During a routine flight to Minneapolis, Rob Young noticed swelling in his ankle and a trip to the emergency room revealed he had a blood clot.
A sales consultant who routinely flies for work, Young wasn't overly concerned, chalking it up to his many miles in the sky.
"So they discharged me and I came back home and got checked out by my local doctor," said Young, 45.
"I wasn't overly concerned. We were a little puzzled because somebody of my age and health shouldn't be getting DVT," or deep-vein thrombosis, Young said.
His family doctor assured him there was no cause for distress.
But further sleuthing on the Internet gave Young pause: One of the causes of DVT was lung cancer.
After a battery of tests -- and a long, anxious wait over the holidays -- his worst fears were confirmed.
He was diagnosed with non-small cell lung cancer.
"I'm a pretty practical guy," said Young, who lives on the East Side.
"I gave myself about a day to be sad and think the worst."
Then he started his therapy, which was aggressive at first and has since eased to maintenance chemotherapy administered every three weeks.
Dr. David Carbone, a professor of medicine at Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, said lung cancer kills about 160,000 Americans per year -- more than breast, prostate and colon cancers combined.
Furthermore, the five-year survival rate is about 15 percent.
Young said he remains optimistic and refuses to hear a prognosis, choosing to take his disease one day at a time.
"I have to be positive," he said.
"One of the tricks when you have advanced serious cancer is -- we kind of joke about it -- stay alive as long as you can with the medicine that's out there," Young said.
One of the reasons it's difficult to diagnose is the usual symptoms, such as chest pain, are nonspecific, Carbone said.
"And when the symptoms become worrisome, they represent metastatic disease and it's too late to cure it," he said.
"Tumors on the lung can get to be melon size before they cause any particular symptom," Carbone said.
"The lung itself has no nerve endings. If you had a melon-sized tumor on your breast you would notice it pretty quickly."
Up until recently, there were no effective screening procedures, even for high-risk patients, Carbone said.
However, just in the last year, a very large study showed that a special type of low-radiation CT scan reduced the death rate by 20 percent, he said.
Carbone said he's upbeat about the new technologies, such as robotic surgery that uses a minimal size incision in the chest wall and stereotactic body radiation therapy, or SBRT, which delivers a high dosage of radiation to a precise target.
There also have been discoveries in the genetic makeup of lung cancer that effectively guide the use of oral medicines.
"It is very frustrating to treat, but in the last decade there's been a lot of excitement in the treating of lung cancer," Carbone said.
Naturally, smoking is discouraged, Carbone said.
Yet, roughly 16,000 people a year who haven't smoked are diagnosed with lung cancer.
"If you are a smoker, stop," he said.
"If you were a smoker and over the age of 55 you should enroll in the CT screening program."
Young, who is being treated at the James but not by Carbone,said he was a non-smoker and an exercise enthusiast before the cancer was detected.
"I was absolutely, definitely, in the best shape in my life when I was diagnosed," he said.
Exercise always is encouraged, although it's difficult to determine whether it prevents the disease, Carbone said.
"I think staying healthy is important and people who are in good shape and healthy in other respects definitely live longer than people who aren't," he said.
"But I don't know exactly the magnitude of the benefits."
As November, which is National Lung Cancer Awareness Month, comes to a close, the discrepancy in cancer funding is worth noting, said Jose Rodriguez, spokesman for Columbus Public Health.
In 2011, the two federal agencies providing most of the research money funded breast cancer research at a rate of $21,641 per death while spending $1,489 per lung cancer death, according to the news agency FairWarning.
"There are great advancements being made, but clearly more research dollars have to go into making a significant difference," Rodriguez said.
"There are great advancements being made, but clearly more research dollars have to go into making a significant difference."
Columbus Public Health