New treatments attack lung cancer

Chief meteorologist Joe DeNardo, of WTAE-TV, quit smoking three years before doctors discovered a cancerous tumor in his left lung.

A two-and-a-half-packs-a-day smoker for nearly 40 years, DeNardo said he is extremely fortunate doctors caught the cancer in its early stages.

DeNardo discussed his cancer treatment during the second presentation in the "A Reason to Hope" education series, sponsored by the Arnold Palmer Pavilion, on Nov. 3 at Mountain View Inn, Unity Township.

"I went to get a regular checkup that luckily included a chest X-ray," said DeNardo.

After undergoing a CT scan and a bronchoscopy in which doctors inserted a flexible tube through his nose and into his lungs to obtain biopsy samples of the tumor, DeNardo was advised to check into the hospital for surgery.

"I told the oncology doctors I wanted a second opinion. My primary care physician said to go through with the procedure," DeNardo said. "They weren't sure whether I would make it through the surgery."

Dr. James Luketich, an associate professor of surgery and chief of the division of thoracic surgery, University of Pittsburgh School of Medicine, performed the operation at UPMC Presbyterian Hospital.

Luketich used minimally invasive surgery to remove DeNardo's left lung through a small 2-inch incision under his left arm.

"I had my surgery on Aug. 14, 1998, exactly two weeks from the time I was diagnosed," DeNardo said. "Dr. Luketich sent me to a cardiologist because 30 percent of those who have a lung removed develop heart arrhythmia. Four days after I got home, my heart got out of rhythm."

Outpatient chemotherapy and radiation treatments followed surgery. Luketich then put DeNardo on a physical therapy regime.

"I got a treadmill at home and began using it every day. I started with just five minutes a day, then worked my way up to 30 minutes a day," said DeNardo. "You have to realize, I couldn't do one mile with both my lungs. Now I walk two miles a day.

"I can play golf. I can't run the New York Marathon, but I've got a good life."

At his five-year checkup in August, doctors at the Hillman Cancer Center, in Shadyside, Pittsburgh, told DeNardo his right lung now occupies 70 percent of the area where his left lung used to be because of his physical therapy.

Dorothy Petrosky, of Latrobe, attended the "A Reason to Hope" program to learn more about new cancer treatments.

Petrosky, 74, was diagnosed with lung cancer in September 1998. A longtime smoker like DeNardo, Petrosky stopped smoking about 14 years before her diagnosis.

"I was on my way to see my newborn great-nephew and I didn't want to burn him with a cigarette, so I threw my cigarettes away. That was it," she said.

Doctors diagnosed her with adenocarcinoma, cancer that begins in cells lining certain organs that have gland-like properties. In the United States, adenocarcinoma is the most common, accounting for about 40 percent of all lung cancers.

An alert medical resident at Latrobe Area Hospital can be credited with discovering Petrosky's lung cancer.

"I was doing my cardiac rehab when I started having chest pains," said Petrosky, who had suffered a heart attack in August 1993. "I went down to the emergency room and this resident kept coming in and listening to my heart. He told me he didn't hear anything wrong with my heart."

The resident asked her to undergo a chest X-ray. When doctors at LAH saw the results, they ordered a CT scan and determined she had cancer.

Petrosky underwent surgery at UPMC Presbyterian Hospital on Oct. 13 to remove the upper lobe of her left lung. She was discharged from the hospital on Oct. 20 and, after spending several days recuperating at a friend's home, returned to her Latrobe residence on Oct. 26.

"Latrobe's oncology department had pulled all my charts, lab tests, X-rays, everything and I just handed them to the oncology surgeon in Pittsburgh. My surgeon didn't think it was necessary for me to travel back to Pittsburgh for my follow-up care. He advised me to go to Latrobe.

"I didn't have to have radiation or chemotherapy. And I went back to my cardiac rehab on Nov. 2," said Petrosky.

According to the American Lung Association, there are 175,000 new cases of lung cancer annually and 150,000 deaths caused by the disease each year in the United States.

"In Stage 1 cancer, there is a 70 (percent) to 80 percent survival rate," said Dr. Chrish Fernando, assistant professor, division of thoracic surgery at UPMC, and one of the presenters at the "A Reason to Hope" lecture. "Early detection is vital."

Oncologists use a variety of techniques to determine stages of cancer, including chest X-rays, CT scans and bronchoscopies. A PET scan, using positron emission tomography, is a nuclear-medicine scan that measures the metabolism of the cancer. Because cancer cells grow faster than normal cells, they metabolize nutrients quicker and that difference can be picked up on a PET scan.

"PET scans are more accurate than CT scans," said Fernando. "They provide more information and are 85 percent accurate in telling doctors if the tumor is cancerous."

Oncology surgeons are focusing on minimally invasive techniques to diagnose and treat cancer. A mediastinoscopy involves a small incision above the collarbone in which the surgeon inserts a special tube into the mediastinum . The tube enables the surgeon to see the lymph nodes near the heart and biopsy them. Video-assisted thoracoscopic surgery, or VATS, allows a surgeon to see the exterior of the lung and biopsy any suspicious-looking areas.

"The goal of any surgical procedure on the lung is to remove the cancer and preserve the lung," Fernando said. "There are procedures in which a small wedge of the lung can be taken, but there is a higher risk of the cancer recurring."

Many new treatments are targeting specific cancer cells, Fernando added.

Stereotactic body radiotherapy, three-dimensional conformal radiation therapy, and intensity modulated radiation therapy are different methods of administering radiation that are more precise than traditional radiotherapy. Radiofrequency ablation uses high-frequency electric current to kill cancer cells.

"Radiofrequency ablation uses an active electrode that actually cooks the cancer," said Fernando. "When we start cooking the cancer, we eventually get a sphere of destruction, thereby eliminating the cancer. However, we don't know the long-term results yet of RFA treatment.

"Research into lung and other cancers continues in Pittsburgh. What happened to Joe (DeNardo) is now standard treatment."

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