Sophie O'Connor | Early Detection Cancer
Sophie O’Connor, a 75-year-old Burlingame grandmother, is living proof of the effectiveness of a Mills-Peninsula study on early detection of lung cancer.
O’Connor is the first patient in the Mills-Peninsula study to be cancer-free five years after detection of an early stage lung cancer by CT screening. Mills-Peninsula’s Dorothy E. Schneider Cancer Center has been a participant in the groundbreaking I-ELCAP (International Early Lung Cancer Action Project) since January of 2003.
The study, still open to qualified participants, provides free annual screening CT scans for three years.
O’Connor, an ex-smoker, reached the all-important five-year milestone because her participation in the I-ELCAP research program enabled doctors to identify her lung cancer in its earliest stages and treat it before it could spread.
“With Sophie’s encouraging diagnosis, the I-ELCAP study now indicates that we may be able to lower the mortality rate from lung cancer with a screening tool that identifies this disease at an earlier stage than was possible before,” said Barry Sheppard, M.D., a thoracic surgeon who leads the Mills-Peninsula I-ELCAP study.
“Just as mammograms and colonoscopies are the most effective screening devices for early detection of breast and colon cancer, low-dose CT scans may prove to be the winning procedure for early detection of lung cancer we’ve long been waiting for.”
The I-ELCAP study tests the effectiveness of using annual low-dose CT screening procedures to detect lung cancer during Stage 1. By contrast, most lung cancers have traditionally remained hidden until a patient coughs up blood or complains of severe shortness of breath, by which time the disease is already in Stage III which has a survival rate of only 10 percent, or Stage IV when that rate drops to one percent.
The American Cancer Society ranks lung cancer as the nation’s number one cancer killer, and this year the disease may claim the lives of approximately 161,000 men and women in the U.S. – more than the number of people dying from the second, third, fourth and fifth deadliest cancers combined (colon, breast, prostate and melanoma). At least 15 percent of those diagnosed with lung cancer are non-smokers.
CT devices, which two decades ago may have produced only 30 images per scan, now yield more than 600 images, enabling doctors to pinpoint anomalies that are only a few millimeters in size. In addition, the Helical Chest CT used in the Mills Peninsula study takes less than a minute to complete a scan and reduces risk to the patient because its rotating camera emits only low-dose radiation.
When the CT scans used in the I-ELCAP study exhibit abnormal shadows or dark spots on a patient’s lungs, doctors are alerted to the potential existence of cancer. By monitoring these CT images over time or obtaining additional studies such as PET scans as needed, the radiologists involved in the study can determine which of these shadows need to be biopsied to confirm a diagnosis of cancer. Since 2003, Mills Peninsula’s I-ELCAP researchers have identified several hundred lung nodules through CT scanning of 380 smokers and ex-smokers, of which 14 were found to be cancer.
For Sophie O’Connor, a CT scan revealed a small spot on her lung, and her enlarged lymph nodes seemed to indicate a metastasizing cancer. At the time she entered the I-ELCAP program, she had been living a healthy lifestyle, including regular workouts at the gym, and had not smoked a cigarette for 20 years. She qualified for the study, which requires a greater than 30 pack/year history of smoking because, prior to quitting, she had smoked one to two packs per day for 41 years (her calculated exposure was 61.5 pack/years of smoking).
After conducting a biopsy on her lymph nodes, doctors discovered that a bacterial infection –tuberculosis (TB) that had claimed her sister’s life six decades earlier – was causing the nodes to swell. The tiny spot on Sophie’s lungs, pinpointed during the CT screening, was indeed cancer, but it was only in Stage 1. Dr. Sheppard was able to remove the cancerous part of her lung. She required antituberculous medication for a year to treat her recurrent TB. Although there was a high likelihood that her surgery was curative, lung cancer is not considered “cured” until the patient has survived five years with no evidence of recurrence on CT scan. Sophie has reached that milestone.
The I-ELCAP program at Mills Peninsula remains open to screen smokers and ex-smokers. “Hopefully this study will increase the number of individuals in our community who can celebrate surviving lung cancer just as Sophie O’Connor is doing,” Dr. Sheppard said.
Note: Mills Peninsula began participating in the I-ELCAP study in 2003 as the first Bay Area I-ELCAP center and is one of only a few community cancer centers taking part in this international collaborative effort that involves 49 institutions in nine countries. I-ELCAP, the largest, long-term study of its kind, was launched in 1993 by researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center.
This was originally published in July 2009