Dr. Andrea Axtell is hopeful that increased screenings and advancements in surgical intervention can help improve early detection of lung cancer and save more lives.
“Lung cancer is the number one killer of both men and women for cancer, and yet it’s not out there being talked about enough,” said Axtell, a cardiothoracic surgeon at UW Health | Carbone Cancer Center.
Currently, guidelines from the U.S. Preventive Services Task Force suggest an annual CT chest scan for adults ages 50 or older who have a tobacco smoking history of at least one pack per day for 20 years, or two packs a day for 10 years, and who currently smoke or have quit within the last 15 years.
However, the American Lung Association estimates only about 7% of those high-risk Wisconsin residents are getting screened. Nationally, that number is 4.5%. Screenings are crucial for early detection, and patients whose cancer has not spread beyond the lungs have a very good treatment outlook. Yet most lung cancer diagnoses are made at later stages, which is why the disease is so often fatal.
“I think it’s lack of awareness, I think there’s some stigma associated with it that we need to combat, and I think it’s access to screening,” she said. “These are all things from the public health perspective that we need to address and work toward improving.”
Axtell has started performing a new minimally invasive diagnostic surgery at UW Health for patients who have a concerning lung nodule show up on a CT scan. Using a robotic bronchoscope, she can reach the concerning nodule for a biopsy, and a waiting pathologist can test if the tissue is cancerous while the patient is still under anesthesia. If the biopsy does confirm cancer, Axtell can remove that nodule immediately.
“It’s one procedure where the patient comes in, they get a diagnosis, and, if appropriate, they get definitive treatment all in one,” she said. “That saves so much time and the stress of an unknown or a cancer diagnosis and waiting for treatment. That’s something I’m really excited about.”
Axtell is also active in research and co-leads the Carbone Cancer Center’s Thoracic Oncology Disease Oriented Team, which brings promising research discoveries into clinical trials. One of their latest trials involves testing a new combination approach of chemotherapy and immunotherapy prior to surgery for stage II or III lung cancer patients. Following surgery, the patients would resume chemotherapy and immunotherapy treatment. The study hopes to show that the combination approach improves survival compared to using chemotherapy alone.
This trial is currently accepting patients, and for more information about this and other trials, contact the Clinical Trials Nurse Navigator team at (608) 262-0439 or clinicaltrials@cancer.wisc.edu, or visit UW Health's cancer clinical trials page.
Aside from increased early detection, Axtell’s research interests also include improving surgical outcomes for lung cancer patients. She recently presented her research on identifying possible risk factors of venous thromboembolism, a serious post-surgical complication that can cause a blood clot to become lodged and block blood flow in the lungs. This can improve post-surgical monitoring for at-risk patients.
Axtell is excited about the progress being made for lung cancer patients and emerging research that will continue to improve survival.
“I think there are a lot of new, exciting advancements in the field of lung cancer,” she said.
