Marylou Capes-Platt knew she was at an especially high risk for lung cancer. She had been a heavy smoker for 45 years, starting in her teens and continuing through a decades-long career in the music industry and as a writer and editor. She finally quit in 2007.
But the threat continued to haunt her, with good reason. Lung cancer is the number one cancer killer of both men and women, and causes more deaths in women than breast, ovarian, and cervical cancers combined.
Seven years after quitting, Marylou read about a way to catch lung cancer early and dramatically improve the odds of surviving. A pilot trial using low-dose CT scans to detect lung cancer in current and former smokers had just started at Memorial Sloan Kettering Cancer Center.
Marylou already trusted MSK’s cancer expertise — she had been impressed by an MSK doctor’s sensitivity when her husband sought a second opinion for his bile duct cancer in 2001. Still, she had to overcome her own fear of judgment — and even guilt — over having been a longtime smoker.
“You’d think it was a no-brainer to enroll in the trial, but I really had to talk myself into it,” she says. “What if the news was bad? There was that mean inner voice: ‘You brought it on yourself. You don’t deserve care.’”
Marylou shut down those thoughts and enrolled in the trial under the care of MSK surgeon Bernard Park, who has devoted his career to treating people with lung cancer.
“Early-stage lung cancer almost never causes symptoms, so usually the only way to diagnose it is through a scan,” says Dr. Park, who is Deputy Chief of Clinical Affairs in the Thoracic Service. “Of those who are diagnosed through screening, the overwhelming majority have stage 1 disease.”
This makes a huge difference. According to the American Cancer Society and American Society of Clinical Oncology, the overall five-year survival rate for non-small cell lung cancer, the most common type, is 25%. But if detected early, the rate jumps to 63%.
A Fast and Easy Procedure
The screening was simple. Marylou came to an MSK imaging center in Midtown Manhattan for a CT scan, which combines special x-ray equipment with computers to take multiple pictures of the inside of the body. The scanner is like a doughnut, open on both ends. The patient passes through it on a sliding bed. The procedure takes less than five minutes and does not require the patient to drink any solutions or get an injection of dyes or contrast.
“You just walk in, they send you through the doughnut in a few minutes, and there is no pain involved,” Marylou says.
The first scan detected a nodule in the upper lobe of Marylou’s left lung. Dr. Park told Marylou it was stage 1 lung cancer, a low-grade form that tends to grow very slowly and is unlikely to spread. They decided to just watch it closely as Marylou continued having scans once a year. At three years, the scan showed new tiny nodules, so Marylou started having scans every six months.
“At MSK, our expertise enables us to use the lowest radiation dose possible while still getting highly accurate scans,” Dr. Park says. “Although radiation from repeated low-dose CT scans can slightly raise cancer risk, this risk is minimal and far outweighed by the benefit of detecting lung cancer early.”
Catching Changes Quickly
In October 2020, they noticed the main nodule had gotten slightly bigger and denser. Dr. Park asked Marylou what she wanted to do; even at that point, delaying surgery was an option, given how slowly the nodule had been growing. But Marylou said, “No, we’re not postponing anything.” She wanted it out.
Dr. Park removed the nodules using minimally invasive, robot-assisted surgery. Lung cancer surgery used to mean making a major incision in the chest and spreading the ribs apart to reach the lung. MSK surgeons, however, can do complex operations through small incisions, by using a 3D visual system and flexible instruments. Dr. Park is one of the world’s experts in these advanced robotic surgical techniques for lung cancers.
“We spared as much lung tissue as possible by taking only a specific section of the lung lobe containing the cancer,” Dr. Park says. “We also removed lymph nodes to make sure the cancer had not spread.”
Thanks to the minimally invasive surgery, Marylou recovered quickly and was discharged from the hospital two days later. Marylou was grateful not just for the surgery but also for Dr. Park’s reassuring words after the operation. “He stopped by within a few hours and said the cancer was really small, and he didn’t think I needed any further treatment,” she says.
Dr. Park says Marylou is highly likely to be cured by the surgery alone, but she will need regular scans to make sure the cancer does not return. Today, she continues to lead an active life from her apartment in New York City’s West Village, working as a part-time book editor and painting.
Who Should Be Screened for Lung Cancer?
“For something that is so effective at detecting lung cancer early, low-dose CT scanning is still underused in people who would benefit,” says Dr. Park.
Leading health officials agree. An influential advisory panel, called the US Preventive Services Task Force (USPSTF), issued new recommendations in March 2021 to expand screening for lung cancer in people who have a history of smoking but no symptoms of the disease. Yearly scans are now recommended for people between the ages of 50 and 80 who are at high risk.
Most insurers will cover lung screening in eligible patients. MSK offers an online quiz to determine if someone is eligible for screening. MSK’s Lung Cancer Screening Program is offered at most MSK locations.
Marylou now recommends the screening program to her ex-smoker friends, as well as MSK in general for cancer treatment. “I know someone diagnosed with cancer who was going somewhere else, and I said: ‘What’s the matter with you? Go to Sloan. Cancer is all they do.’”