Dr. John Fleishman is an opthamologist practicing in Dayton. Fleishman lost his wife Dr. Jill Rosset to lung cancer in April of 2017.
"My wife was a very smart woman but she had one weakness," he says. "And that was her weakness with cigarettes. She started smoking at the age of 15 and by the time I met her she was an addicted smoker. She promised me before we got married several times that she would quit smoking and she didn’t, and so I married her anyway."
Fleishman says that after “many years of pestering” his wife to quit smoking, she finally succeeded. Then, soon after she quit in 2013, she saw her family doctor for several health screening tests, including a mammogram, pap smear, and colonoscopy.
However, it wasn’t recommended that she be screened for lung cancer, says Fleishman.
In December, 2016, Rosset experienced “horrific chest pain," and had breathing difficulties after hiking in the mountains of Virginia.
Fleishman says a chest x-ray found Rosset had a massive tumor involving the right lower lobe of her lung. By April of that year, she was gone.
“So this experience let me into looking into a little bit more about cancer in the United States,” Fleishman says. “If you look at the rates of cancer deaths in U.S., about 50,000 people a year die from colon cancer, about 40,000 people die from breast cancer and another 30,000 prostate cancer. Add those three together and you don’t get close to the number one cancer killer, and that’s lung cancer, which kills, each year in the U.S., over 160,000 people.”
Statistics show smoking is responsible for 80 percent to 85 percent of lung cancer deaths.
Fleishman says, following his wife’s death, his research indicated a big disparity between the numbers of people who should be tested for lung cancer and those who are tested. And he cites a separate 2011 study, the National Lung Screen Trial.
“This was a multicenter study that was conducted across the U.S. at 33 centers and looked at 53,000 patients, all of whom were heavy smokers over the age of 55.”
Fleishman says the study divided former heavy smokers into two groups. One group got chest x-rays each year for three years. The other group got low-dose chest CT scans.
“What they found was, after three years there’s a 20-percent reduction on the mortality rate in the patients who had received the low-dose chest CT.”
Fleishman says once the trial’s data was published, the American Association of Thoracic Surgeons, the American Society of Clinical Oncology, American Lung Association, and the National Comprehensive Cancer Network, all made recommendations to increase the use of low-dose CT scans for eligible patients.
In 2013 the American Cancer Society made the same recommendation, and in 2015 the federal Medicare program recommended screening for at-risk patients, and began reimbursing for the procedure.”
However, Fleishman expresses his disappointment that the American Academy of Family Practice did not follow suit, and issued a neutral statement on the trial. He believes the group's on-the-fence statement, along with what he says is a bias among some doctors against patients who smoke, are keeping many doctors from screening their patients for lung cancer before it’s too late.
“This is born out by the evidence,” he says. “In 2015, of the 6.8 million Americans who met the criteria for long cancer screening, only 4 percent were screened. In 2015, the following year, of the same 6.8 million Americans only 2 percent were screened.”
Fleishman says he has written a letter to the American Academy of Family Practice in an effort to get them to join other medical associations in endorsing the use of more low-dose CT scans to detect lung cancer earlier.
And, as president of the medical venter at Elizabeth Place, a small physician-owned community hospital, he is encouraging other doctors to step up their efforts in early lung cancer screening and detection.
An upcoming Lung Cancer Research Foundation event is Dayton aims to draw attention to the fight against lung cancer. The group's annual Free To Breathe 5K Run/Walk returns to The Dayton Raceway at Hollywood Gaming on Saturday, Sept. 8, 2018.
Organizers say they hope the event will draw an even larger number of attendees than it has in previous years.
Organizer Kathleen Fennig serves as a volunteer with the Lung Cancer Research Foundation.
"We would like to see this year about 450 people and that would be growth from last year," Fennig says. "We had about 400 last year and we raised about $35,000. We would like to raise, of course a little bit more every year."
Fennig is a registered nurse at Miami Valley Hospital. She also works with Wright State University as a clinical research specialist in maternal fetal medicine.
Yet, her lung cancer advocacy is something Fennig has been passionate about since she herself became a lung cancer survivor.
She's pushing to increase awareness of the disease and encourage more people to get tested .
"Screenings are really only for people who are most likely to develop lung cancer," she says. "And that’s kind of unfortunate. But there are pros and cons to screening and you would want to talk to your doctor about actually taking part in the screening program. "If you’re 55 years or older and you have smoked at least a pack of cigarettes for 30 years and if you quit smoking 15 years ago you are a candidate for lung cancer screening. If you’re 50 years or older and you’ve smoked two packs of cigarettes for 15 years, or 20 years, you are eligible for a lung cancer screen as well."
Aubrey Rhodes with the Lung Cancer Research Foundation has high praise for the work Fennig is doing for the organization. She says events such as Free to Breathe are crucial to advancing the foundation's work.