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Lung cancer study participant Kathy Leiser talks with Pierre Massion, M.D., left, and Eric Grogan, M.D., MPH, during a recent follow-up visit. (photo by Joe Howell)

Lung cancer screening trial helps first patient

BY: DAGNY STUART

3/01/2012 - Kathy Leiser first heard about Vanderbilt-Ingram Cancer Center’s lung cancer screening trial through a sponsorship ad on WPLN radio last summer.

The Nashville office technology saleswoman and grandmother of three had stopped smoking in 2009, but she knew her smoking history put her at risk for lung cancer. So she enrolled in the screening trial, a decision that may have prolonged her life.

“I had no symptoms, I wasn’t sick, but my risk factor would have been high because I smoked on and off most of my life,” said Leiser. “I was one of those people who started smoking freshman year in college. I quit many, many times, for a year, for five years.”

The accumulated years of smoking made Leiser a perfect candidate for the Nashville Lung Cancer Screening Trial, a research project led by principal investigator Pierre Massion, M.D., associate professor of Medicine and Cancer Biology. The trial is designed to determine which biomarkers could be helpful for early diagnosis.

Lung cancer is typically diagnosed at a late stage, which is why only 15 percent of patients are still alive five years after diagnosis. The disease kills more people in the United States every year than breast, colon and prostate cancers combined.

VICC has partnered with the VA Tennessee Valley Healthcare System and the Matthew Walker Comprehensive Health Center to offer the clinical trial for high-risk individuals who live in the Nashville area.

Leiser was the 42nd person to enroll in the trial, which offers participants age 55 to 74 a series of screening tests, including a lung function test, CT scan (X-ray imaging) of the chest and a bronchoscopy, which involves threading a flexible tube into the airway to obtain tissue samples. Patients are also asked for blood or urine samples.

Study participants are followed for five years and are treated if lung cancer is found during any of the screenings.

Leiser was the first trial participant whose initial screening tests revealed something highly suspicious in her lung.

“On the CT we found a mass on her right upper lobe that was 2.8 centimeters in diameter, the average size for a Stage 1a lung cancer,” said Massion. “The lesion was characteristic for being lung cancer.”

“At that point, and knowing how experienced Dr. Massion was, I was pretty sure when they did the PET scan it was going to come back positive,” Leiser remembered. “My thought at that point was ‘get the thing out of there.’”

Massion referred Leiser to Eric Grogan, M.D., MPH, assistant professor of Thoracic Surgery.

“The spot on her lung looked suspicious enough and worrisome enough that we took her directly to the operating room to do both the diagnosis and potentially treat this at the same time,” explained Grogan.

Instead of having to spread the ribs, Grogan was able to use minimally invasive surgery to access the lung. Making three incisions, the surgeon inserted instruments, including a tiny camera to find and remove the cancerous lobe from her lung.

With this minimally invasive technique, Grogan was able to make incisions no longer than 3 centimeters.

“Technology has improved and our incisions have gotten smaller so the recovery time is quite a bit better, with less pain and a quicker return to function for our patients,” said Grogan.

Leiser’s cancer had not spread beyond the lung.

“Based on that, her five-year life expectancy is more than 70 percent,” said Massion.

“That doesn’t mean the tumor cannot come back and it doesn’t mean that she could not develop another tumor, but this is the best scenario for the management of lung cancer.”

After two months at home, Leiser has returned to work and is feeling good.

“I consider myself the poster child for this, for proving exactly what they were seeking to prove. What Dr. Massion is doing is amazing,” said Leiser.

Funding for the screening trial is provided by the Early Detection Research Network Clinical Validation Center award from the National Cancer Institute.

Otis Rickman, D.O., director of Bronchoscopy, Ronald Walker, M.D., professor of Clinical Radiology and Radiological Sciences, research coordinators Anel Muterspaugh and Sanja Antic, and Gary T. Smith, M.D., associate director of PET/CT Radiology Services at the VA Tennessee Valley Healthcare System, are also participating in the lung cancer study.

For more information about the study, call 322-4100 or contact anel.w.muterspaugh@vanderbilt.edu.

A full description of the study is available at www.vicc.org/lungscreening.

©2014 Vanderbilt University Medical Center
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