Well Starts with Clean Colons

It seems "defeat" just isn't in John Cashen's vocabulary. A survivor in more ways than one, John has overcome not only a catastrophic natural disaster, but also fought cancer with unyielding resilience.

In 2005, as flood waters from Hurricane Katrina rose and threatened his New Orleans home, John took an axe to his attic's ceiling, climbed atop his roof and tied himself to his chimney so he wouldn't be swept away. Days later, no help had arrived, so John untied himself and swam to an overpass where he was rescued by a helicopter. He joined the rest of his family in Georgia.

Since then, John has become a proud citizen of LaGrange. A master of everything Mardi Gras, John runs a local krewe and is a natural at building parade floats from the foundation up. But when he was diagnosed with lung cancer in 2019, he summoned his fighting spirit, squared his shoulders, and faced his cancer journey head on.

The Wellstar Georgia Cancer Center Pharmacogenomics Program (CaPP) has launched pharmacogenomics testing services for the center’s patients and oncologists. Pharmacogenomics employs genetic sequence alterations in drug metabolism genes to predict toxicity.

The tests measure changes in genes that make proteins that metabolize common chemotherapy drugs. If a patient has a mutation in these genes, their metabolism will not handle the drug properly. This may cause the patient to become sick.

“These tests can help people avoid severe toxicity from chemotherapy. We want to optimize treatment for patients who need a lower dose when they have any gene mutation,” said Dr. John W. Henson, director of neuro-oncology at the Medical College of Georgia and the Wellstar Georgia Cancer Center. The Pharmacogenomics Program is co-led by Henson in the Hereditary Cancer Clinic and Dr. Katherine Saunders-Wohlfrom in Oncology Pharmacy.

The program’s initial focus will be on patients with gastrointestinal cancers in conjunction with Dr. Asha Nayak. Henson said this is where the biggest impact will come right away. Other service lines, including breast cancer, will benefit as more testing is done.

“This is a valuable message to the community,” said Henson. “CaPP services will include testing support, report interpretation, document management, clinician consultation, and patient and family consultation.”

Henson also thanked Dr. Brandy D. Gunsolus in Clinical Laboratory Science for her help with the program, saying she was instrumental in developing the order process.

From catching cancer to following through with expert care, Wellstar ensures patients never have to fight lung cancer alone.

Wellstar is dedicated to early intervention in lung cancer, which improves outcomes for patients. After detection of an abnormality on a CT scan, patients are immediately surrounded with an interdisciplinary support team devoted to their well-being.

Identifying lung cancer early

If you are at increased risk for developing lung cancer, talk to your care team about screenings. With a low-dose CT scan of the chest, it only takes a few seconds to check in on your lung health. These screenings are offered at several Wellstar imaging centers.

The United States Preventive Services Task Force has revised lung screening guidelines. Patients may qualify for screening if they are 50 to 80 years old and smoked for 20 years. If they are a former smoker, they may qualify if they quit less than 15 years ago.

“Lung screening improves a person’s chances of detecting a lung cancer at an early stage and being cured of that cancer,” said Wellstar Thoracic Surgeon Dr. William Mayfield.

Because finding cancer and starting treatment sooner can be life-saving, Wellstar has invested in the incidental nodule program. When people come into a hospital seeking care for something else—whether that be a health condition like appendicitis or a traumatic event like a motorcycle accident—they might get a scan of the abdomen or chest that also shows portions of the lungs.

Using artificial intelligence, reports of those scans are fed to report coordinators, categorized based on their risk level, and if the patient is higher-risk, forwarded to nurse navigators for review. Nurse navigators consult with physicians about the findings, and Wellstar can then initiate care if cancer is found.

“People that come to the hospital for other problems may also be walking around with a lung cancer they didn’t know about,” Dr. Mayfield said.

The program, which started in fall 2020, has identified a total of 148 lung cancers and 14 other types of cancer, as of October 2024.

“Now those people are getting care, and it’s quite likely those cancers would have been missed,” Dr. Mayfield said.

Wellstar is developing another incidental nodule program for the abdominal area, which could lead to the discovery of several cancers including ovarian, kidney, bladder and liver cancers.

The program aligns with the Wellstar mission of enhancing the health and well-being of every person we serve.

“It was the right thing to do for the community. If we miss these cancers, it is a broken promise to the patient,” Dr. Mayfield said.

Then, if cancer is found, Wellstar “closes the loop” by initiating treatment and connecting the patient with resources, Dr. Mayfield said.

Expert care and support at every step

From the very beginning, lung cancer patients at Wellstar are surrounded by a team of experts. Rather than go through the time-consuming process of driving to multiple appointments with different specialists, patients meet with all these physicians in one place.

The Wellstar Lung Cancer STAT Clinic, at Wellstar Cobb, Douglas, Kennestone Regional, North Fulton and Paulding medical centers, as well as the Thoracic NOW Clinic at Wellstar MCG Health Medical Center, give patients immediate access to specialists in medical oncology, radiation oncology, pulmonary medicine and thoracic surgery.

“No other health system does multidisciplinary care the way Wellstar does,” Dr. Mayfield said.

Getting multiple expert opinions from the start not only gives patients peace of mind, it speeds up treatment, too. In the United States, the average time between an abnormal scan and the beginning of treatment is 95 days, Dr. Mayfield said. The STAT Clinic reduces that time to as little as 14 days. Time-to-treatment affects long-term survival in lung cancer patients, Dr. Mayfield said—a six-week delay can reduce five-year survival by up to 13%, according to research from the Cleveland Clinic.

“Time really does matter in the treatment and diagnosis of lung cancer,” Dr. Mayfield said.

High-tech surgery options

For many patients, surgery is a crucial part of lung cancer treatment. Wellstar offers several minimally invasive options, reducing recovery time for patients.

Dr. Mayfield said more than 90% of lung cancer surgeries at Wellstar are performed using either the da Vinci Surgical System or Video Assisted Thoracic Surgery techniques (VATS).

Minimally invasive surgeries reduce pain, scarring, blood loss and infection, as well as time to recover—getting patients back to work and other routines quicker.

The da Vinci system is equipped with 3D cameras and instruments that can make very intricate, precise movements, allowing for shorter incisions and more accurate surgery. Some patients can leave the hospital as early as the next day.

For biopsies, Wellstar has completed 500 procedures using the Ion system, a robotic-assisted platform.

To prevent lung cancer and keep your lungs healthy, talk to your primary care team and follow a few tips, such as avoiding smoking and getting your exercise. Learn more about treatments on our cancer care page.