Early diagnosis of lung cancer is possible, White River Junction VA has the latest technology to safely diagnose
By Katherine Tang, Public Affairs Officer
Early detection and intervention of disease, particularly cancer, are what decades of medical research and advancements have helped modern medicine accomplish.
At the U.S. Department of Veterans Affairs (VA) Healthcare System in White River Junction, Vermont the Pulmonary Medicine team along with Respiratory Therapy proudly offer a comprehensive program to Veterans for early detection and diagnosis of lung cancer.
Lung cancer is the deadliest cancer among U.S. Veterans, with incidence rates 25% higher than in non-veterans. It is the leading cause of cancer-related death among Veterans, often linked to smoking and exposures to environmental carcinogens like asbestos, Agent Orange, and possibly burn pits. Early detection and diagnosis as a result of screening is crucial for survival.
“It is important to speak with your providers about your history of smoking and exposures to aerosolized toxins.” explains Sarah Stone, RCP/RRT, Chief of Respiratory Therapy Department at White River Junction VA Healthcare System, “This is crucial for our team to better understand your lung health.”
Nationwide, VA encourages Veterans to participate in lung cancer screenings if they are 50-80 years old, smoke cigarettes now or quit within the past 15 years, and smoked cigarettes for at least 20 pack-years.
“A 20 pack-year smoking history means one pack of cigarettes per day for 20 years or two packs a day for 10 years” explains Kathie Doton, APRN-Lung Cancer Screening Coordinator at the White River Junction VA Healthcare System.
For Donald Graham Jr., Army Veteran from Brookfield, Vermont, he checked all the boxes warranting the annual lung cancer screening and scheduled for a low-dose computed tomography (CT) scan. During a low-dose CT scan, the patient lies down on a table where an x-ray machine takes detailed images of their lungs while using minimal radiation.
“They saw something in the scan.” Graham explained, “They told me they could sample it.”
The nodule spotted was in the right lung in Graham and was approximately 14 mm in size. When an abnormality or mass is detected during lung cancer screening, the patient’s case is reviewed by the Pulmonary team for the least invasive and least risky method of diagnosis. For many patients a nodule this tiny cannot be biopsied easily or at all depending on what equipment is available at their medical centers, but luckily for Veterans like Graham, White River Junction VA Healthcare System has a state-of-the-art program to include an Ion Endoluminal Robotic-Assisted Navigational Bronchoscopy System.
“This piece of equipment allows me to navigate efficiently and precisely into the lymph nodes.” Dr. Peter Delong, Chief of the Medical Service and an Interventional Pulmonologist at the White River Junction VA Healthcare System explains, “I can see precisely where I am in the lung, navigate to the nodule and extract a sample which can be tested for any malignancies. It’s truly remarkable.”
Graham opted to undergo a robotic navigational bronchoscopic procedure to learn what exactly the nodule in his right lung represents. Diagnosis with this procedure is safe and fast and will determine the best choices for treatment and cure of this nodule.
“It is our privilege to work with Veterans and help them be active participants in their healthcare journeys.” Doton said, “We build the rapport that helps their journey be less frightening and allow them to feel more in control of their health.”
Upon arrival for his robotic-assisted navigational bronchoscopy, Nurse Practitioner Doton greeted Graham to once again go over the procedure plan which would begin with a CT scan to map out his lungs and the airways within them. The images from the scan were then uploaded to the robotic-assisted equipment Dr DeLong would use during the procedure to assist him in safely navigating through Mr Graham’s lung to the nodule.
The next step takes place in the Same-Day Surgery Unit where procedure preparations begin. Graham was greeted by the nursing staff and the anesthesiologist before being transported to the Interventional Radiology space where the rest of the team was waiting for him.
The procedure took approximately 2 hours which included Dr DeLong not only navigating to the nodule in question but also sampling lymph nodes looking for any possible spread of the process going on in the nodule.
“No complaints about it.” Graham said. “I did not have pain after and got to go home that day.”
Veteran Graham received the difficult news a few days later that his nodule was in fact a cancer, but it was caught very early at a time when it has a very high likelihood of being cured with either radiation or surgery.
“The care I get at VA is the best.” Graham said when asked about his experience, “I have been using this VA for 17 years, no regrets. Sign up for VA, I love it here.”
If you are interested in learning more about the lung cancer screening program at VA please visit https://www.cancer.va.gov/CANCER/lung-cancer-screening-month.html.
“Very simply, lung cancer which is detected early can be cured.” Dr. DeLong explains, “Early detection saves lives.”