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Facing Lung Cancer: My Journey From Diagnosis To Surgery
Diagnosed with early-stage lung cancer, I chose robot-assisted surgery, navigating pain, fear and the bond with fellow cancer patients through it all.
A woman shares her journey through early-stage lung cancer, choosing robot-assisted surgery and finding strength in the support of fellow cancer patients along the way.
In 2018, when I first saw the doctor around in his fifties. He explained my condition by looking at a CT image attached to the wall.
"So, do I have cancer?"
"Yes, that's right. It's a very early stage."
Six years earlier, a tiny nodule was found on my lung at a regular check-up. The doctor suggested I get a CT once a year and added that if it doesn't change in size or get darker, there would be no problem. After several times of CT, I came to think, "I'm ok. This is just a trace of pneumonia from childhood." And I skipped it.
"Do I have to have surgery?" I asked the doctor.
"Yes, you have to."
"Are there any other options besides surgery? Medicine or something?"
"No, there isn't."
"Or… in time, will it ever fade away?
"It never goes away." The doctor, wearing glasses, answered in a firm voice without hesitation.
"Doctor, almost how many centimeters would you cut? Could you cut it as small as possible?"
"Here it is, an example. It was done for the sake of the patient, but…." He showed me another CT image from his laptop.
"Look, this is two years later."
I was frightened. The picture was all white, like a cloud. The cancer had spread throughout the lungs. I couldn't ask him if the image was from his patient or just some reference material. He then explained two types of surgery. One was a simple thoracoscopic, and the other was a robot-assisted Da Vinci.
"Which is less burden to the body?"
"Da Vinci is."
"So, how much does it cost?"
"It costs three million yen. I'm sorry, but Japan's National Health Insurance hasn't covered it yet." (Under the Japanese Medical Insurance system, patients usually only pay 30% of expenses, and for those over seventy years old, it is 20%)
Despite that, the words "less burdened" lingered in my ears.
Luckily, the cost was all covered by private insurance for cancer. My husband and I chose the robot-assisted surgery, as that doctor was an expert in Japan. From then on, I counted and waited for that day, staring at the calendar on the wall. I've often imagined a scene where the cancer suddenly vanishes and the doctor is left wondering what happened.
Three months later, that day came. The doctor was going to perform four surgeries. I was the last. Suddenly, the door of my room opened, "Please don't mind, it's soon," and disappeared in a flash. The man in a blue surgery gown was my doctor. The first operation took much longer; he cared about me so that I didn't become too nervous. When the orange sun began to set, finally, two nurses came in to pick me up on a stretcher.
In the operating room, the air conditioner worked hard. I felt chilly, wrapped in a thin, nonwoven fabric. Doctors, nurses and patients were all in the air conditioning roar, which reminded me of flying in a jet. A young woman anesthesiologist with bangs following one side told me with a smile. "You're getting warm soon." Lying on the operating table, I tried to face up to see Da Vinci, but she had already set the table in the fixed position for surgery. "Should I have shown you that?" While listening to her voice, I was momentarily taken away to an unknown world.
Like I had been told, the day after surgery was tough. I was nauseated all day. If I ever get cancer again, I will choose a large room because I want someone to share the same pain with me. I, too, have a cancer mate to exchange greetings with, who got surgery under the same doctor. That is cool; some patients with breast cancer form groups to do the patchwork in a circle. In good times and bad, we need companions to associate with because that enables us to ease our hardships. Our lives become more irreplaceable if we accept and cherish the turbulences than if nothing happens.
I still have navy pajamas with white marguerite. The day after surgery, I woke up in the ICU and changed into my pajamas. When a young nurse helped me change clothes and said, "Pretty!" Every time I see those pajamas, I can't help but press them against my cheek like a pal who has passed through a burden together.
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Lung Cancer Rising Among Non-smokers — Here's Why
Cigarette smoking is by far the biggest risk factor for lung cancer, data shows — but in a surprising turn of events, the most common form of the disease is primarily found in non-smokers.
Researchers at the International Agency for Research on Cancer (IARC) analyzed global trends in four main lung cancer subtypes: adenocarcinoma, squamous cell carcinoma, small-cell carcinoma and large-cell carcinoma.
They found that adenocarcinoma has been the most "predominant subtype" in recent years, according to a press release summarizing the study. Younger females were found to be at a particularly high risk.
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The study was published in The Lancet Respiratory Medicine earlier this month, based on global cancer data from 2022.
Adenocarcinoma — which starts in the cells lining the air sacs in the lungs — is the most common type of lung cancer among people who have never smoked, comprising up to 50% of diagnoses in that group, per the Centers for Disease Control and Prevention (CDC).
Worldwide, adenocarcinoma made up more than 45% of lung cancer cases in males and nearly 60% of female cases, data shows. (iStock)
Air pollution was cited as a key driver of this type of lung cancer, with the highest levels reported in East Asia, particularly China, the release stated.
