Lung cancer is the leading cause of deaths related to cancer in the United States, but Kevin Haas envisions a future when so many lives aren’t lost each year due to the disease.
“We have hundreds of thousands of dollars worth of technology today and diagnostic yields for pulmonary nodules or spots on the lung is only about 70 percent,” said Haas, MD, University of Illinois Cancer Center member and assistant professor of clinical medicine in the department of internal medicine at UI Health. “That’s not very good. It’s not to say that cancer is being missed 30 percent of the time; it’s that we don’t know exactly what the pulmonary nodule is. We need to change that.”
About 230,000 Americans receive lung cancer diagnoses each year, accounting for 14 percent of all new cancer findings in the U.S. Men are statistically more likely to suffer from the disease than women. One out of 14 men will develop lung cancer at some point during their lifetime, according to the American Cancer Society.
Lung cancer can be diagnosed using a number of procedures, but Haas is most familiar with bronchoscopy, where a soft rubber camera is inserted through the mouth or nose down into the lungs while a patient is sedated. Should something abnormal be detected, a biopsy is taken.
“With a biopsy, a surgeon can cut out part of the lung, but we have very sick patients and many don’t want to have surgery,” he said. “Unlike diagnosing something on a person’s skin, we’re going after something that we can’t physically see in a pulmonary nodule. It’s a tricky thing.”
Finding a better way to diagnose the nodules while patients experience the least amount of complications is what interventional pulmonologists like Haas are working towards. “In the future, we want to sample the nodule in the procedure room, have a physician diagnose it and then have a bronchologist treat the cancer all at once,” he said. “No cutting, no knives, no nothing. Patients walking out of there cancer-free.”
In 2017, Haas received a Respiratory Health Association (RHA) award for his research entitled “Pulmonary Nodule Diagnostic and Therapeutic Timeliness Study (PuNDiTT)”. The organization funds local researchers as they study predictors, develop treatments, and seek cures for lung diseases, including asthma, chronic obstructive pulmonary disease (COPD) and lung cancer. The organization also hosts educational events for health care providers and convene advisory councils for lung cancer and COPD to share new information and address community health concerns.
Haas not only wants to treat his patients, but teach them as well. As part of his research award, he is developing materials focused towards patients with low health literacy to educate them about lung cancer screenings. The Centers for Disease Control (CDC) recommend annual lung cancer screenings with low-dose computed tomography – an X-ray machine scans the body and uses low doses of radiation to make detailed pictures of the lung – for people who have a history of heavy smoking; smoke now or have quit within the past 15 years; and are between 55-years-old and 80-years-old.
“Thirty eight percent of our patients have poor health literacy, and we need to find out how to better educate them, especially about lung cancer screenings,” Haas said.
Haas reviewed patient-centered literature from various health care organizations and found that the readability index for many of them was a 10th grade level. He believed that was too high for UI Health patients, as does the American Medical Association, as it recommends that literature should be written below a sixth grade reading level.
To increase awareness of lung cancer screenings, Haas has begun writing a brochure he can share with patients during their visits. The literature contains illustrations and information on what lung cancer is; what spots on the lung mean; and how the disease can be diagnosed and treated. He is not only developing a version for his patients, but a second one that he hopes will be included on the American Thoracic Society’s website.
“Lung cancer is a huge killer, and the problem is we catch it too late most of the time,” Haas said. “Research has discovered there is a lower incidence of mortality by conducting lung cancer screenings. It’s still relatively new but I think we’re going in the right direction in determining the best way to catch lung cancer earlier.”