Detecting lung cancer earlier

New technology transforms biopsies

Doctors at Adena Cancer Center are using new robotic bronchoscopy to help diagnose lung cancer in its earliest stages when treatment is most successful.

Lung cancer is the deadliest type of cancer, causing about 7,000 deaths every year in Ohio. One of the reasons for the high death rate is that symptoms, such as coughing and hoarseness, don’t usually appear until advanced stages. About 65% of lung cancer cases in Adena’s service area are diagnosed in stages 3 and 4, according to the Ohio Department of Health.

If found early, lung cancer often can be successfully treated, sometimes even cured. Lung cancer screening using a CT scan can detect small lesions that can be tested to determine if it is cancer. And that is where robotic bronchoscopy is making the true difference.

“To diagnose someone with lung cancer, we must collect and test a sample of tissue,” says Rajinish Jesudoss, MD, an Adena pulmonologist. “We can perform needle biopsies in many cases. But if the lesion is deep in the lungs, the only way to get a sample in the past was to do surgery.”

Open lung biopsy requires cutting through the chest wall and into the lung. This surgery is difficult with a long recovery time and often requires removing a portion of the lung just to reach the nodule. Many patients are not healthy enough to undergo this surgery.

Adena’s robotic bronchoscopy offers a nonsurgical option. To perform the procedure, the Adena pulmonologist first uses a CT scan to plan the route through the lung airways to the suspicious nodule. During the procedure, the physician inserts a thin catheter through the patient’s throat and into the lungs. A tiny camera on the catheter displays the real-time image of the inside of the airway. The robotic system uses the preplanned map to guide the physician to the nodule. The physician then uses a tool on the catheter to collect tissue. The procedure can be completed in minutes.

Experiential learning

Teaching the importance of colon cancer screenings

Anyone passing by Adena Cancer Center on March 23, 2024, might have done a double take when they saw a giant inflatable colon. And that’s exactly the reaction Jina Fields, RN, a colorectal nurse navigator at Adena, was hoping for when she organized Adena’s first Colorectal Cancer Awareness Walk/Run.

“You hear a lot about other types of cancer, but there’s not as much awareness about colorectal cancer,” Jina explains. “I’ll do whatever I can to help people understand how important colorectal cancer screening is.”

The giant colon was positioned at the end of the 2-mile walk/ run near the cancer center. Inside, the more than 250 participants had a chance to see how precancerous polyps can be found and removed to prevent cancer.

“Many people in our area are scared of colonoscopies,” Jina says. “I want everyone thinking, ‘If I would just do this one simple thing, I could prevent cancer and having to get chemotherapy and radiation therapy.’”

Colorectal cancer is the third most common cancer treated at Adena Health. Jina hopes that as awareness grows, that number will go down. After a first successful event, she plans to hold the walk/run each year during Colorectal Cancer Awareness Month.

Future preparation

New radiation therapy brings benefits to patients today and tomorrow

Adena Health’s radiation therapy department has completed the installation of its second new linear accelerator, making treatment faster and more precise today, while also positioning Adena for future advancements.

“Radiation therapy is rapidly evolving to precisely target and kill tumors while sparing adjacent healthy tissue to improve outcomes,” says Gregory Thompson, MD, an Adena radiation oncologist. “In replacing our previous units, Adena invested in adding advanced tools and techniques to offer safer and more sophisticated services for our patients.”

Adena is one of the first in southern Ohio to offer three techniques that make radiation therapy more precise for patients:

1. deep inspiration breath hold: This technique helps protect the heart during radiation treatments for left-sided breast cancer patients. When the patient holds their breath for about 15-20 seconds, the heart moves to the middle of the chest and drops down slightly. Delivering the radiation at this exact moment helps limit exposure to the apex (bottom tip) of the heart, reducing the risk of associated cardiac disease, Dr. Thompson says. Patients who needed this treatment had to previously travel to Columbus.
2. respiratory gated radiotherapy: This process uses advanced computer software to deliver radiation as a patient breathes. A tumor can sometimes move during treatment, especially if it is in an area that naturally moves as a result of respiration, such as the lungs, chest, or abdomen. Using this technique, caregivers can deliver radiation precisely to the tumor that is timed to the patient's inhalations or exhalations.
3. surface-guided radiotherapy: This technology allows constant monitoring of the surface of a patient during treatment to ensure that the radiation is always targeted precisely. It also ensures that the patient is treated consistently during each session. It is used for many types of cancer, including lung, breast, head, and neck cancers.

Passion for precision

Oncologist extends Adena Health's ability to create customized treatment plans

When Akaolisa “Samuel” Eziokwu, MD, was in medical school, the molecular changes that cause disease fascinated him. That fascination led him into the field of cancer.

“Medical oncology is a field where if you can understand the disease at a molecular level, you can actually practice personalized precision medicine,” says Dr. Eziokwu, a medical oncologist and hematologist who joined Adena Health in 2024, and treats patients at Adena Fayette Medical Center.

Precision medicine drugs, matched to the biological makeup of a patient’s cancer, target the cancer molecule without affecting healthy cells.

Thinking in terms of proteins, enzymes, and proteasomes doesn’t mean, though, that Dr. Eziokwu is a scientist who can’t talk to patients. In fact, he is equally passionate about translating the technical into the understandable.

