Peoria Doctors Breathe Life into Diagnosing Lung Cancer

New equipment, studies implemented to increase survival

By Dayna R. Brown of the Peoria Journal Star, October 1, 2006

It’s basically a death sentence. By the time a patient is diagnosed with lung cancer, he or she typically has less than two years to live. And the numbers haven’t improved in 10 years.

“The truth is that people walk around with lung cancer, and they don’t present until a late stage,” and by then it usually is too late to reverse the disease, said Dr. William Tillis, a pulmonologist with Peoria Pulmonary Associates. 

People know these cases all too well, doctors said. From the time newsman Peter Jennings announced he had cancer, for example, it was just four months until his death.

But local doctors aren’t satisfied with that prognosis. They are trying new equipment and participating in studies to improve the chances of survival for Peoria-area patients with lung cancer.

“If I could blink my eyes and make something happen — it would be to come up with a good screening test. But we aren’t there right now,” Tillis said. “If you have to wait until the patient has symptoms, it has already spread. That is not a good way to find it.”

Lung cancer is the world’s most common and deadliest malignancy. More than 174,000 Americans will be diagnosed with it this year, and 162,400 will die. It will kill more people than breast, prostate and colon cancer combined. “It is a growing, continued problem in the United States,” Tillis said.

The key to beating the disease is to identify the cancer early, before symptoms begin, said Dr. Sachdev Thomas, of Oncology Hematology Associates of Central Illinois, who has been involved with several studies to improve early detection.

“Lung cancer continues to be the most common cause for cancer deaths for men and women. It is a major health problem,” Thomas said. “And, despite some successes that have occurred in the last few years — in terms of treatment and survival — that progress has been very modest.”

Doctors at OSF Saint Francis Medical Center are banking on a new machine to help with early diagnosis. Called an endoscopic ultrasound broncoscopy system, it will help locate tumors at an earlier stage, Tillis said. It combines a standard broncoscopy, which is fiber optic, with ultrasound. Doctors place a lighted scope — typically through the nose — down through the trachea looking for lesions.

“It is a finer picture, and you can go beyond what we were seeing before,” Tillis said. “The ultrasound allows us to visualize lymph nodes and legions that cannot be seen with the standard scope.” Doctors can then biopsy those lesions.

The new machine arrived in late August and will be in use by November. But Tillis recognizes this is just a piece of what needs to be done to improve the odds for lung cancer patients.

Thomas has clinical trials for non-small cell lung cancer right now and tries to have lung cancer trials going on all the time. A national study looking at an advanced type of computerized tomography scan in patients that are at high risk could be helpful to future lung cancer patients, Thomas said.

Some patients in the study will get a spiral CT scan periodically, while other patients will get routine chest X-rays. The detection results will then be compiled. Thomas was involved in the initial work and will participate in follow-up studies.

Thomas also is involved with finding better ways to do radiation and improving the use of medications to help survival, because even if people survive lung cancer, the reoccurrence rate is extremely high.

When working to reduce incidents of lung cancer, doctors can’t ignore the smoking factor, Thomas said, so he has been extremely involved in studies on smoking cessation. Thomas participated in a large study to find out which is the most effective method to get people to quit smoking, and he is involved in a new study that explores the use of medication, psychotherapy and supplements to try to get people to stop smoking. He is also involved in a study to look at certain genetic profiles that predispose somebody to getting lung cancer.

“I think that is the key…unlocking what predisposes someone to cancer,” Thomas said.

Underfunding for lung cancer research is part of the problem. Funding for breast cancer is three to five times greater than what is spent on lung cancer, Thomas said.

“I think a lot of it has to do with this notion that a lot of lung cancer has to do with a certain lifestyle — smoking,” Thomas said. “In my practice, I have yet to see a smoker that has not tried to quit…to say this disease happened because of a lifestyle is unfair.”

More than 87 percent of lung cancers are caused directly by smoking. But while most lung cancer deaths are smokers, there is a rising number of cases in women who are nonsmokers, Thomas said. They aren’t sure what is causing that, but studies are under way, he said.

“What I am trying to do is set up a lung cancer center, and our ultimate goal is to decrease the death from lung cancer,” Tillis said.

The first goal of the center will be for community-based education and preventive measures — smoking cessation strategies, as well as getting people to not start smoking. “That is the best way to prevent lung cancer,” Tillis said.

The second part is to develop strategies to increase earlier diagnoses, and the new equipment will work toward that goal, Tillis said.

The final area is getting into some research and newer treatments and diagnostic tests.

“Anything we can do to improve early diagnosis…and improve treatment…will reduce the mortality,” Tillis said. “Ultimately, the goal is to do whatever we can to decrease the deaths.”