How can veterans with lung cancer better understand their risks, testing options, and care? U.S. Navy veteran and lung cancer survivor Jim Pantelas shares his experience with diagnosis and treatment, alongside insights from lung cancer experts Dr. Joshua Sabari of NYU Langone Health, Dr. Michael Kelley of Duke University School of Medicine and the Department of Veterans Affairs, Dr. Drew Moghanaki of UCLA Health, and Dr. Eugene Manley Jr. of the STEMM & Cancer Health Equity (SCHEQ) Foundation.
Learn about lung cancer screening, biomarker testing, military exposures, treatment options, and navigating care through the VA and other health systems, with practical guidance to help patients ask informed questions and take an active role in their care.
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Transcript
Jim Pantelas:
The day I was diagnosed, lung cancer was literally the last thing on my mind. My wife and I had been married about three years. She was six and a half months pregnant, so my only real thoughts were of wanting to live long enough to see our baby born.
I wasn’t coughing up blood or losing weight. I was just tired a lot, and I was having joint pain, all things that felt like they could be the result of turning 50.
You make these incremental goals that are short: stay alive till this point. And I did that for quite a while, always being surprised that I kept living. So I went into the operating room at a Stage 1B with this three-centimeter mass in my lung. I came out and didn’t see the surgeon until the next day because I was pretty much out of it. But the thought was that this was going to be a simple thing, and that removing this mass was going to resolve the issues, and that, as an insurance policy, we’ll follow it up with chemotherapy.
What my surgeon came to tell me the next day was that the pathology reports weren’t good, and that he had to take out more of my lung than he had planned. I was now Stage 3B. He really had no prognosis to share other than that it’s not good.
It’s that conversation that pretty much had me deciding that I had to play an active role in defining my treatment plan.
Dr. Drew Moghanaki:
I try to teach all my veterans, look, we’ve got surgery, we’ve got radiotherapy, and we’ve got drug therapies. And if it’s spreading, we really need the drug therapy to put the drugs into the bloodstream and be able to chase down the cancer wherever it may be.
Dr. Joshua Sabari:
All you need is lungs to develop lung cancer, and all patients should have all molecular testing done, or broad molecular testing done.
Dr. Eugene Manley:
Really advocate for biomarker testing and try to advocate getting the full panel of at least 10 or 11 biomarkers, because most often when you’re Black or underserved, you may get only one or three max.
Dr. Michael J. Kelley:
Smoking is the greatest risk factor for lung cancer, and if you ever smoked, then you should be considered for lung cancer screening. But the military personnel have a higher rate of having smoked sometime in their life.
Jim Pantelas:
My activation tip is to get screened annually, but also to reach out and bring other vets with you to get screened. And to understand that if you were exposed to any toxins while you served, you’re eligible to get screened at no cost at the VA.
Dr. Michael J. Kelley:
Military exposures, we don’t really take into consideration right now in terms of lung cancer screening or treatment. But if you do have a particular exposure that you’re concerned about, then please talk to your primary care doctor, and we can discuss with you whether there’s a screening test that might be appropriate.
Jim Pantelas:
The military ethos of taking care of one another, of having each other’s backs. You didn’t serve alone. I didn’t serve alone. You don’t get exposed alone. And if you smoked, you didn’t do that alone either. Spread the word that there is screening available.
Dr. Michael J. Kelley:
VA has instituted a program to provide that testing and the expert consultation service to be able to interpret those results.
Jim Pantelas:
You need to talk to your docs about the exposures, even if they’re not VA docs.
Dr. Drew Moghanaki:
Healthcare systems aren’t just automatic systems. They’re environments where there are people like myself who work in a healthcare system. And depending on where a veteran’s getting care, that staff may or may not know much about what it means to be a veteran.
Jim Pantelas:
If you can get your care at the VA, do that. Continuity of care is really, really important, and it’s one of those things VA really excels at.
You may have gotten a diagnosis of lung cancer, but that just means that you have an opportunity to try and make sure that others don’t have to wait as long.