“I want to be a trusted partner,” he says. “At the first visit, I spend most of my time listening. I want to know my patient’s story, their understanding of what’s going on, the challenges they face, the process that led to the cancer diagnosis. My goal is to try to explain their cancer in a way they will easily understand.”

Researching tomorrow's treatments

Clinical trials offer early access to advancements

When most people think of medical research, they imagine large university-based cancer centers. However, much of this research is being carried out at community cancer centers, including Adena Cancer Center.

“More than 80% of cancer care is in community care centers like Adena,” says Alex Wilson, MD, Adena Cancer Center medical director. “We provide unique insights into how the care is actually being delivered.”

Adena participates in clinical trials as a member of the National Cancer Institute Community Oncology Research Program (NCORP). Adena is one of the largest community clinical trial sites in the Columbus NCORP, which includes surrounding areas like south central and southern Ohio. Adena currently has more than 30 trials open to patients. Dr. Wilson is a member of NCORP’s Cancer Care Delivery Research Steering Committee nationally and the principal investigator at the Columbus NCORP overseeing clinical trials at 26 community cancer centers.

Current clinical trials at Adena involve a wide range of research, from new treatments to health care access. One of the new trials opened this year, PREDICT-RT, is a clinical study for people with high-risk prostate cancer. Patients are assigned into different levels of hormone therapy based on the genetic profile of their tumor. The goal is to determine if less aggressive treatment is effective in patients with particular genes. A sister trial uses the same genetic profile to compare the effectiveness of radiation therapy alone to the standard treatment of radiation and hormone therapy.

“These are examples of trials that give our patients early access to the most current treatments and protocols,” Dr. Wilson says.

Colon cancer patient urges others to get screened

Kay of Londonderry, Ohio

Everyone has regrets in their life. Adena Health patient Kay Barker, however, hopes to turn one of her biggest regrets into an opportunity for others to make a potentially lifesaving decision for themselves.

Fearing a colonoscopy, Kay, 67, of Londonderry, Ohio, had put off being screened for colorectal cancer. After her primary care provider finally convinced her to have a colorectal cancer test, which came back positive, Kay had her first colonoscopy and was diagnosed with rectal cancer in April 2023.

“I'm now out here telling everybody to get their colonoscopy,” says Kay. “I don’t know why I had these fears all those years — there’s nothing to it. I wish I would have done it when I was supposed to.”

Colorectal cancer screening tests can actually prevent cancer if polyps are found and removed before becoming cancer. Colonoscopies detect more than 90% of polyps, which can be removed during the screening. While stool tests are less effective, they can detect some larger precancerous polyps and also detect colorectal cancer in early stages, says Jina Fields, RN, an Adena nurse navigator for patients who are being treated for colorectal cancer.

“My goal is to get everyone to do something,” Jina says. “A colonoscopy is best, but a stool test is better than nothing.”

In October 2024, Kay celebrated news that there were no signs of cancer at her one-year checkup. Now cancer-free, she urges others not to put off getting screened as she did.

“I tell people that getting a colonoscopy is a lot easier than cancer treatment,” Kay says.

Pediatrician opts for local cancer care

When Adena Health pediatrician Lois Jetty, MD, was diagnosed in fall 2023 with breast cancer, some asked if she would be going to Columbus for treatment.

Her answer, every time, was absolutely not. She would trust her care to her colleagues at Adena Health.

“We have such a wonderful cancer center at Adena, so I always say I want to be here,” Dr. Jetty says.

Dr. Jetty was a member of the hospital board when Adena opened its cancer center in 2012. At the time, she didn't think she would become a patient. Her experience, however, has only solidified her belief in the center's importance to the community.

Dr. Jetty was especially impressed by how quickly the cancer team jumped into action and outlined a treatment plan. Her treatment involved six cycles of chemotherapy, mastectomy surgery, and radiation therapy.

Speaking from her experience as a patient, Dr. Jetty says the quality of care that she received and the convenience of being able to stay close to home to receive it should make Adena a destination of choice for both her fellow caregivers and community members.

“I would definitely trust all of those providing care here,” she says. “Plus, your family is not being disrupted by having to drive all the time to Columbus or elsewhere. Exceptional care close to home, that's something that I know from my experience is really, really important.”

Nurse navigators race the clock to spread awareness

There never seems to be a spare moment for Carrie North, RN, and Holly Hooks, RN, who spend their days helping women with breast cancer or gynecologic cancers navigate their way through tests, treatments, and doctor appointments.

But somehow, the two managed to find time to organize a 5K walk/run to raise awareness of breast cancer and raise funds to help their patients. Nearly 200 participants attended the event on Oct. 5, 2024, which raised more than $20,000.

“It’s been a little bit hard to find the time, but we just had to make the time because of the benefit it will provide to our patients,” Carrie says.

The two navigators plan to use the proceeds from the event to purchase “port” shirts for patients who are receiving chemotherapy infusion. Adena purchases the shirts and sends them to volunteers, called the Gang of Seamstresses, in Xenia, Ohio, who add zippers down the side of the port location. They also are using part of the proceeds to offer “cold cap” therapy, which helps chemotherapy patients preserve their hair.

“Patients love these shirts because they make it easier to access the port and provide a lot more privacy,” Carrie says.