Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Advances in screening, surgery help more survive lung cancer

TAMPA — Richard Macdonnell started smoking when he was a teen. When he heard about low-dose CT scans to detect lung cancer, he knew he was a candidate.

"It was always in the back of my mind," said the 59-year-old, who smoked a pack a day for 40 years. "I knew I should do it, but I always put it off."

Last month, he summoned the courage, went to Moffitt Cancer Center and handed over $150 for the test, no prescription required.

The news was bad and yet good, too.

He did have lung cancer — but the tumor was only the size of his thumbnail and had not spread.

Just a few years ago, it could have been a much different story.

"Most of the time lung cancer isn't picked up until someone has symptoms and when tumors are the size of an orange or have spread to other organs in the body," said Dr. Jacques Fontaine, the thoracic surgeon at Moffitt who treated Macdonnell.

"Screening has changed that. Now we can catch cancers earlier when they are operable with robotic surgery and small incisions, and patients can get back to work and normal activities much faster."

Though breast cancer gets much more attention, lung cancer is actually the nation's top cancer killer. In 2010, 201,000 Americans were diagnosed with lung cancer, and 158,000 died from it.

Last year, a landmark study came out that confirmed that routine CT scans could help save the lives of people like Macdonnell whose long-term heavy smoking put them at high risk of lung cancer. Since then, medical groups have been recommending the scans, but they've been slow to catch on, possibly because they're not covered by most insurance plans yet.

"That will change as word gets out that these are curable cancers," Fontaine said. "Screening will change the lung cancer landscape."

If a lung cancer is found when it is less than a millimeter, or about the size of a blueberry, patients have an 80 percent chance for cure, Fontaine said. "If it's the size of a strawberry, there's a 70 percent cancer for cure."

So, why not screen everyone?

Like any medical test, lung CT scans have benefits and risks, notably exposure to radiation that itself can cause cancer. Researchers have shown the benefits outweigh the risks among people most likely to have lung cancer — those who smoke at least two packs a day for 15 years or one pack a day for at least 30 years.

"We don't know if screening someone who smoked a pack a day for 20 years, for example, is beneficial, because we didn't study that group," Fontaine said. "We will screen them, yes, but we require a prescription from your doctor."

Before CT screening, the only people diagnosed early were those who learned of it by accident when they had a CT scan for some other reason. For Virginia Costenbader of Gulfport, it was a fainting spell in 2011 that spurred her doctors to order a battery of tests. They found no reason for her fainting, but they did find a small speck on one of her lungs that was later found to be lung cancer.

"It was such a shock. I never would have thought I'd have lung cancer," said the 85-year-old, who has never smoked.

Costenbader and Macdonnell found their cancers in different ways, but both benefited from recent advances in surgical techniques. Today, early-stage lung cancers can be removed without cracking open the chest and spreading the ribs. Instead, less invasive robotic surgery, which involves making a few small incisions in the chest, is all the treatment patients such as Macdonnell and Costenbader need.

"No radiation, no chemotherapy and I'm clear as a bell," said Macdonnell, who works in construction and equipment maintenance at a Sarasota golf course.

Costenbader, who has always been physically fit and active, was home in two days and walking around her neighborhood within a week. Macdonnell is still recovering at home but expects to return to his physically demanding job in the next couple of weeks.

"I'm still fighting fatigue. But, if I worked in an office, I'd be there today," he said.

Irene Maher can be reached at

Advances in screening, surgery help more survive lung cancer 11/29/13 [Last modified: Friday, November 29, 2013 10:07pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Video: Loggerhead sea turtle found in Islamorada resident's pool


    An adult female loggerhead sea turtle, discovered in an oceanside residential pool in Islamorada on Monday, has been rescued and released off the Florida Keys.

    An adult female loggerhead sea turtle, discovered in an oceanside residential pool in Islamorada on June 22, 2017, has been rescued and released off the Florida Keys. [Photo from video]

  2. What Wilson Ramos will mean to the Rays lineup, pitching

    The Heater

    ST. PETERSBURG — Chris Archer was stumping for all-star votes for Corey Dickerson during a live interview Wednesday morning on the MLB Network when he lifted the right earpiece on his headset and said, "I hear a buffalo coming."

    Tampa Bay Rays catcher Wilson Ramos (40) waves to the crowd after being presented with the Silver Slugger Award before the start of the game between the New York Yankees and the Tampa Bay Rays at Tropicana Field in St. Petersburg, Fla. on Tuesday, April 4, 2017.
  3. Deon Cain, Duke Dawson, Derrick Nnadi among SI's top 100 players


    Sports Illustrated's countdown of the top 100 players in college football continues with three more local players.

  4. She doesn't care if you accept her, as long as you respect her

    Human Interest

    Mary Jane Taylor finds strength walking quietly among the dead.

    Mary Jane Taylor,18, visits Oaklawn Cemetery in downtown Tampa when she is feeling low. "When I hit my low points in life I go the the graveyard," she says. "people are afraid of the graveyard. I love the graveyard." The transgender teen recently graduated from Jefferson High School. She is  enrolled in summer classes at Santa Fe College in Gainesville studying international business. She plans to transfer to the University of Florida, attend law school and become a civil rights lawyer. (JOHN PENDYGRAFT   |   Times)
  5. Few new details in state investigation of Tarpon Springs officer-involved shooting of Nick Provenza

    Public Safety

    TARPON SPRINGS — An investigative report, released this week by the Florida Department of Law Enforcement, into the officer-involved shooting that killed 25-year-old Nick Provenza included largely the same narrative prosecutors released this month that ruled the shooting a "justifiable homicide."

    Stopping while riding by on his bike Michael Prater, 15, hangs his head after looking at the memorial at Safford and Tarpon avenues for Nick Provenza, a 25-year-old who was shot and killed there during a car show Saturday by a Tarpon Springs police officer. Investigators said Provenza pulled a knife on the cop who shot him. Friends find it hard to believe a man they described as a peaceful vegan and musician would be capable of such an act. Prater didn't know the victim but was at the car show.