Early detection, better outcomes
A CT scan to check for pneumonia revealed something unexpected for nonsmoker Brenda Spillman: a small lung mass.
When Lexington resident Brenda Spillman came down with pneumonia in 2016, the illness lingered in her lungs, gradually causing her to lose her breath. For three weeks, she tried over-the-counter medicines to no avail.
“Then one morning I got up, called my son, and said, ‘I can’t breathe,’” Spillman said. “And he said, ‘If you don’t go to the doctor right now, I’m going to come and take you.’”
Spillman’s primary care doctor ordered a CT scan, which found two things: pneumonia, as expected, and another thing her doctor did not expect: a small spot in the upper lobe of her right lung. She sought out a pulmonologist, who decided to scan her annually to watch for changes in the small lung mass.
The first two years, the spot appeared the same. After her third yearly scan, she was told the mass was growing rapidly.
A diagnosis at Markey
Spillman was referred to the UK Markey Cancer Center’s Multidisciplinary Thoracic Clinic, where she saw interventional pulmonologist Dr. Ashish Maskey. Due to the tumor’s increased size and PET scan results, the chance of cancer was very high. Spillman was referred to Markey thoracic surgeon Dr. Jordan Miller, that same day for a definitive intervention that would be both diagnostic as well as therapeutic.
Miller suggested a minimally invasive wedge resection followed by possible removal of the affected lung lobe, depending on pathology results. The pathology results confirmed their suspicions: Spillman had a stage 1 adenocarcinoma, a type of lung cancer commonly seen in nonsmokers.
After her surgery to remove the growth, she spent three days in the hospital and completed outpatient therapy to help regain her exercise tolerance.
Lung cancer among nonsmokers
The diagnosis surprised Spillman. “I never smoked nor drank,” she said. “But things happen.”
While smoking is the biggest risk factor for lung cancer, Miller notes a national trend of more patients like Spillman receiving similar diagnoses.
“As the stage of lung cancer increases, the survival decreases. That’s why we want to identify it early – it’s our opportunity to cure it.”
Dr. Jordan Miller
Because her cancer was found early, Spillman didn’t have to undergo chemotherapy or radiation. For two years, she’ll visit Miller every four months and get scanned to make sure her cancer doesn’t return. Her prognosis is good – Miller says the five-year survival rate for her cancer and staging is about 90 percent.
“As the stage of lung cancer increases, the survival decreases,” Miller said. “That’s why we want to identify it early – it’s our opportunity to cure it.”
In 2015, the Food and Drug Administration approved low-dose CT screening for lung cancer. This screening is recommended for current and former smokers ages 50-80 who have a 20 pack-year smoking history, and it is the most effective tool available to find lung cancers early.
“If something abnormal is found on a CT scan, even if that person is a nonsmoker, it should be taken
seriously and followed,” Miller said.
Spillman is now doing well, keeping herself busy with volunteering and maintaining her yard.
“It’s just the grace of God that I’m still moving,” she said. “I’ve been blessed.”
