When Paul Uken met with his primary care provider in September 2023, he knew there was something wrong. Not long before, he had encountered a urologic issue and was worried he was bleeding internally. His doctor ordered a CT scan of his bladder and kidneys to determine if there were any abnormalities. The scan did not indicate any issue with either the bladder or the kidneys, but it did catch something else. The image picked up the lower part of the lungs, and a small lung nodule looked problematic. While still very small, growth of these nodules often indicates cancer.
By all accounts, Paul was a health-conscious man. The 76-year-old had quit drinking alcohol and smoking in 1995 and 1996, respectively. He had also survived a bout with prostate cancer thanks to his decision to do proactive screenings. During his battle with prostate cancer, a scan noticed the same lung nodule, but at the time, it was deemed not a major risk. However, this time around, it appeared to have grown. His doctor recommended a closer look.
Paul was referred to Logan Health Heart & Lung for further testing, where Bethany Weiler, MD, a pulmonologist with the clinic, ordered a second CT scan, this time of Paul’s lungs. Because of his history with cancer and elevated risk level, he was placed into Logan Health’s High Risk Pulmonary Nodule Clinic, which prioritizes patients with high-risk cases to expedite their treatment plan.
Just months earlier, Logan Health had added the Ion Endoluminal System, a minimally invasive robotic-assisted platform used to biopsy lung tissue, even in the outermost parts of the lung. This new, state-of-the-art technology would allow much greater reach than ever before and the ability to diagnose even the smallest cases of lung cancer.
“Dr. Weiler explained that they were going to go in and mark the nodule using GPS technology,” Paul recalled. “Then they had this entire system developed to follow that marking. That was so cool how they were able to do that.” The Ion uses a biopsy marker feature, which allows the physician to track exactly where the nodule in question is.
After having the lung tissue biopsied, Paul received the news he had been expecting. “They knew it was going to be malignant,” he recalled. “The CT scan showed that the nodule had feelers coming off it, which indicated cancer. So, I kind of knew what was coming.” Paul was diagnosed with stage 1 lung cancer. “Lung cancer has always been in the back of my mind,” he continued. “I used tobacco – smoking and chew – for more than 30 years. So, it was always something I knew was a possibility.” While the news of cancer dealt a blow to Paul, Dr. Weiler instilled optimism because of how early it was caught.
Unlike many other cancers, lung cancer does not cause symptoms until the later stages, when it has already spread. So, the fact that the cancer was incidentally picked up in stage 1 was extremely lucky for Paul. With such an early diagnosis, time was of the essence.
Thanks to Paul’s priority level within the High-Risk Pulmonary Nodule Clinic, he was scheduled for surgery with Dr. Luis Alberton, thoracic surgeon at Logan Health, within a week. “It was all very fast after that,” he said. “One week I’m being diagnosed with lung cancer and the next week I’m on the operating table.”
Dr. Alberton conducted a lobectomy, removing the cancerous portion of Paul’s lung. The procedure was conducted using the da Vinci robotic surgical system, a minimally invasive platform. Using this technology, Dr. Alberton, one of the region’s most renowned robotic surgeons, was able to operate through small incisions between Paul’s ribs. With this technique, there was no need to break or spread the ribs, thus allowing for a far quicker recovery time for Paul.
“What I found absolutely remarkable was his recovery,” said Rennie Corrigan, Paul’s significant other. “Within two weeks he was playing nine holes of golf. Another week later, he played eighteen holes and came home and started bagging leaves. The recovery time was amazing!”
“The first couple weeks I noticed a difference,” said Paul. “There was certainly difficulty taking deep breaths, which was to be expected since part of the lung was removed. But now, I feel like my lung power is pretty much back to where it was before the surgery.”
Paul admitted that he was lucky that the cancer was caught when it was. If not for an incidental urologic issue (a condition that was later cleared by his urologist), his lung cancer would not have been found early. It probably would have been discovered in a later stage, increasing the chances of it
being fatal.
“If there were to be one takeaway from my story, it would be that lung cancer screening is necessary to see what is going on in there,” said Paul. “If that hadn’t happened, there would’ve been no way to see what was there and they never would’ve caught my cancer.”
The U.S. Preventive Services Task Force recommends yearly lung cancer screening with low dose CT scan for those who meet all the following criteria:
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Age 50-80
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Have a 20 pack-year or more smoking history
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Smoke now or have quit within the past 15 years
A pack-year is smoking on average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.