Jackie’s Story: An unexpected lung cancer diagnosis, quick action — and relief
Last fall, Jackie had just retired and decided it was a good idea to get all those suggested routine medical tests out of the way, so the St. James resident could begin the next chapter of her life. But a coronary calcium scan recommended by her cardiologist turned into anything but routine. It was the day before Thanksgiving 2021 when Jackie got the startling news that there was a spot on the right lower lobe of her lung.
Jackie teared up recalling how the test result sent her husband, James, and four adult children into shock. “Everybody was like, `It can't be.’ It was hard to tell the kids, but it was harder to tell my sisters because I'm the baby in the family. I had quit smoking 23 years ago and had no symptoms of lung cancer, so none of us could believe it.”
The next step was to visit a pulmonologist who told her not to worry; they’d just watch it. That didn’t sit well with her or the cardiologist who ordered a CT scan of her lungs. That led to a biopsy, which revealed a malignant tumor. Surgery appointments were then scheduled at a community hospital in April — and postponed five times. At that point, Jackie just wanted to “get the tumor out,” but felt that the staff at the local hospital was being inattentive to her wishes and concerns.
It was her 30-year-old daughter who called Stony Brook Medicine to ask for help. Just days later, Jackie met with Ankit Dhamija, MD, a cardiothoracic surgeon and Director, Robotic Thoracic Surgery, Stony Brook Medicine. Dr. Dhamija confirmed she needed surgery to remove the tumor and explained in detail both the surgery and recovery.
He recommended a minimally invasive lobectomy — the removal of the lung lobe that contains the cancer — a procedure that is considered the gold standard for lung cancer treatment. Dr. Dhamija felt that Jackie’s situation was a perfect fit for the robotic-assisted approach.
Robotic-assisted surgery is an ideal platform when the lung cancer is found at an early stage. The robotic approach is an extension of video-assisted thoracoscopic surgery (VATS), which uses a handheld camera and instruments through small holes in the body. When performing robotic-assisted surgery, the surgeon docks the robot right next to the patient as the surgery is performed. It provides 10 times greater camera magnification, which gives surgeons better visualization of the arteries and veins. Another advantage is that the surgeon can remove the lymph node packet— the area around the tumor — more precisely, which leads to better cancer staging, and therefore, better outcomes.
Unlike with Jackie’s previous medical care, Dr. Dhamija was the first doctor to show her the biopsy and thoroughly explain what was happening inside her lung, which she appreciated. “He showed me where it was in my lung and how he was going to do the surgery. I had done some research on my own about the robotic approach, and then he explained everything so well. I was super comfortable at that point and knew I wanted to go ahead with his recommendation.”
After all the delays and stress she had experienced prior to coming to Stony Brook Medicine, Jackie and her family were relieved when her surgery was scheduled in May. “I just wanted to be able to say, `Okay, good. It's gone.’”
A day after surgery she was already home. Within days, Jackie said she was walking around and doing well. “Three days post-surgery I was taking Motrin for a pain on my side from my shoulder down where it was uncomfortable to breathe. I couldn't move as easily. But that was the worst of it and that was only a couple days,” she said.
By the second week post-surgery, Jackie was feeling better and by the third week was out walking with a friend. “I'm a big walker and hiker. My biggest fear is that I wouldn't have the stamina or the breathing capability of doing it," she said. "I'm slower, but I am really close to being back to my normal pace."
Jackie said she also valued knowing that the robotic-assisted lobectomy would result in more precise staging. Post-surgery she got the good news that her cancer was early stage one and wasn’t found in her lymph nodes. “They took nine lymph nodes out and they were all clear,” she said.
Now Jackie, who had prior experience with Stony Brook Medicine — she had given birth four times here — said she can’t say enough about how positive her experience was this time as well.
“From the minute we walked into the presurgical unit until the minute I left, they were just amazing. The nurses, the anesthesiologist, I couldn't complain about anybody. If I had to experience it, that's the place I want to go,” she said. “They would hug me if they saw I was getting upset. They were just a really good group of people. Dr. Dhamija was very calming. Everyone who spoke with me was pleasant and helpful. Some actually sat and had a conversation with me. I'm lucky that I finally got to where I was supposed to be.”
Jackie scheduled an appointment with the medical oncologist, Roger Keresztes, MD, who is also a member of the Lung Cancer and Chest Disease Team. She wanted to make sure there wasn’t anything she needed to do as a follow-up to surgery. Because Jackie’s cancer stage is so low, Dr. Keresztes agreed with Dr. Dhamija that she does not need any adjuvant therapy, like chemotherapy. However, she is still a patient of the team and will be cared for by them for years.
“Based on the Cancer Center’s lung cancer survival protocol, we follow patients first at a three-month interval and then subsequently that increases to a six-month interval and then, a one-year interval,” Dr. Keresztes said. “As long as there's no evidence of a new cancer growing that we need to then subsequently reevaluate, and there is no evidence of recurrence from the primary tumor that we resected, we do this for 10 years.”
In June, Jackie was still trying to deal emotionally with the fact that she has lost part of a lung and thinks she might participate in one of Stony Brook Cancer Center’s support groups. But for now, she’s just taking it one step at a time. She’s expecting her eighth grandchild in October and is taking a family vacation with all of her children and grandchildren this summer.
“My family is such a support, and after all that we went through from last fall to now, I’m looking forward to it,” she said. “I never thought a routine test would lead to where I am now, but I am grateful for the care I got at Stony Brook Medicine and for how well I’m doing.”
Since Jackie has done so well, she is encouraging everyone to make an appointment with their doctor and schedule the tests that are recommended, as soon as possible. “It’s better to find any ailment or condition early, so you have more options and more time to make decisions.”
Jackie and her family are sure glad she did.