AnMed program helping to catch lung cancer early

Liv Osby
Anderson
Dr. Chet Walters checks a nasal passage with patient Kim Edward Vaughn of Anderson Monday, after a previous visit to remove a nodule at the AnMed Health Campus on Monday.

When the doctor told him that he had a dime-sized spot on his left lung, Kim Edward Vaughn was knocked unsteady for a moment by a wave of fear.

But soon, that feeling evolved to gratitude because the spot had at least been found early.

And when it comes to lung cancer, early detection can make all the difference in the outcome.

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That's because most lung cancers are found in a late stage, and that makes them especially deadly.

The Belton man recently had surgery to remove the spot, which did turn out to be lung cancer.

But doctors, who also removed the upper lobe of his left lung, are confident they got it all, making his outlook brighter. 

Dr. Chet Walters looks at a nodule of patient Kim Edward Vaughn of Anderson during a checkup at the AnMed Health Campus on Monday.

“I’m one of the luckiest dudes on earth,” Vaughn told The Greenville News. "Catching anything early, I'm for it." 

Early diagnosis

Lung cancer is the leading cause of cancer death, killing more people than cancers of the breast, colon and prostate combined, according to the American Cancer Society. It accounts for about 14 percent of all new cancers.

Nationally, about 234,030 people are expected to be diagnosed with lung cancer in 2018, and 154,050 people will die of the disease, the society reports.

South Carolina ranks 16th nationally for lung cancer incidence, according to the state Department of Health and Environmental Control, and smoking is the leading cause of the disease.

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The five-year survival rate for lung cancer is 54 percent when caught early, according to DHEC.

But in South Carolina, only about 18 percent of all lung cancers are diagnosed in the earliest stages, when they can be removed surgically before they’ve spread to other parts of the body, DHEC said.

Without adequate tests to detect lung cancer early, the medical community was hamstrung for years.

An image from a lung scan of a patient with a lung tumor.

Then the U.S. Preventative Services Task Force recommended annual screening with low-dose CT scans for smokers between 55 and 80 who have a history of smoking a pack a day for 30 years or those who’ve quit within the past 15 years. And in 2015, the U.S. Centers for Medicare and Medicaid Services began to cover it. 

Expediting care

That provided an opportunity for AnMed Health in Anderson to begin designing a new program to catch the disease in its earliest stages and expedite diagnosis and treatment in the hopes of saving lives, said Dr. Chet Walters, a pulmonary and critical care physician with AnMed Health Pulmonary and Sleep Medicine.

“At AnMed, we see a lot of spots on the lungs ... and until recently, there was no one pathway to ensure everyone was receiving care in a timely fashion,” he said.

“So we came up with a program that when anybody has a scan or X-ray or anything the radiologist finds ... we determine the urgency and how it should be followed,” he added. “And if something is serious, we (expedite) interventions to make sure it’s taken care of as quickly as possible.”

Dr. Chet Walters conducts a checkup of patient Kim Edward Vaughn of Anderson. Vaughn was stunned when he learned he had a spot on his lung, but recent surgery removed the cancer when it was still in its early stages.

Scans uncover some kind of abnormality in about a quarter of these patients, Walters said.

Before the nodule program, patients were referred to an oncologist, surgeon or pulmonologist, who often ordered additional tests, a process that could take four weeks and generate untold anxiety as patients imagined the worst, he said.

But an abnormal finding can mean anything from a harmless quarter-inch spot that’s been there for years to an 8-inch malignant mass, he said.

'Waiting is the worst'

Now, patients are funneled into the new program, where they are followed by a nurse navigator who coordinates appointments, tests and other care. So now, Walters said, the time frame — and the duration of the anxiety — can be cut in half.

“The longer you sit at home and think ... you can’t concentrate on anything else,” he said. “But we had a patient last week ... who had a one-week turnaround for an actual diagnosis. They appreciate that because the waiting is the worst.”

Vaughn, the father of three and grandfather of six, smoked for half a century. And he'd been seeing a doctor who monitored him for his COPD, or chronic obstructive pulmonary disease.

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When he began coughing so hard that he passed out, he went to the ER and was referred to Walters, who wanted him to have a low-dose CT scan in June.

But the 64-year-old heavy equipment mechanic canceled when things got too busy at work.

So his wife, Debbie, along with the nurse navigator, kept pushing him to reschedule. In July, he had the test, he said, and learned about the spot and the high likelihood that it was cancer.

Saving lives

“The scan showed a new spot on the lung,” Walters said. “And the risk of cancer in somebody like him is over 90 percent.”

With a risk that high, the patient goes straight to surgery to have the nodule removed because even a negative biopsy can’t rule out cancer, he said.

While Vaughn was still in the OR, the tissue was examined by a pathologist, who determined it was cancerous, enabling surgeons to remove the lobe right away.

Dr. Chet Walters recently removed a cancerous nodule from Kim Edward Vaughn's lung. A new AnMed program that gives CT scans to high-risk patients helped find the cancer early.

If the cancer hasn’t spread to the lymph nodes, patients are considered cured, Walters said.

Vaughn’s case is one of the good ones, since his nodule was found early, he said. And though there have been other patients who’ve fared as well after screening, there could be more, Walters said.

“With the (task force) guidelines being so new,” Walters said, “there are still a lot of patients not getting the right screening out in the community.”

Vaughn, who will be recuperating for six to eight weeks, said he’s happy to help spread the word that early screening can save lives.

“I’m glad somebody made me go,” he said. “It’s been a godsend.”