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.
JohnCare
Published on November 25, 2024
Last updated 01:25 PM November 25, 2024
A master of everything Mardi Gras, John runs a local krewe and is a natural at building parade floats from the foundation up.
For patients like John, there’s a lot of different aspects we take into consideration when creating a treatment plan. We pull all factors together—like general health, medicines, personal preferences and family concerns—to create the best care plan possible.
- Dr. Robert Taylor
Wellstar Radiation Oncologist
Listen to John's story
A troubling diagnosis
It all began with lung discomfort and tiredness that he just couldn't shake, no matter how much sleep he had each night. Concerned, he visited his primary care provider to get to the bottom of the issue.
After John's vital signs revealed low blood pressure, the doctor sensed something bigger might be happening behind the scenes. John underwent diagnostic testing, including bloodwork and X-rays, to find the cause of his fatigue.
"When the X-rays came back, my doctor noticed a spot in the upper left lobe of my lungs," John said, remembering the fuzzy dot on the X-ray screen. "I had been feeling tired and run down, but overall, I didn't feel that bad."
The troubling results pointed to a clear answer: lung cancer. Even though John didn't notice many red flags when it came to his health, his body was battling a disease he couldn't see.
According to Mayo Clinic, many patients may not experience any symptoms in the early stages of lung cancer. Once the warning signs—such as coughing, shortness of breath, chest pain and hoarseness—set in, the disease may already be at an advanced stage.
After a round of CT and PET scans, the concerning lung spot appeared to be growing in size, even after just a short few days.
Without delay, John was on a mission to find the right health partner to treat his lung cancer before it had the chance to spread.
Cutting-edge cancer care
Soon after the concerning X-ray results, John sought out the medical opinions of several different doctors. All of the professionals recommended a biopsy and other surgical means to treat his cancer.
However, John was firmly against any invasive treatments. That's when he crossed paths with Wellstar Radiation Oncologist Dr. Robert Taylor, who suggested a solution.
"When John first came into the office, he was very worried about the prospect of surgery," Dr. Taylor said, recalling their first meeting at Wellstar West Georgia Medical Center. "He knew about many cancer treatments and was seeking the least invasive option possible."
After discussing John's concerns about surgery, the physician suggested an innovative cancer treatment called stereotactic ablative radiotherapy (SABR).
"SABR is like virtual surgery. Using X-ray technology, you can "reach" inside of a patient and virtually cut out the tumor," Dr. Taylor explained. "When the patient leaves a treatment session, they feel the same as when they entered. There is no surgery or downtime."
For John, this was the perfect, non-invasive option to take care of his cancer, quickly and effectively. He also left the consultation feeling like an equal partner in the process.
"Dr. Taylor explained everything to me clearly," John said. "He knew I wasn't a physician, so he spoke to me in a way that I could understand and laid out all my treatment options."
When building a custom care plan for any patient, Wellstar always takes a personalized approach.
"For patients like John, there's a lot of different aspects we take into consideration when creating a treatment plan," Dr. Taylor shared. "We pull all factors together—like general health, medicines, personal preferences and family concerns—to create the best care plan possible."
With a clear path forward and renewed hope, John felt confident trusting Wellstar with his lung cancer care.
Care right around the corner
A short time later, John began SABR treatments at Wellstar West Georgia Medical Center. With the most advanced cancer technology right in LaGrange, he didn't have to travel out of his way for treatment.
For the hard-working father and grandfather, the access to quick and convenient cancer treatments fit right into his busy schedule.
"Typically, this type of radiotherapy is delivered in about five separate treatments, in 30-minute intervals," Dr. Taylor said, explaining how the specialized treatment works. "The sessions are often done just a few days apart."
Without any incisions or other invasive measures, SABR uses concentrated radiation beams to target tumors precisely. Because his lung cancer was localized, the focused doses could treat the affected areas without damaging the healthy tissues.
Dr. Taylor was pleased with John's health progress throughout the treatment, and his prognosis was quickly looking up.
"John had no side effects and responded very well to treatment," said Dr. Taylor. "One time, he even asked if the machine was turned on because he couldn't feel a thing."
From start to finish, John kept a positive attitude about his cancer care. "The treatments weren't painful. It was a half-hour long, so just long enough for a good nap."
Wellstar offered support every step of the way, addressing John's concerns and crafting an effective cancer treatment plan. But the care didn't end when he left the building.
"During my treatment, the Wellstar team helped me through everything. Afterward, they would call me often to see how I was feeling and ask if I was eating enough," John beamed. "Wellstar is full of caring people. It's not just for show."
The radiation sessions were successful. Just months after the initial diagnosis, John was pronounced cancer-free. His yearly scan and monthly check-ins have all shown no signs of the disease returning either.
