When she was 16, Sydney Solley picked up her first cigarette and started to smoke it.
The rush of nicotine and the peer pressure from her older sibling to continue indulging were too much to turn from. From there, smoking quickly became a habit that felt impossible to break.
For more than 30 years, the Berkeley County resident was a pack-a-day smoker, she said. It wasn't until seven years ago that she finally kicked the habit.
But years from her last cigarette, Solley began facing some of the after-effects.
Around August of 2020, Solley watched one of her closest friends go through radiation after being diagnosed with lung cancer.
“It's been a very big battle for her,” Solley said. “She told me that I was eligible to receive this low dose CT scan.”
Solley was eligible for the low dose CT lung scan due to her long history of smoking that put her at a high risk for lung cancer. Solley was diagnosed with lung cancer after doctors found a tumor in her left upper lobe of her lung through the CT scan.
On a Wednesday in March this year, Solley was set to have minimally invasive surgery to remove the tumor using robotic-assisted equipment. On the Friday of that same week, she was back home and able to perform her normal daily activities.
“Being a (former operating room) nurse, I know that it would have normally been at least a two-week stay,” said Solley, who worked in the OR at the Medical University of South Carolina for many years.
Diagnosing lung cancer
The surgery and scan were part of a program launched by Trident Health.
Back in 2011, Wes Fox, who is the medical imaging director for Trident Medical Center, read an article about a national lung screening trial that discussed lung cancer screening as a technique to treating the cancer before symptoms appear in a patient.
This new idea was not only a huge breath of hope for those at high risk of being diagnosed with lung cancer but for the evolution of caring for lung cancer patients. Lung cancer has the highest mortality rate of all cancers.
For Fox, the news felt close to home.
“I was kind of attached to that initially when I read the article because my grandmother had just passed the year before from lung cancer within about a year of her original diagnosis,” Fox said.
“Lung cancer historically has been a very difficult disease because it doesn't present itself symptomatically until later stages," Fox said, noting that once the cancer is already on those later stages, the chances of a patient surviving is very low.
Lung cancer claims more lives than breast cancer, prostate cancer and colon cancer combined, Fox said. But even still, there wasn’t much of a screening process in place for lung cancer. When the trial was published, Fox immediately felt passionate about pursuing something similar at Trident Health.
“We (staff at Trident Health) established a multi-disciplinary approach with cardiothoracic surgeons, pulmonologists, radiologists and the administrative team,” Fox said.
From there, Fox said, they created a grassroots movement by going around to different health fairs and primary care physicians' offices around the Lowcountry to promote the opportunity to have a lung cancer screening at Trident.
Since then, the team has screened more than 9,000 patients in the last 10 years and has detected nearly 20 lung cancers every year, Fox said.
“I feel very proud on behalf of the community and the patient population,” Fox said. “Since 2014, we have steadily nationally seen a decline in lung cancer deaths, and maybe that's attributable to change in understanding of the impacts of smoking, but also it is these types of screening programs that are really increasing the survivability of lung cancer.”
Embracing robotic-assisted surgeries
If doctors can diagnose lung cancer early, the survivability rate is immediately higher, Fox said. With the screening process, medical staff can identify pulmonary nodules as small as six millimeters and determine whether they are cancerous.
Of the patients that are identified as having lung cancer early, many of them can have minimally-invasive robotic-assisted surgery. Cardiothoracic surgeon Karen Gersch, who performs these lung cancer surgeries at Trident, has seen firsthand the advancement of robotic surgery technology since the program first began. Gersch leads the lung cancer program for Trident Health and Colleton Medical Center.
“The generation that's coming, we inherently embrace artificial intelligence to help direct us. We are embracing this change and welcoming it. How we are going to save people's lives is through early detection and early intervention,” Gersch said. “These tiny pulmonary nodules that are early cancers, we are going to get them. And if we get them, they aren’t going to get them.”
Gersch said the most important thing for patients is to recognize their risk. If a patient is a smoker, which is the number one leading cause of lung cancer, making the decision to come in for a preventative screening is vital.
“Clearly there are other factors, but really the biggest contributing factor is smoking,” Gersch said, noting that some of those include environmental exposures and genetics. “The key is early detection. Symptoms of lung cancer, where you are coughing up blood or you are short of breath, if you are seeing those, then that's too late. You are already in an advanced stage. If you think, 'Well I'm just going to wait until I have symptoms,' your average survival at that point is six months.”
By using robotic equipment, Gersch can make incisions the size of the tip of a sharpie pen to remove nodules, and patients often return home within a day or two.
“Through our early detection program, we are finding lung cancer in its early stages, and through minimally invasive robotic-assisted surgery I have many patients who are going home 24 and 48 hours after surgery,” Gersch said in a press release. “We’re doing this without the traditional opening of the chest and long recovery time. What we are doing is truly saving lives. It’s very satisfying as a surgeon to give patients new hope.”