'If you can find the cancer early on': Underused lung cancer screening could save lives

It was only at the hospital, after collapsing from the fluid that squeezed her heart, that Amy Loiacono, 65, learned what was truly wrong with her.

"It’s definitely cancer, it’s this big and you probably have 3-6 months to live," the doctor told her as she sat alone in the room at Doctors Hospital of Augusta. "And of course, my first reaction was tears started streaming."

Most lung cancer patients like Loiacono are only diagnosed after the cancer has spread and it is far more difficult to treat, said Dr. Nagla Abdel Karim, a medical oncologist specializing in lung cancer at Georgia Cancer Center at Augusta University. But if more high-risk patients took advantage of screening, their cancer could be caught earlier and their prognoses improved.

"Basically, if you can find the cancer early on, then we can see about curative options, like surgery and take it out completely," Karim said. For former smokers 55 and older, that would be a lung CT scan that could find those cancers sooner.

But nationally, only 5.7% of those eligible for those screenings got them, according to the American Lung Association. Georgia was 31st in that rate at 5.6%, the report found.

Many high-risk patients are simply unaware of the screening, Karim said. Smokers who are at high-risk may also be resistant to having one done, she said.

"A lot of times with the screening programs they also tell people to quit smoking and many people do not want to quit smoking," Karim said.

Health: Genetic 'signature' could point the way to better diagnosis, treatment of lung cancer

More than a tote bag: The Lydia Project addresses many needs during cancer patients’ fight

Even with an improving death rate, lung cancer is still the biggest source of cancer deaths for both men and women, according to the American Cancer Society's Cancer Facts and Figures 2021. While the death rate has fallen 54% since 1990, lung cancer accounts for 12% of all cases in men and 13% of cases in women but 22% of all cancer deaths for both, the cancer society noted. In Georgia, lung cancer will kill an estimated 4,200 people this year and 2,550 in South Carolina, according to the report.

Those CT screenings lower the risk of death by 20% and while only 17% of cases are caught early, the 5-year survival rate improves with early detection from 21% to 59%, according to the report.

The problem with lung cancer is there are no obvious early symptoms that would alert the patient, Karim said. In Loiacono's case, her sudden weight loss, dry skin and hair falling out led her to self-diagnose a thyroid problem. Then she began feeling chilly and lethargic.

"In May I was wearing coats, I was so cold," Loiacono said. "And I couldn’t hardly walk."

Her sisters came in, took a look at her sitting pale on the couch, and rushed her to the emergency room.

"They literally saved my life," Loiacono said. The cancer had caused a massive build-up of fluid in the sac around the heart that was severely squeezing it and causing her other organs to shut down. After they drained the fluid and did other tests, Loiacono got the bad news of her Stage IV cancer. She will never forget that day.

"That was my wedding anniversary, May 19, 2020," Loiacono said. "And then a couple days later was my birthday. That was a very crying week there."

But then her attitude changed.

"I got over it real quick," Loiacono said. "I said, 'I am going to live like I’ve always lived, live every day.' "

At the cancer center, she was able to get three weeks of radiation therapy and chemotherapy plus an immunotherapy drug to help her immune system join the fight. Loiacono responded very well, said Karim, who is her doctor. Loiacono qualified for a clinical trial where radiation therapy went after lingering spots of cancer in her body.

"Thankfully, that even responded better and we can’t see active cancer now," Karim said. Although Loiacono is now on a maintenance therapy where she receives a chemotherapy drug every three weeks, she actually looks forward to it.

"It gives me energy," Loiacono said. And while she can't say enough nice things about Karim and the cancer center, there is another she credits for her continued survival.

"Every day, I ask my Lord to put a little eyelash on my shoulder and let me live another day," Loiacono said. "I want a piece of my God with me. He’s been blessing me. Here I am, still alive."

Who should get lung cancer screening?

The U.S. Preventive Services Task Force earlier this year recommended CT scans to screen for lung cancer in patients ages 50-80 who have a "20 pack-year" history, someone who smoked a pack a day for 20 years, who are current smokers or who have quit within the last 15 years.

This article originally appeared on Augusta Chronicle: Lung cancer screenings could lead to earlier diagnosis, save lives