Now, John can get back to life and what really matters: planning his annual Mardi Gras parade for family and friends. Moving forward, he will always consider Wellstar to be an essential part of his health krewe.
"My Wellstar care team made me feel like I was a person, not an object they were trying to fix. Nobody treats you like Wellstar."
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Newsroom
Wellstar Georgia Cancer Center’s Pharmacogenomics Program may Help Reduce Side Effects From Chemotherapy for Some Patients
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.
Highlights
Wellstar Experts Collaborate to Help People Fight Lung Cancer
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.
Highlights
Make Lung Health Your Habit
Whether you’re running a marathon or simply running errands, having healthy lungs helps you to live comfortably and do the activities you enjoy.
Lung health is an important part of overall wellness. It’s best to prevent health issues before they start, and Wellstar experts will partner with you to personalize a plan to keep your lungs healthy.
Book an appointment online to check in with a provider about your lung health and follow these tips to breathe a little easier.
Don’t smoke or vape
If you are a smoker, keep in mind that there are both short-term and long-term benefits to quitting. One to nine months after the last cigarette, your shortness of breath should decrease. Within 10 years of quitting, a former smoker's risk of developing lung cancer is 30% to 50% below that of a person who continues to smoke.
Also, if you don’t smoke, do not pick up the habit. Nicotine is highly addictive, even more so than many other drugs including narcotic opiates, according to Wellstar Pulmonologist Dr. Hitendra Patel.
Dr. Patel said that vaping is gaining popularity, especially among younger people. However, vaping irritates a person’s airways and increases their risk of asthma.
“Nothing but air should go in and out of the lungs,” Dr. Patel said. “Any other chemical or substance, or inhalation of smoke of any kind, is going to be detrimental and harmful.”
Wellstar Primary Care Physician Dr. Jignesh Dholaria said misinformation about vaping is common.
“People have the notion that vaping is somehow safer and that it doesn’t have the same chemicals that cigarettes do,” Dr. Dholaria said. “We’re seeing a lot more harmful effects from vaping just because we don’t always know all the chemicals that are in these vapes. That has caused a lot more lung-related injuries.”
Get your exercise and sleep
While staying active is a critical component of overall wellness, it’s especially important to keep your lungs in top shape.
“As you’re breathing in and out, getting rid of carbon dioxide and inhaling more oxygen, that helps your tissues, which helps you feel better overall,” Dr. Dholaria said.
Even if it is raining—or if pollutants are especially high that day and you’re worried about lung irritation—there are ways to get your steps in. Dr. Patel recommends going to an air-conditioned shopping mall or store to get some exercise if being outside is not an option.
“Continuing to exercise to the fullest of your body’s ability is an important step of maintaining whatever lung health you have,” Dr. Patel said. “If you start with healthy lungs, staying on an exercise program and regimen is vital.”
Balance that exercise with some rest, too. Dr. Patel, who is also the medical director of the Wellstar sleep program, said being well-rested can ward off sickness, including some respiratory illnesses.
“If you don’t sleep well, that means your immune system is not going to function as well as it should,” he said.
Try breathing exercises
In addition to getting your sleep, some relaxation and breathing techniques can have benefits for both mental wellness and lung health.
Dr. Patel recommends “4-7-8 breathing,” which involves inhaling for four seconds, holding your breath for seven seconds and then exhaling for eight seconds.
Benefits of breathing exercises may include lower stress and anxiety levels, lower blood pressure and better sleep.
Manage your asthma
If you have asthma, know your lungs and avoid the environmental triggers that cause the condition to flare up, Dr. Patel said. Common triggers include pet dander, seasonal changes, allergens like perfume and smoke inhalation.
Asthma can also run in families, although there is often no specific reason why a person develops asthma, Dr. Patel said.
“Sometimes people underestimate how bad asthma can be,” Dr. Patel said.
If you have asthma, see your primary care physician to monitor your lung health. Pulmonologists specialize in caring for people’s lungs, and they often collaborate with primary care clinicians to create personalized plans to manage their patients’ asthma.
Ask your care team about screenings
Early detection is key in cancer treatment, but many lung cancers present in later stages, Dr. Patel said.
“In that area in the middle of the lungs and the middle of the chest, there are no pain fibers or pain sensors in there,” Dr. Patel said. “If a tumor occurs there, patients don’t know it. They don’t feel it, and it doesn’t hurt them.”
Lung cancer is sometimes found when it spreads and causes complications, Dr. Patel said.
If you are at increased risk for developing lung cancer, ask your care team about screenings. You should consider screenings if you are a current or past smoker. Visit our lung cancer screening page to learn more about if screening, which involves low-dose CT scans, could benefit you. To keep up with your lung health, find a Wellstar physician near you.