Taking Action Against Lung Cancer

Grand Rounds

By Liz Krieger

Dr. Jonathan Villena and Shaundi Best

“What would have happened if my cardiologist didn’t take my concerns seriously, or if I hadn’t trusted Dr. Villena?” Shaundi Best, seen at right in photo above with Dr. Jonathan Villena.

It’s not often that being tired can save your life, but for Shaundi Best, extreme fatigue (and a doctor with a hunch) led to a surprising diagnosis. In 2022, having recently graduated from law school, Best, now 39, was studying for the bar exam. She was also experiencing exhaustion and heart palpitations. Her symptoms eventually led her to her cardiologist, Dr. Ellen Mellow (M.D. ’80), clinical assistant professor of medicine, who ordered a non-contrast chest CT.

The test revealed two nodules on her lungs. “I was concerned, but not overly worried, because they explained that such nodules are often benign, resulting from a prior infection,” says Best, who works as the director of intake for a nonprofit organization. “In fact, I was told there was a possibility that the nodules would go away on their own.” Best was encouraged to enroll in Weill Cornell Medicine’s Incidental Lung Nodule Surveillance Program, which gives patients access to experts who review their tests and recommend further steps. It was then that cardiothoracic surgeon Dr. Jonathan Villena, assistant professor of clinical cardiothoracic surgery, joined her team.

After a follow-up scan a year later, one of her nodules looked suspicious to Dr. Villena — suspicious enough that he wanted to perform surgery to remove and test the nodule. “We’re seeing an increase in lung cancer diagnoses, especially adenocarcinomas, in women — like Best — who’ve never smoked,” he says. “While we know about factors like exposure to radon, secondhand smoke and pollution, we’re also investigating certain genetic factors and the potential role of ones like estrogen.”

The timing was especially difficult for Best, whose stepfather was also battling cancer. “I really didn’t want to have the surgery, and in fact, the day before I was scheduled, I asked if I could delay it. Dr. Villena explained that doing so would be ‘kicking the can down the road on your health,’” says Best. “He convinced me that acting quickly was the best bet.”

In May 2023, Dr. Villena performed robot-assisted surgery. There was difficult news at first: Best had minimally invasive adenocarcinoma, an early-stage lung cancer that is almost always without symptoms in the early stage. But two weeks later, after the testing of her lymph nodes was complete, there was good news: the cancer had not spread. With surgery behind her, Best won’t need further treatment. She will have annual scans, but she should be among the over 99% of patients with the disease who are cancer-free after five years, Dr. Villena says.

Today, Best is grateful that her team of doctors pushed her to take action. “What would have happened if my cardiologist didn’t take my concerns seriously, or if I hadn’t trusted Dr. Villena?” she says. “Lung cancer doesn't only happen to smokers or older persons. It can affect anyone.”

Photo: Julia Xanthos Liddy

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