Mike's Lung Cancer Story
October 18, 2021
Advanced Lung Cancer Treatment Gives Mike Hope
A smoker for more than 40 of his 62 years, Mike Kapsak had been having annual CT scans of his lungs to screen for signs of cancer. In December, the scan detected a mass on his left lung and his doctor referred him to Bryan Steinberg, MD, FACS, FCCP, Holy Cross Health’s medical director of Thoracic Surgery. Although Mike felt hopeless about his diagnosis, Dr. Steinberg had a solid plan from their first encounter, which gave Mike not only confidence but a fighting chance.
“Dr. Steinberg didn’t hesitate,” Mike said. “He had a plan that started with further testing to get me going in the right direction.” That plan included a prescription for nicotine patches, and Mike quit smoking the day he met Dr. Steinberg. From the beginning, Mike knew he was in good hands.
The first step was a lung biopsy performed at Holy Cross Germantown Hospital, a minimally invasive procedure called Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS). The biopsy determined the cancer was stage 3.
Next, Dr. Steinberg assembled an expert cancer team dedicated to developing a personalized care plan. Mike had six weeks of chemotherapy and radiation treatment. He also had a blood test to determine molecular profiling of the tumor, which suggested his tumor could have a positive response to immunotherapy.
“Dr. Steinberg and his team checked on me often, and I can’t say enough about the nursing staff. Every time they changed shifts, everyone was on top of things, and even the food service was great,” said Mike, shown here with Debi and their daughter Megan.
Mike handled the aggressive treatment regimen well. “I didn’t miss any days of chemo or radiation — or work,” he said. “I was surprised that my only side effect was feeling a little more tired than usual.”
A month later, another scan showed that the tumor had shrunk significantly and suspicious lymph nodes in the first images were no longer positive for cancer. A repeat EBUS now demonstrated that Mike was eligible for surgery.
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“While data shows that patients who have surgery to remove an entire lung after undergoing chemo and radiation tend to have worse outcomes, many of these patients are older, with coexisting medical conditions, and in poor health overall. In comparison, Mike was younger, stronger, had tolerated treatment extremely well, and only needed a portion of his lung removed,” said Kashif Firozvi, MD, Mike’s medical oncologist.
“While the combination of chemo and radiation killed 90 percent of the tumor, 10 percent remained viable, which warranted surgery,” Dr. Steinberg said. “By removing the burden of disease, it’s much more likely that the immune system will be able to fight residual tumors.”
Dr. Steinberg and Dr. Firozvi recommended that Mike pursue a more aggressive treatment approach that included surgery followed by immunotherapy. Recent data presented at the American Society of Clinical Oncology has shown a significant improvement in survival with this approach.
Mike and his wife Debi were unsure about surgery when they met with Dr. Steinberg again. “Debi has been my advocate throughout this whole process. As she has for all my appointments, she came prepared with a list of questions — and Dr. Steinberg always had the answers.” Reassured, they decided to proceed with surgery.
Dr. Steinberg performed Mike’s surgery at Holy Cross Germantown Hospital, using the da Vinci® Xi Surgical System, the most advanced robotic technology available. It gives the surgeon greater dexterity and improved optics, enabling the operation to be performed minimally invasively, which leads to a quicker recovery for the patient.
“Robotic surgery enables us to bring the highest level of surgical care to our patients,” said Dr. Steinberg, who has performed 450 lung resection procedures using the da Vinci surgical system in the last six years.
“Knowing that Dr. Steinberg has done hundreds of these surgeries gave us confidence that he would be able to take care of my cancer,” said Mike, who also has high praise for his care while at Holy Cross Germantown Hospital: “Dr. Steinberg and his team checked on me often, and I can’t say enough about the nursing staff. Every time they changed shifts, everyone was on top of things, and even the food service was great.”
With the surgery behind him, Mike will continue immunotherapy and have regular tests to detect circulating tumor DNA in his bloodstream. This not only helps identify early markers and signs of cancer progression but also helps identify select targeted therapies for the most effective treatment.
“Mike had the most aggressive treatment we can offer someone. We took a situation where there was limited hope and have now given him nothing but hope,” Dr. Steinberg said.
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