Last September, Harvey Hasart went to his primary care doctor for what he thought would be a normal annual physical.
Looking back, he credits that day with saving his life.
His doctor, Arashdeep Litt, MD, an internal medicine doctor with Spectrum Health Medical Group, suggested he undergo lung cancer screening.
For anyone age 55 to 80 who is at high risk of lung cancer, the Spectrum Health Lung Mass and Cancer Care Multispecialty Team early detection screening program recommends one low-dose CT scan each year for a minimum of three years.
As a former smoker, Hasart qualified. He remembers the day 50 years ago he caught his older brother smoking.
“He made me start so I wouldn’t tell Dad,” Hasart said.
A few days after his appointment with Dr. Litt, Hasart went to Spectrum Health Gerber Memorial Hospital in Fremont for his CT scan. Within 24 hours, Dr. Litt’s office called. They had found a suspicious nodule.
It was an early catch, which is a big advantage in fighting lung cancer.
“The idea with the screening is that we can diagnose it when it’s more treatable,” said Marc McClelland, MD, a Spectrum Health pulmonologist.
Lung cancer tends to have poor outcomes because it usually gets diagnosed at an advanced stage, Dr. McClelland said. The disease typically does not have any symptoms until it has advanced beyond stage one or two.
Since its creation in 2015, the lung cancer screening program has identified 33 cases of lung cancer and nine cases of other kinds of cancer, including kidney and liver. Nineteen of the lung cancer cases were found in the earliest and most treatable stage, stage one.
The program is currently following 728 patients with annual CT scans.
A few days after receiving the bad news, Hasart met with the Lung Mass and Cancer Care Multispecialty Team. The group of cancer specialists includes a diagnostic radiologist, medical oncologist, pathologist, pulmonologist, radiation oncologist, thoracic surgeon, nurse and social worker, all coalescing to offer coordinated care for patients like Hasart.
The next step, a PET scan, revealed the nodule and a lymph node looked suspicious and needed biopsy.
Hasart’s case grew more complicated yet. Within days of his PET scan, he experienced chest pain on the golf course. He ended up needing a heart stent and he had to regularly take a blood thinner.
The multispecialty team thought it best to admit Hasart to Spectrum Health Butterworth Hospital for the biopsy, which allowed them to switch blood thinners and monitor his heart closely, Dr. McClelland said.
The results of the biopsy held more bad news: small cell lung cancer.
Small cell lung cancer makes up only 10 to 15 percent of all lung cancers. It is known for growing rapidly and spreading quickly, although it typically responds well to chemotherapy and radiation.
Dr. McClelland said the fact that Hasart’s cancer was small cell rather than the more common non-small cell cancer surprised him and the other specialists on Hasart’s team. It didn’t appear to be small cell originally, he said.
“That’s the beauty of the lung (multispecialty team),” Dr. McClelland said. “As long as I have been doing this, no case is the same as any other case. There’s no textbook in the world that could include the extensive variety and depth of what we see, so that’s why the team is so valuable.”
The team meets together on a regular basis to discuss each case, allowing for effective communication and more streamlined care. This ultimately means patients get answers faster, sometimes with same-day biopsies and results, Dr. McClelland said.
The week after Thanksgiving, Hasart started four rounds of chemotherapy at Spectrum Health Cancer Center. The day after Christmas, he started radiation. Both steps were successful fighting the cancer in his lungs.
When a scan then revealed a small lesion on his brain, the multispecialty team opted for him to receive radiation treatment to his brain, Hasart said. It’s common for small cell lung cancer to spread to the brain. In early May, a post-radiation brain scan showed the lesion was gone and there was no more evidence of cancer.
Hasart’s girlfriend, Deb Bisel, has been at his side throughout this journey. The two met online when Hasart lived in Wisconsin and Bisel in Newaygo, Michigan. They dated long distance a few years before Hasart retired and moved to Newaygo in November 2016.
Bisel lost her husband of 26 years, Ned, to lung cancer in 2011. By the time they found his cancer, it was too late to do much.
In a serendipitous twist, Bisel works for Spectrum Health as the manager of cancer program compliance. In this role, she helped develop the lung mass and cancer multispecialty team. Bisel also helped plan a symposium for primary care physicians to learn more about cancer screening, including lung cancer. Dr. Litt attended that symposium.
“We are so thankful (Dr. Litt) ordered the CT scan, and we think it saved his life,” Bisel said. “This validates how important this stuff is.”
Those eligible for the screening program are active smokers with a history of 30 or more pack years and former smokers who have quit within the past 15 years. (Pack years is calculated by multiplying packs per day by years smoked.)
Patients with lower risk who do not meet those guidelines may speak with their doctors about whether they would benefit from screening outside of the program, Dr. McClelland said.
Patients like Hasart, who have quit smoking, can sometimes be forgotten, Dr. Litt said.
“This reinforces my faith in primary and preventive care,” Dr. Litt said. “You want to intervene before things go out of control, before things go in the wrong direction.”
Dr. Litt grew humble when she heard Hasart credited her with saving his life.
“I was doing my job as any good primary care physician should be doing,” she said. “I’m grateful and thankful he thinks highly of me, but mostly I am grateful he is doing well.”
Hasart is now focused on enjoying his retirement. He works part-time driving cars to the east side of Michigan for auto dealers. Most of the time, however, you will find him on the golf course or in the kitchen baking or cooking.
His last day of chemotherapy treatment was Valentine’s Day. He couldn’t wait to get home to make lobster dinner for Bisel.
That day, Bisel’s assistant, Diane Ivy, came down from her office in the cancer center with a celebratory gift for Hasart—a mix of cookies, a chocolate rose, a teddy bear and other goodies.
“I just wanted to come and see you for the last day,” she said.
The teddy bear, she said, was for “whenever you need a hug and Deb is not there.”
As Hasart readied to leave, a nurse wished him well and asked how he felt.
“I don’t feel sad, that’s for sure,” he said.