When Devonne Swift developed a persistent cough in 2021, she never imagined it could be a sign of lung cancer — after all, she had never smoked. But thanks to a lifesaving new diagnostic technology called a robotic bronchoscopy, doctors were able to peer deep into Swift's lungs to detect her cancer before it had spread.
Prior to her diagnosis, Swift was living an active, outgoing life. A self-described extrovert, she loved bowling and spending time with friends and family, especially her son.
The 55-year-old mother has worked for American Airlines for 34 years, lugging around pounds of bags every day. But in 2021, she had to face something much heavier than any piece of luggage she had handled: lung cancer.
A nagging cough with a surprising cause
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"I had an ongoing cough that just would not go away," Swift told TODAY in a segment aired Tuesday, Feb. 28. The cough lasted at least two weeks, Swift said, but she kept putting off going to the doctor — until people around her grew concerned.
"A very close friend of mine said, 'Listen, get dressed, I'm coming to pick you up and take you to the ER.' I'm glad she did because they did an X-ray, and they saw a spot on the lower, right part of my lung," said Swift, adding that she was diagnosed with pneumonia.
Doctors treated the pneumonia and prescribed a steroid, in hopes that it would help shrink the spot in her lung, but it didn't do anything. After following up with her primary care doctor, Swift was referred to Dr. Jae Y. Kim at City of Hope's Comprehensive Cancer Center in Duarte, California.
U.S. & World
"Dr. Kim discussed with me a couple of procedures to do a biopsy, and one was a robotic bronchoscopy," said Swift, adding that she opted for the new robotic procedure because it was less invasive. "About three days later, he gives me a call and I can hear it in his voice. ... It was cancer," she said.
The diagnosis came as a total shock. "I never smoked, therefore I did not think it would be lung cancer or cancer of any sort," Swift continued.
Fortunately, her cancer was detected early, which does not usually happen, especially in nonsmokers.
Lung cancer in women and nonsmokers
"Lung cancer is the No. 1 cause of cancer death in the United States. ... More people in the U.S. die from lung cancer than colon cancer, prostate cancer and breast cancer combined," Dr. Jae Kim, chief of the division of thoracic surgery at City of Hope, told TODAY in a segment aired Tuesday, Feb 28.
Anyone can get lung cancer, as long as you have lungs: "There's so many people who get lung cancer who have never smoked. ... About 20% of lung cancers in women occur in women who have never smoked," said Kim.
Cigarette smoking is the No. 1 cause of lung cancer, but it can also be caused by breathing in secondhand smoke, exposure to substances like asbestos and a family history of lung cancer, according to the U.S. Centers for Disease Control and Prevention.
The average age of people diagnosed with lung cancer is 70. Survival rates depend on the type of lung cancer and the stage at diagnosis, according to the American Cancer Society. As with many cancers, the earlier the cancer is detected, the better the chances for a successful treatment.
Why lung cancer is often caught too late
Lung cancer is very difficult to detect in the early stages, said Kim. “What we mean by stage is: Has the cancer spread anywhere? One of the first places lung cancer spreads is to the lymph nodes,” he explained.
Unlike breast cancer or colon cancer, where it's recommended to start screening at a certain age, lung cancer screening is more complex.
“The current guidelines recommend lung cancer screening for patients who are at least 50 and have smoked what we call at least 20-pack years in their lifetime,” said Kim. This means smoking one pack a day for 20 years or half a pack a day for 40 years, he added.
Only 3% of lung cancers are detected by lung cancer screening (which is done using a low-dose CT scan), because only about 6% of people who are eligible for lung cancer screening end up getting scanned, partly because of lack of awareness and stigma, said Kim.
Of the lung cancers that are detected with screening, 90% are cured, Kim estimated. But overall, most people who get lung cancer end up dying from it.
Kim encouraged anyone who has ever smoked in their lifetime, even if they have quit, to talk to their doctor about a lung cancer screening. This also applies to anyone who has symptoms.
Lung cancer typically does not cause symptoms until it has spread, according to the American Cancer Society — but they may include:
- A cough that won't go away or gets worse
- Coughing up blood or bloody phlegm
- Chest pain that worsens with breathing, coughing or laughing
- Bronchitis or pneumonia that won't go away or keeps coming back
If you experience any of these, talk to your doctor to determine the underlying cause.
Lung cancer awareness is increasing, said Kim, and people are living longer after their diagnoses because more cases are being found early, per the CDC. Technology like the robotic bronchoscopy only makes that early detection easier.
A new technology provides hope for early, less invasive detection
“Bronchoscopes have been around a long time — a bronchoscope is just a long, flexible camera,” explained Kim. The camera is threaded into the mouth or nose, down the windpipe and into the lungs. “It’s a very good tool, but it’s relatively bulky in terms of (accessing) the small branches of the airway in the lung," he added.
The robotic bronchoscopy is able to solve this bulkiness issue, Kim said: “(Its) catheter is much smaller, and the robotic controls allow us to drive it very precisely and direct it exactly where we want to go."
With a robotic bronchoscopy, doctors can look for tumors deep within the lung and drive the camera to within 1 to 2 millimeters of the tumor. “(Then) we can put a needle in or forceps in to biopsy and get a sample,” Kim said.
The robotic bronchoscopy is not being used right now to treat any tumors, but clinical trials are underway. "It's a great diagnostic tool, but we are really interested in ways that we can use it to actually treat (or destroy) cancers," Kim explained, added that this approach could be more targeted and less invasive than traditional surgery to remove tumors.
In Swift's case, the spot on her lungs — which was about the size of a chestnut, per Kim — was biopsied, in addition to her lymph nodes. The robotic bronchoscopy found that the cancer had not spread. "Based on that, it looked like she had stage 1 (cancer)," said Kim.
Only about 15% of lung cancers are diagnosed at the earliest stage (stage 1), said Kim, adding that if you're African American, Latino or Asian, you're 50% less likely to be diagnosed at an early stage.
“In my case, they caught it early, and normally it doesn’t get detected until it’s stage 4,” said Swift, who credits the robotic bronchoscopy — as well as her friend who brought her to the doctor — for saving her life. "I'm just so grateful."
The road to recovery and life after cancer
Kim recommended surgery to remove Swift's cancer, which was also done robotically. "She did really well. ... She was in the hospital for about two days and had a good recovery," Kim added.
"They kept me an extra day because I think they liked me so much," joked Swift, who credits the support of her friends and family for her speedy recovery. "They brought me to all my appointments when I had to do chemo even afterwards," she added.
Today, almost one year later, Swift is back at work, exercising regularly and cancer free. "She's living her best life," said Kim.
"I’m grateful for Dr. Kim and City of Hope in Duarte for going the extra mile to make sure that I was OK," said Swift.
Swift's message to others? Talk to your doctor. She encouraged anyone with a persistent cough like hers to get it checked out as soon as possible. "It can save your life like it saved mine," said Swift.
This story first appeared on TODAY.com. More from TODAY: