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A hybrid operating room at the medical center allows for real time imaging to spot early-stage lung cancers and then remove them in a minimally invasive procedure. This cuts time between

assessment, testing and, treatment—when it comes to cancer, time is everything. Lung cancer is the leading cause of cancer-related death in the United States, claiming more lives each year

than breast, prostate, and colon cancer combined.  Veterans’ risk for developing lung cancer is more than twice the national average for the general public but at the Charles George VA

Medical Center in Asheville, early detection and timely, personalized treatment are transforming outcomes. The facility combines real-time CT imaging with minimally invasive surgery,

allowing doctors to detect and remove nodules before they grow, often during the same procedure.  “We at the Western North Carolina VA Health Care System are extraordinarily blessed to have

one of the very few, early detection of sub-centimeter lung nodules/early lung cancer programs in the nation,” said Dr. Douglas B. Huntley, the deputy chief of staff. “Drs. Schroeder and

Bashir use the latest technological advances in finding and treating lung cancers at a very small size while they are still curable.” A hybrid operating room at the medical center allows for

real time imaging to spot early-stage lung cancers and then remove them in a minimally invasive procedure. This cuts time between assessment, testing and, treatment—when it comes to cancer,

time is everything. “This is a complete game changer,” said Dr. Carsten Schroeder, a thoracic surgeon at the Charles George VA Medical Center. “I can now offer an early resection. Before, I

had to wait until the tumor got bigger so I could feel it or identify it. That wait lowered survival rates.” Schroeder said that he came to the Asheville VA knowing that they had a Hybrid

Operating Room where he could implement this treatment and that many Veterans had an increased need because of exposures. “Veterans have unique exposures — burn pits, Agent Orange, asbestos

— on top of smoking history,” said Schroeder. “That adds up to a significantly higher risk of lung cancer than the general public.” Roughly 80 to 90 percent of lung cancers are linked to

smoking, but many veterans have additional environmental exposures from their service. “It’s one of the reasons lung cancer screenings is so critical in this population,” Schroeder said.

Army Veteran Robert Young, who was recently at the medical center for the procedure was one of those Veterans. He spent time in Haiti, Kuwait and Iraq where he saw burning oil wells, burn

pits and every other kind of smoke and dust that came with deployments to those places. “I had a checkup about a year ago, and they identified something they said they needed to keep an eye

on,” said Young. “When I got a checkup this year, they said it had grown and doubled in size.” After retiring from the Army, Young later became a middle school teacher and had planned to

retire from teaching this May. After talking with his wife and the doctor, he decided not wait to get the growth removed given how important it is to catch the cancer as soon as possible.

Young has this advice for his fellow Veterans about getting treatment, “Don’t ever hesitate, don’t slouch on it. Get it checked out.” Nationwide, only about 25% of people eligible for lung

cancer screening actually get it. People move around a lot, and many don’t maintain consistent primary care that can help them track their risks.  The VA’s system tracks Veterans throughout

their life and has processes to automatically screen Veterans for common health risks. “Here at the VA, we have a centralized record system that flags veterans who qualify,” Schroeder said.

“Their smoking history and age are already in the computer, so during an annual visit, the nurse or doctor gets a prompt: this patient is due for lung cancer screening.” The gold standard

for that screening is a low-dose CT scan, not an X-ray. It’s the only method proven to catch lung cancer early and early-stage detection is everything. “If we find it at stage one, the

five-year survival is about 92%,” Schroeder said. “But if it’s found after symptoms appear, chest pain, coughing, shortness of breath, survival drops to about 1% at stage four.” In the

Hybrid OR, doctors can locate and remove tiny lung tumors, even ones under one centimeter in a single procedure.  “Every millimeter counts,” Schroeder said. “Once that nodule grows from 1 to

2 to 3 centimeters, the survival rate drops significantly, from 92% down to 75%.” Schroeder says the VA system gives him the flexibility to act fast and decided on a treatment plan that is

best for the Veteran. That autonomy extends to follow-up care. If Schroeder wants a three-month scan instead of six, he orders it.  One Veteran who can attest to this is Navy Veteran Gary

Book who had the procedure several years ago. Book already knew he had some increased risk because of exposure to Agent Orange during Vietnam and smoking in his younger years so he was

already getting screened in the private sector before he came to the VA. When he enrolled in VA health care, one of his first requests was to get another lung screening.  “They called me the

next morning, and said I had an appointment set up for a Pet Scan, an appointment for a Pulmonary Function Test and an appointment with the Thoracic Surgeon, it was not a nice weekend,”

said Book referring to the initial anxiety he felt. After meeting with Dr. Schroeder, Book decided to go ahead and have the surgery to remove the growth. Now, more than five years later,

Book says he is still cancer free and credits the VA with saving his life. It’s important for Veterans to be honest about their smoking history so that dedicated staff can ensure patients

are identified, screened, and followed closely if anything suspicious is found. While the VA routinely screens Veterans for risk factors, Veterans who have concerns about their lung health

should discuss it with their primary care provider.