Only in the hospital, after the collapse of the fluid that was pressing on her heart, Amy Loiacono, 65, found out what was really wrong with her.
“It’s definitely cancer, it’s so 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 flowing.”
Most patients with lung cancer like Loiacon are only diagnosed after the cancer has spread and it is much more difficult to treat, said Dr. Nagla Abdel Karim, a medical oncologist specializing in lung cancer at the Georgia Cancer Center at Augusta University. But if more at-risk patients would benefit from screening, their cancer could have been caught earlier and their prognosis had improved.
“Basically, if you can find the cancer early, then we can look at medical options, like surgery and get rid of it completely,” Karim said. For former smokers 55 and older, this would be a lung CT scan that could find those cancers sooner.
But nationally, only 5.7% of those eligible for those screenings received them, according to the American Lung Association. Georgia was 31st in that rate at 5.6%, the report found.
Many at-risk patients are simply unaware of the examination, Karim said. Smokers who are at high risk may also be resistant to making one, she said.
“Many times with the exam programs they also tell people to quit smoking and a lot of people don’t want to quit smoking,” Karim said.
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Even with improving mortality, lung cancer continues to be the largest source of cancer deaths for both men and women, according to the American Cancer Society’s Cancer Facts and Figures 2021. While mortality 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 about 4,200 people this year and 2,550 in South Carolina, according to the report.
These CT scans lower the risk of death by 20% and while only 17% of cases are detected early, the 5-year survival rate improves with early detection from 21% to 59%, according to the report.
Karim said the problem with lung cancer is that there are no obvious early symptoms that would alert the patient. In Loiacon’s case, her sudden weight loss, dry skin and hair falling out made her self-diagnose a thyroid problem. Then she began to feel cold and lethargic.
“In May I wore coats, I was so cold,” Loiacono said. “And I could hardly walk.”
Her sisters came in, saw that she was sitting pale on the couch, and hurried her to the emergency room.
“They literally saved my life,” Loiacon said. The cancer caused a massive accumulation of fluid in the sac around the heart, which strongly pressed on it and caused her other organs to close. After they drained the liquid 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 after a few days it was my birthday. That was a very crying week there.”
But then her attitude changed.
“I overcame it very quickly,” said Loiacon. “I said, ‘I’ll live like I’ve always lived, live every day.’ ”
At the cancer center, she was able to receive three weeks of radiation therapy and chemotherapy plus immunotherapy medication to help her immune system join the fight. Loiacon responded very well, said Karim, who is her doctor. Loiacon qualified for a clinical trial where radiation therapy went after prolonged spots of cancer in her body.
“Thankfully, that responded even better and we can’t see active cancer right now,” Karim said. Although Loiacono is now on maintenance therapy where she is receiving chemotherapy medication every three weeks, she is actually looking 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,” Loiacon said. “I want a piece of my God with me. He blesses me. Here I am, still alive.”
Who should get an examination for lung cancer?
The U.S. Prevention Service Task Force earlier this year recommended CT scans to examine lung cancer in patients ages 50-80 who have a “20-pack year” history, someone who has smoked a pack a day for 20 years, who are current smokers or who resigned in the last 15 years.