More Than a Lark – Lung Screening and VATS Surgery Save Jackson, NJ, Woman

A lark. Nedra Eagle, a smoker for 35 years, was not speaking about a venerable brand of cigarette.

Eagle was referring to how she viewed the prospect of participating in the Comprehensive LungCare Program at CentraState Medical Center in Freehold, N.J., where she had worked for seven years in the medical billing department until retirement two years ago.

“It was a lark,” she said. “Every month CentraState sends out a magazine that highlights what they’re doing for public awareness for all kinds of diseases. I’m one of those people who reads everything that comes to me. This article was about what they’re doing for lung cancer. They were running a free screening for people who meet certain criteria.”

The criteria? People older than 55. Check. A smoker for more than 20 years. Check. Someone who had quit the habit more than 10 years ago. Check.

The objective of cancer screening is to detect the disease before symptoms reveal themselves. Detection at an early stage gives doctors the opportunity to treat the disease with the greatest odds of long-term success for the patient.

“I lost my husband to lung cancer five years ago, so I made an appointment and had a CT scan,” said Eagle, who has lived in Jackson since moving to New Jersey 10 years ago from Long Island. “Two days later I was called with the news that they saw something suspicious.”

A nurse practitioner who works alongside Thoracic Group surgeons at CentraState Medical center, Sharon Lorfing, was the liaison between the screening program and the doctors’ office. Eagle said that Lorfing was with her “every step of the way. She was always available, answering questions both prior to the doctor’s appointment and in the weeks following before the surgery. She is definitely an asset to the practice who made my journey a bit more palatable.”

Among men and women in the United States, lung cancer is the leading cancer killer. About 160,000 Americans each year die from the disease, more than the combined deaths caused by colon, breast, pancreatic and prostate cancer. Before the end of 2015, more than 200,000 people will receive a diagnosis of lung cancer.

It is no secret that the increase in lung cancer numbers has been directly linked to tobacco use. Early in the 20th century, there were fewer than 400 documented cases of lung cancer in the U.S. In the middle of the second decade of the 21st century, about 85 percent of all lung cancer cases are linked to cigarette smoking among current and former smokers. But those afflicted with lung cancer are not only smokers – each year more than 30,000 people who may have never lighted a cigarette contract the disease from carcinogens or pollution.

Eagle’s free screening, a non-contrast low-dose CT scan of the chest, revealed a positive finding. Part of the program is that any time there is a positive finding a committee of doctors, specializing in the treatment of lung cancer, meets at CentraState to discuss the results and recommend a course of treatment. Eagle had non-small cell adenocarcinoma of the lung, the type most frequently seen by doctors at Thoracic Group.

“I had the surgery on November 19 with Dr. Caccavale and Dr. Bocage,” Eagle said. “The surgery went smoothly. It was very impressive the way they did it. It’s a procedure they had invented, so to speak, video assisted where there was no cracking of my ribs. I was only in the hospital for 24 hours. I was very lucky. A week later I got a call saying everything was clean except for the mass that was removed. It was contained. I didn’t need any further treatment or radiation.”

The minimally invasive surgery Eagle mentioned, Video Assisted Thoracic Surgery (VATS), was pioneered by Drs. Robert J. Caccavale and Jean-Philippe Bocage at Thoracic Group. Drs. Caccavale and Bocage were the first practitioners to publish an English-language paper on the procedure in the United States, in 1991, and have performed more than 8,000 of the procedures.

VATS offers patients important benefits over more traditional thoracotomy, including: only four one-inch incisions on the involved side of the chest compared with a 10-to-14-inch incision that also includes injury to the ribs and muscles in a more traditional procedure; only a one-to-two-day hospital stay compared with a stay of seven to 10 days; a quick recovery; and minimal complications.

“Their approach was very professional,” Eagle said. “They explained the situation. Dr. Caccavale was compassionate, but definitive. The tumor was small, but they wanted it out as soon as possible.”

Time from consultation to operation was a mere three weeks. Eagle was home after an overnight stay. And though she said she felt short of breath and was fatigued for the first month and a half after the operation, she worked her way back to the treadmill at home and back into a hiking program. “Everything seems to have come back. I play tennis and golf. No problem.” Eagle said.

“All of my friends say how lucky I was and how smart I was to have this test done in the first place,” Eagle said. “Really, it’s not about being smart. It’s just something I read about. It was there for the taking and I took the opportunity. All of my friends are concerned about their own health and have said they plan to sign up for screening.”

Now recovered from her operation and eager to get away from another New Jersey winter, Eagle is ready for a vacation. Where?

“Any place warm at this point,” she said. “Arizona. Maybe some shopping, but I’ve never been much of a shopper. I’m going with a group to explore a different area. I like to be active. All through my married life we played tennis with friends. When we got too old for that we started playing golf. I’ve always had an active life. I’m in the Monmouth County senior hiking program and we go to a different park every week. The hikes are about three and a half miles, for seniors. Not too strenuous. That’s what I plan in Arizona. It’s great to get out and walk and breathe the fresh air instead of walking on the treadmill.”

What began as a lark evolved into serious business. For Eagle, that ounce of prevention may have saved her life.