Coordinated VA team efforts result in early-stage lung cancer remission

However, its early detection proved lifesaving as the Veteran left TVHS cancer-free, without the need for radiation.

With the nodules complex location, the Veteran’s case was promptly presented to a multidisciplinary Tumor Board, where the team determined that a conclusive diagnosis was essential. The pulmonologists and thoracic surgery teams, collaborating closely, devised a plan to diagnose and treat the nodule simultaneously, minimizing the need for multiple invasive procedures and reducing the time to diagnosis.

TVHS Attending Physician Dr. Rafael Paez utilized advanced navigational bronchoscopy, akin to a GPS system, to locate the nodule accurately. This technology enabled precise injections of special dyes and fluorescent compounds, which helped the surgical team to visually identify the small lesion. While the Veteran remained under anesthesia, the thoracic surgery team employed specialized robotic techniques to excise the lesion, guided by the fluorescence.

The excised mass was promptly examined by the pathology team, confirming it was cancerous. Fortunately, it was identified as early-stage cancer. The immediate transition from diagnosis to cancer operation during the same surgical session allowed for efficient treatment, sparing the Veteran from additional invasive procedures.

Thanks to this coordinated effort, the Veteran experienced a swift recovery and did not require chemotherapy or radiation therapy post-surgery. He will, however, continue to undergo regular CT scans every six months for several years, transitioning to yearly scans thereafter.

This case highlights the importance of having a specialized, multidisciplinary team at VA facilities. The collaborative efforts of radiologists, pulmonologists, surgeons, pathologists, oncologists, nurse practitioners, nursing staff, and researchers ensured that the Veteran received comprehensive and effective care.

Lung Cancer Screening at TVHS

Lung cancer occurs when abnormal cells in the lungs grow uncontrollably, leading to tumors. It is one of the most diagnosed cancers and is the deadliest cancer worldwide and Veterans may be at higher risk due to exposure to certain environmental factors during their service, such as smoke from burn pits, asbestos, radiation and other hazardous substances, according to the American Lung Association and other institutes. 

Early detection was essential in this case, and it can be for you too. 

Here are the lung cancer screening guidelines. Please ask your primary care provider if you qualify: 

1. Individuals aged 50-80 years old with a smoking history
2. Currently smoke or formerly smoked and quit within the past 15 years
3. Individuals with a smoking history of 20 or more pack-years. A pack-year is defined as smoking one pack of cigarettes per day for an entire year.

In addition, VA research study, MAS-EXPAND, is screening Veterans for lung cancer with CT who do not meet the traditional eligibility criteria, including Veterans with military environmental exposures. Please contact the research team to see if you qualify for the study at masexpand@va.gov. Learn more here.  

TVHS is here for you should you be told you have a lung nodule through smoking cessation services, nutrition services, psychological support, social work services, and chaplain support. The collaboration among specialists ensures that Veterans and patients receive holistic and effective care throughout their cancer journey. 

Story written by Rhonda Pinkerman, NP