Worldwide, adenocarcinoma made up more than 45% of lung cancer cases in males and nearly 60% of female cases.
"Air pollution can lead to adenocarcinoma of the lung, which is almost 50% of lung cancers."
"This population-based study seeks to better understand variations in lung cancer incidence by place and time according to its constituent subtypes. We examine changes in risk in different countries across successive generations and assess the potential burden of lung adenocarcinoma linked to ambient particulate matter (PM) pollution," said lead study author Dr. Freddie Bray, head of the Cancer Surveillance Branch at IARC, in the release.
"The results provide important insights as to how both the disease and the underlying risk factors are evolving, offering clues as to how we can optimally prevent lung cancer worldwide."
US NAVY VETERAN BEATS CANCER WITH EXPERIMENTAL TREATMENT AND RELIANCE ON FAITH
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Health and Fox News senior medical analyst, was not involved in the study but discussed these lung cancer trends with Fox News Digital.
"The main reason for increasing rates in non-smokers is air pollution, which can lead to adenocarcinoma of the lung, which is almost 50% of lung cancers now," he confirmed.
Increased vaping rates are also associated with the ramp-up of lung cancer rates, the doctor noted.
Increased vaping rates are also associated with the ramp-up of lung cancer rates, according to Dr. Siegel. (iStock)
"Secondhand smoke also continues to be a factor, even though smoking rates have fallen dramatically," Siegel said.
Genetic risk factors may also come into play and "need to be further explored," according to the doctor.
"Artificial intelligence can play a huge role here in terms of early diagnosis and pattern recognition, even before discrete lung nodules develop," he added. "However, lung CT scans remain the best diagnostic tool for those at risk."
"Pollutants in the air, such as particulate matter and industrial emissions, can damage lung tissue and lead to cancer over time."
Marianne Matzo, PhD, a certified advanced nurse practitioner in Norman, Oklahoma, agreed that poor air quality and pollution can contribute to lung cancer. (Matzo also operates Everyone Dies, a nonprofit organization that aims to educate the public about the processes associated with dying and death.)
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"Pollutants in the air, such as particulate matter and industrial emissions, can damage lung tissue and lead to cancer over time," Matzo, who was not part of IARC's research, told Fox News Digital. "This complicates the diagnosis and treatment process."
Some veterans who have been exposed to hazardous materials may also face a higher risk of lung cancer, she noted.
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"Veterans based in the Middle East (in particular Afghanistan and Iraq) were exposed to burn pits," said Matzo, who worked in oncology at the VA hospital.
"The waste included paints, solvents, human and medical waste, trash, and plastics that were ignited with JP-8 jet fuel, which contains benzene."
One doctor told Fox News Digital that some veterans who have been exposed to hazardous materials may also face a higher risk of lung cancer. (iStock)
"We are starting to see the effects of the pollution from those pits on young vets being diagnosed with lung cancer."
Exposure to high doses of radiation, as well as chemicals like asbestos and benzene, can also increase the risk of developing cancer, she cautioned.
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"Bacterial and viral infections can also cause genetic mutations and chronic inflammation, which contribute to the development of cancer."
In some cases, lung cancer can develop seemingly at random with no direct cause.
"Secondhand smoke also continues to be a factor, even though smoking rates have fallen dramatically," one doctor said. (iStock)
"What people miss when they say, 'I never smoked a day in my life, how could I have lung cancer?' are the variables of chance and genetics," Matzo added. "We can't control our genetics, and there can be genetic predispositions to cancer."
Ravi Salgia, M.D., Ph.D., medical oncologist and chair of the Department of Medical Oncology & Therapeutics Research at City of Hope in California, noted that there is "considerable variability" of lung cancer subtype based on geography and gender.
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"There are a number of potential causes of lung cancer — smoking, pollution, radon exposure and genetics, for example," Salgia, who was also not involved in the research, told Fox News Digital.
"More research is needed to determine the exact causes of lung cancer and the progression of this cancer. It is indeed concerning that pollution can potentially lead to lung cancer. We truly need to understand how the disease develops and ultimately how to better prevent and treat it."
Melissa Rudy is senior health editor and a member of the lifestyle team at Fox News Digital. Story tips can be sent to melissa.Rudy@fox.Com.
Robotic-assisted Bronchoscopy A 'game Changer' In Early Diagnosis Of Lung Cancer
February 12, 2025
4 min read
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Key takeaways:Robotic bronchoscopy can help diagnose spots in the lungs when they are still small, catching cancer sooner and saving many more lives. The earlier you can diagnose someone with lung cancer, the more potential you have to cure them.
Robotic bronchoscopy has become a game changer.
When lung cancer is detected in its early stages, the 5-year survival rate is greater than 60%. Image: Adobe Stock The robot revolution Traditionally, bronchoscopy had not been able to access nodules in the peripheral lung less than 20 mm, often due to the difficulty of reaching these peripheral areas. Additionally, the utilization of small gauge needles made bronchoscopy diagnostic yields very low.
