment. This will help prevent delays in care and treatment, which can be life-prolonging and life-saving.”
Lung cancer begins in the lungs and may spread to lymph nodes or other organs in the body. There are two main types of lung cancer called small cell and non-small cell. Non-small cell lung cancer makes up 80 to 85% of all cases and isn’t as aggressive, while small cell lung cancer grows and spreads faster.
Woolery said there are many risk factors and causes of lung cancer, but one, in particular, stands out.
“Cigarette smoking is the No. 1 cause of lung cancer accounting for 80 to 90% of lung cancer deaths,” he said. “Other risk factors include secondhand smoke, which is smoke from other people’s cigarettes, pipes or cigars, as well as asbestos exposure, but that is seen less frequently now than in past years as this risk is more understood and asbestos is used less and less.”
The most common symptoms of lung cancer include coughing that gets worse or doesn’t go away, chest pain, shortness of breath, wheezing, coughing up blood, feeling tired all the time, or weight loss with no known cause.
Early symptoms can mimic a cold or other common conditions, so most people don’t seek medical attention right away. That’s one reason why lung cancer isn’t usually diagnosed at an early stage.
Kara Sheeley, director of Bothwell’s Susan O’Brien Fischer Cancer Center, said most people with lung cancer don’t have symptoms until the cancer is advanced, which is why regular screenings are critical. All adults from age 55 to 74 who have a history of at least 30 pack years of smoking and who quit less than 15 years ago or are still active smokers should be screened for lung cancer once a year. A pack year is calculated by multiplying the number of packs of cigarettes per day by the number of years the person has smoked.
“A lung cancer screening is a low-dose CT scan of the chest, which uses less radiation than typical CT scans and is used to screen for lung abnormalities,” Sheeley said. “The scan only takes a few minutes and is painless. The patient simply lies down, receives the scan and can go back to their day.”
Lung cancer is treated in several ways, depending on the type of lung cancer and its spread. Treatment can be by medical and radiation oncologists who prescribe chemotherapy, radiation therapy or targeted therapy, by surgeons who remove lung masses found to be cancerous or a combination of these treatments.
Dr. Matt Triplett, medical oncologist at the Bothwell Cancer Center, explained the advances in medical oncology regarding lung cancer.
“Immunotherapy and targeted therapies have given us several more options when treating lung cancer,” he said. “Immunotherapy works to enhance our own immune system to recognize and attack the cancer cells. Targeted therapy drugs seek out and attack the specific cancer cells they are formulated to affect. Depending on the information provided to us from the biopsy, we are able to create a care plan to have the best chance at shrinking or eliminating the cancer.”
Dr. William Decker, radiation oncologist at the Bothwell Cancer Center, said radiation can be delivered in several different methods depending on a tumor’s size and patient’s situation.
“For small tumors, stereotactic body radiation therapy, which delivers highly focused radiation in just a few treatments, can be used for patients who are not a surgical candidate or who do not wish to have surgery,” he said. “Larger tumors are treated with external beam radiation treatment along with chemotherapy or newer immunotherapies when appropriate.”
In addition to earmarking proceeds from its biennial benefit for the EBUS system, Sheeley said the Bothwell Foundation has been instrumental in providing many helpful resources for cancer patients.
“We are fortunate to have nutritional products to provide our patients at no cost for those in need, transportation cost assistance and various other services that help people undergoing care,” she said. “The EBUS system will allow us to provide a new service to our community so they won’t have to travel outside the area.”