Prostate Cancer Saved My Life. Let Me Explain.
Stomach Scan Revealed An Unexpected Tumor in My Lung. Lucky for Me.

By John Clemens Campbell
Special to The Washington Post
Tuesday, January 15, 2008; HE04

What do Washington artist Abbey Griffin, Sen. Ted Kennedy and I have in common?

Unforeseen detection syndrome, or UDS. That's what I call it, anyway, and I've come to the conclusion that it's a good thing.

Sure, we know modern imaging techniques -- X-ray, CT, PET, MRI and ultrasound -- can confirm the presence of disease when specialists suspect its presence. I'm talking about something more serendipitous: the unexpected discovery of a serious medical condition by health professionals who were looking for something else.

Now I'm not suggesting all symptom-less people go and get a full-body scan, just in case. No way. Because some scans involve radiation exposure and all can lead to costly and invasive follow-up tests, many experts say that would do more harm than good.

But for those of us with good reason for testing -- as I had following a diagnosis for prostate cancer -- UDS may prevent deaths. As my daughter Kay said while visiting my hospital room little more than a year ago, "Dad, prostate cancer saved your life."

In May 1995, The Post published a special health section on prostate cancer. It included my story of diagnosis and treatment decision-making in 1994. Tests over the next decade indicated I had no further cause for concern.

So imagine how I felt when I learned in late 2006 that five needle biopsies of my prostate area were positive for cancer. A new tumor had emerged and there was concern it might have spread.

Scans of my bones, pelvis and abdomen were all clear -- suggesting the prostate cancer hadn't metastasized. But the stomach scan caught a couple of inches of my right lung in the picture -- and it wasn't pretty. A suspicious nodule was growing in the lung's lobe, apparently unrelated to my prostate cancer. A PET scan "lit up" the nodule, confirming it was a live growth.

On Halloween 14 months ago, I dressed up as a cancer patient and underwent surgery at Washington Hospital Center. The small mass was removed, along with the right lobe and a batch of lymph nodes. Pathology showed the tumor's features to be mostly that of small-cell lung cancer. (Yes, I used to smoke -- but quit in 1974.)

It is very rare to detect small-cell lung cancer at such an early stage. By the time I had symptoms, the surgeon said, the tumor would have been as large as a man's fist -- too big to remove surgically -- and the cancer probably would have spread beyond the lung. Five-year survival rates for such cases are poor.

I underwent four cycles of chemotherapy, ending about a year ago. CT and PET-CT scans showed nothing to worry about (other than calcification near a coronary artery). An MRI of the brain showed, as the old saw goes, nothing there.

This past spring we turned back to the prostate cancer, and I underwent eight weeks of daily radiation therapy at Sibley Memorial Hospital.

Repeated chest CT and skull-to-thigh PET scans over the past nine months showed no sign of tumors. I'll continue to have scans for the next few years.

My experience puts me in a select group of people lucky to have received an accidental lifesaving diagnosis.

The group includes Griffin, an early childhood educator, infant-family specialist and painter, who lives in Washington and in Calvert County.

In October 2005 and again in June 2006 she underwent CT scans to find why she was having repeated kidney infections. A comparison of the two scans showed that her lymph nodes were "firing" in increasing numbers -- a possible sign of cancer.

A biopsy revealed that she had non-Hodgkin's lymphoma -- a surprise to her and her doctors.

Lymphoma is an idiosyncratic cancer, and a person with a case that's diagnosed early, such as Griffin, has a life expectancy as good with no treatment as with multiple cycles of chemotherapy. She decided against treatment and is now part of a lymphoma watchful waiting group at the National Cancer Institute, while she works to build up her physical strength, believing that fitness works in her favor.

What Griffin took away from her surprise diagnosis is the need to trust her instincts about health concerns and insist doctors take them seriously:

"I had been complaining of fatigue and hot flashes for almost a year before those tests," she said. "I just talked to my doctors and then wrote [my complaint] off to menopause or sloth. It is a lesson for me to be more aggressive when I feel there is something wrong."

In October, Kennedy underwent a routine evaluation of his back and spine, which he has had many times before, related to back injuries suffered in a 1964 plane crash. "MRI studies picked up an unrelated, asymptomatic blockage in the senator's left carotid artery," a statement by the senator's office said.

A few days later surgery was performed to repair the partially blocked artery and prevent a stroke.

Christopher Rothstein, a radiologist with Doctors Groover, Christie and Merritt, a practice in the District and Montgomery County, said similar discoveries occur up to five times a month in the firm's hospital practice, with perhaps two turning out to be serious. That's out of more than 7,000 images per month.

"Recently a patient of ours with a failed colonoscopy underwent a CT scan of his colon," Rothstein said. "The scan unexpectedly revealed a mass outside the colon. It proved malignant.

"It's one thing to screen for something among ill patients and detect what we were looking for. It's quite another to discover an entirely different medical issue."

During my most recent PET-CT scan, the technician at Sibley told me, "You can't imagine how many of these [unexpected problems] we find when we're looking for something else entirely."

Yes, I can.

My response? Don't get a full-body scan if you don't need one. And be aware that any scan can cause scares -- and lead to further testing -- with findings that turn out to be false alarms.

But I'm now a believer in the serendipitous element of medical diagnosis -- and committed to getting any scan my doctor recommends.

You just never know what might turn up. ¿

John Clemens Campbell is a Washington area freelance writer who has a marketing and survey research business. Comments:health@washpost.com.