Winter 2010

Breathing Easier

Open Procedure Treats Lung Cancer

Thoracic surgeon Stephen Cattaneo, M.D., removed the entire upper lobe and part of the lower lobe of Nancy Kearns’ right lung. Now cancer free, Ms. Kearns is back at work.

On March 9, 2009, after battling for weeks with what she thought was a persistent cold accompanied by a nagging, biting cough, 55-yearold Annapolis resident Nancy Kearns learned she had lung cancer.

“I had a chest X-ray, and my primary care provider, Rachel M. Sweeney, C.R.N.P., didn’t like the results,” Nancy recalled. “I went in for my fi rst CT scan and, again, they didn’t like what they saw.” A PET/CT scan, which combines the X-ray images of a CT scan with the three-dimensional, nuclear imaging aspects of positron emission tomography, confirmed what physicians suspected: the upper and lower lobes of Ms. Kearns’ right lung showed cancer.

A smoker for 43 years, Ms. Kearns wasn’t completely surprised. Once a competitive gymnast, she focused on her treatment options with the goal of winning this battle.

But then, just two days after her own devastating diagnosis, Ms. Kearns’ mother-in-law died of injuries she had sustained in a fall less than a week earlier. Ms. Kearns had been keeping vigil by her mother-in-law’s bedside for three days when the injuries fi nally took their toll.

“On top of getting the news that I had cancer,” said Ms. Kearns, “I was suddenly dealing with the loss of my mother-in-law. But my primary care provider contacted physicians for me and set up my radiology tests. She was so great; everyone was supportive.”

Once in the AAMC system, that support grew. AAMC nurse navigator Teresa Putscher, R.N., orchestrated Ms. Kearns’ appointments at the AAMC Geaton and JoAnn DeCesaris Cancer Institute, while thoracic surgeon Stephen M. Cattaneo, M.D., brought her case before the Cancer Institute’s multidisciplinary thoracic tumor board.

“Ms. Kearns’ case was examined by not only me, but by several other physicians from different specialties on our Tumor Board,” said Dr. Cattaneo. “Due to her overall good health and relatively young age, we treated her disease as two separate cancers, rather than as one cancer that had spread to a second location. As a result, her surgical planning was far different, and probably far better for her.”

Dr. Cattaneo opted for an open procedure to clearly evaluate the lung and to identify any nodules that may have been missed through radiologic testing.

“In this case, Ms. Kearns was battling locally advanced disease, and an open procedure gave me the best chance to fully examine the lung tissue,” said Dr. Cattaneo.

Dr. Cattaneo removed the entire upper lobe and a large part of the lower lobe of Ms. Kearns’ right lung. She was then treated with chemotherapy and radiation at AAMC to kill any remaining cancer cells.

Now cancer free, Ms. Kearns has taken smoking cessation classes at AAMC and is back at work and on the golf course. “My trio of physicians at AAMC — medical oncologist Barry Meisenberg, M.D., radiation oncologist Ashish Chawla, M.D., and Dr. Cattaneo—along with my nurse navigator, worked completely as a team and made everything very comfortable for me,” she said. “I felt very connected to my care.”

–Justin Paquette

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