Lung Cancer Awareness: Hari Keshava Stresses the Importance of Screening

Advances in lung cancer treatment are extending lives, but early detection is still key. A new clinical trial led by Hari Keshava, MD, aims to expand screening criteria.

Before Hari Keshava, MD, became a thoracic surgeon, he worked for the Department of Water and Power in Los Angeles doing wireless telecommunications. “I was an electrical engineer in my previous life,” he says. That was before his mother had to undergo a double lung transplant.

“After helping her recover, I decided that this was what I wanted to do with my life,” says Keshava. “So I switched careers and went into medicine. That was my impetus to become a thoracic surgeon.”

Today, he is an assistant professor in the Division of Thoracic Surgery at the UC Irvine School of Medicine and chief of thoracic surgery for the U.S. Department of Veterans Affairs at the Tibor Rubin VA Medical Center in Long Beach. “I wanted to be in an academic setting where I could do research, and with UCI Health and the VA, everything fell into place. It’s a good fit.”

For Lung Cancer Awareness Month this November, Keshava is stressing the importance of screening, which ties in with some of his current research. While he encourages current and past smokers to get a CT scan, he is also running a clinical trial to extend screening to family members of certain lung cancer patients.

Detection is Key

“The problem right now is we only find lung cancer early in about 20% of patients,” says Keshava, lamenting how few people get the needed CT scans. “The scan is painless, and if we find a nodule that happens to be lung cancer, we can do something about it.” If detected early, surgery can offer a cure. Furthermore, there are other options available today, including immunotherapy, targeted therapy and radiation.

“We’re seeing patients, even with later stage lung cancer, living for a long time,” he says. “So if you’ve smoked in the past — that’s the main reason we screen — don’t be afraid to get screened; there’s no stigma.”

Keshava notes that insurance covers the scan if you meet certain criteria. “If you’re 50 to 80 years old, have smoked a pack per day over 20 years, and are currently smoking or have quit within the last 15 years, insurance covers a low-dose CT scan.”

Screening Nonsmokers

Keshava’s research relates to the 10–20% of lung cancers seen in people who never (or rarely) smoked. He is running a clinical trial with the hope of eventually expanding screening criteria to include immediate family members of patients with lung cancer who have a genetic mutation.

“We’ve seen a lot more patients who don’t have a smoking history but still get lung cancer,” he says. “There’s a predominance of lung cancer in family members, so why don’t we screen them for a genetic or an environmental component?” That’s the question that motivated his clinical trial.

So, if you are between the ages of 40 – 80 and have at least one first-degree relative with a diagnosis of lung cancer with a driver mutation — a genetic alteration “driving” the cancer growth — you could be eligible for a free lung cancer screening.

“We don’t have screening guidelines for anybody who doesn’t smoke,” says Keshava. Lung cancer in such patients is usually found either incidentally or once they already have symptoms. “We see a lot of lung cancer found after a CT scan for another reason, like after a car accident,” he says, “or because of later-stage symptoms such as a cough or intractable pain.”

This clinical trial could lead to changes in screening guidelines. “I hope to open up lung cancer screening for a whole population that we currently don’t screen for, because if we find the cancer early, we can cure it with surgery.”

Interested in participating in this clinical trial? Apply online today.