CT guided biopsy, on the other hand, had the ability to localize the needle within the target in real time and, hence, has been the gold standard for diagnosing patients with smaller peripheral pulmonary nodules.
Due to these deficits, advances were made in bronchoscopy technology with the use of navigational platforms and small peripheral ultrasound probes.
The navigational platform enabled the proceduralist or physician to create a virtual pathway to the nodule, similar to a GPS map. This mapping allowed the physician to reach these small nodules. Despite these advances, yields continued to be low compared with CT guided biopsy, but they did increase to approximately 60% to 70%.
Then, along came robotics.
Robotic systems for bronchoscopies were first FDA approved for commercial use in 2018 and 2019. With the advent of robotics, there were also advances within scope technology.
Bronchoscopes had to become smaller and more maneuverable to travel through smaller generation airways to reach the peripheral aspects of the lungs. Robotic systems allow for a different approach, as physicians no longer hold the scope in their hand.
With this new technology, interventional pulmonologists are using controllers that are akin to an Xbox controller or a tracking ball with which one can control the scope. Being able to navigate safely, efficiently and accurately enables physicians to reach the spots that they believe indicate a high risk.
These systems have also made additional advances by the use of either electromagnetic navigation or shape-sensing catheters to accurately drive the catheter into the periphery and almost to the chest wall.
The greatest addition to advancing the practice, though, was the ability to have advanced imaging intraoperatively to now see the tool within the lesion, similar to CT guided biopsies.
Now with the improvements to steer, maintain stability and see your tool in real time, diagnostic yields have improved dramatically, allowing robotic bronchoscopy to be equivalent to the previous gold standard of CT guided biopsy.
In our field, that is truly a game changer. We have the ability now to reach these areas and accurately biopsy them.
Safety profilesCommon risk factors for lung biopsies are bleeding and collapse of the lung, known as a pneumothorax. From the literature, with CT guided biopsies, 15% to 20% of patients will get a pneumothorax, and 50% of those will require a chest tube.
Recent robotic bronchoscopy studies have revealed that the rate of bleeding and pneumothorax is significantly less when compared with CT guided biopsy. A recent survey indicated 19 patients with pneumothorax and seven with bleeding in a cohort of 679 patients with lung lesions who had robotic-assisted bronchoscopy.
Simply put, we are seeing substantially fewer adverse events with bronchoscopy.
The need for roboticsLung cancer is a devastating disease. Deaths from lung cancer outnumber those from colon, breast and prostate cancer combined. Five-year survival rates for patients diagnosed with advanced lung cancer are less than 30%.
This is why early detection and screening are crucial. When physicians can reach the lung nodules and diagnose cancer in its early stages, the 5-year survival rate is greater than 60%.
High-risk patients — those aged 50 to 80 years who have a 20-pack year history of smoking and are currently asymptomatic — should be screened on a yearly basis with a low-dose CT to look for those spots.
Screening these high-risk patients can decrease mortality by 20% and save more lives. But although we have lung cancer screening guidelines, high-risk patients are not always screened.
By current estimates, there are approximately 13 million people in the United States who should be screened, but unfortunately, we are not getting close to these numbers. Only 16% of those eligible are being screened on a yearly basis. Further, patients need to be screened before they can be biopsied, and screenings are falling short.
In addition, providers have also become more aware of the need to manage and follow pulmonary nodules that are found incidentally, such as when patients get an X-ray or CT scan after an automobile accident.
The focus on finding nodules in these earlier stages or smaller states pushed the need to advance bronchoscopy. Literature has showed that 70% of early stage lung cancers are often located within the periphery of the lung.
Therefore, the need to not only reach these areas but also minimize the patient risk during a procedure has pushed these advances within the robotic community.
More greatly, the advancement of tool-in-lesion has overcome the previous deficits once faced by early robotic bronchoscopy. Tool-in-lesion technology enables proceduralists to overcome the concept of CT-body divergence and allows for more accurate sampling.
Challenges remainTechnologies are expensive, so they must be shown to be cost-effective before more hospital systems can take advantage of them.
One second-generation bronchoscopy robot includes tool-in-lesion tomography, negating the need to purchase other pieces of equipment. This can be a real cost saver for some hospital systems, reducing financial barriers for hospitals and improving accessibility to patients.
Robotic bronchoscopy has become a game changer. It is allowing us to reach smaller peripheral pulmonary nodules in high-risk patients, which enables us to diagnose lung cancers at early stages and ultimately save more lives.
Reference: For more information:Sy Sarkar, MD, is a board-certified interventional pulmonologist and director of interventional pulmonary services, Mercy Medical Center. Clara Yoder, BSN, RN, CCRN, is a lung clinical nurse navigator at Mercy Medical Center.
Sources/DisclosuresCollapse Source: Expert SubmissionDisclosures: Sarkar reports being a physician educator for Biodesix and a consultant/advisor for Noah Medical. Yoder reports no relevant financial disclosures.
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