The Cancer That Kills More Women Than Breast And Ovarian Combined Gets A New Tool

A physician reviews lung imaging with a patient — a conversation happening more often as lung cancer screening programs find more small pulmonary nodules, and more women face the question of what minimally invasive lung surgery options exist for them.

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Lung cancer will kill an estimated 61,950 American women in 2026—taking as many lives as breast, ovarian, and cervical cancers combined. Despite that toll, it has never had its lumpectomy moment. The surgical toolkit for small lung nodules has changed little in decades, leaving patients caught between two bad options: an imprecise needle biopsy or a surgery that can permanently reduce lung function.

Joanna Nathan, CEO and co-founder of Houston-based Prana Surgical, is trying to change that. Her company’s Prana System received FDA clearance in April 2026, positioning it as what Nathan calls “the lumpectomy of the lung.”

Lung Cancer Is A Women’s Health Crisis Nobody Is Talking About

Most people associate lung cancer with men and smokers. Both assumptions are wrong, or at least badly incomplete. In 2026, more women than men will be diagnosed with lung cancer for the first time in recorded history: 118,500 women versus 110,910 men, per the American Cancer Society.

Non-smoking women are nearly twice as likely to develop lung cancer as their male counterparts. And the fastest-growing patient population within the disease is young, never-smoking women. A May 2026 paper in Nature described lung cancer in women as “almost a completely distinct disease.”

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Nathan encountered that finding just weeks before this interview and considers it a turning point in how the field talks about the disease. “Lung cancer actually kills more people, more women in particular, and yet, historically, it’s received much less federal funding and much less cultural attention,” she emphasized.

Funding levels do not track with lethality. NIH research funding totaled $1.58 billion for breast cancer, compared with $440 million for pancreatic cancer, $227 million for non-small cell lung cancer, and just $62 million for small cell lung cancer.

Nathan puts it plainly, “Women deserve both. We need the same urgency, visibility, innovation, energy for the cancer that kills the most women.”

Screening Is Working, And That’s The Problem

The parallel to breast cancer runs deeper than death statistics. When mammography became standard in the 1970s, surgeons were still performing mastectomies on most patients. It took another decade of patient advocacy and clinical pressure before lumpectomy became the default for early-stage disease. Lung cancer is now in that same transitional decade, Nathan argues, and the forces driving it are strikingly similar.

Lung cancer screening with low-dose CT has been available for more than a decade. Medicare and many private insurers cover it for people at elevated risk. Current guidelines recommend annual screening for adults ages 50 to 80 with at least a 20 pack-year smoking history, who smoke or formerly smoked. Scans often find abnormalities that require additional imaging or testing. The screens are finding nodules. The clinical system is not ready for what comes next.

Only 20% to 25% of eligible patients are currently getting screened annually, Nathan says, and the incidental population—nodules found through routine ER imaging—is growing at 10% a year on top of that. Once screening crosses the 60% adoption threshold seen with mammography and colonoscopy, she warns, "that's when we're going to start seeing this tsunami of nodules" hitting a clinical infrastructure that has no good answer for small, peripheral anomalies.

Dr. Gavin Wright, director of Surgical Oncology at St. Vincent’s Hospital Melbourne and the lead investigator in Prana’s early feasibility study, sees the same pressure building. “Earlier lung cancer detection is changing the disease we encounter. Cancers are found sooner, often in healthier patients with many years ahead of them,” Wright said. “New, minimally invasive technologies such as Prana could help physicians make these decisions earlier while preserving future treatment options.”

Walk through what the standard of care currently looks like for a patient who finds a 6-millimeter peripheral nodule. In most cases, Nathan explains, that patient lands in watchful waiting, repeating CT scans every six to 12 months, sometimes for years. “Disease can progress so quickly that…you can easily go from something that was a manageable stage one cancer to something that is now all of a sudden later stage,” she said. Stage one is still curable through surgery. Stage three or four means chemotherapy, radiation, and managing a disease rather than ending it.

Grief Became The Founding Thesis

Nathan’s path to building Prana is not a straightforward market-opportunity story. She had a strong case for not leaving Johnson & Johnson’s Center for Device Innovation, where she spent years evaluating medical device startups and co-developed an extensive portfolio of seven resident companies. But, in April 2021, she found her four-year-old son, Lionel, unresponsive at home. She was his first responder. He was at Texas Children’s Hospital for five days before she made the decision to donate his organs. He died from an undiagnosed heart condition. She was 29.

“If I can help one patient avoid an untimely death, one person avoid an untimely loss in the family, then I will be able to say I set out to do what I wanted to do with my career,” Nathan reflected. After grieving, she returned to what she knew—medtech—but this time as a founder, getting as close to patient impact as possible.

The result is the Prana System, a sterile, single-use electrosurgical tool that uses CT-guided targeting and bipolar radiofrequency energy to localize and excise a suspicious nodule in a single, minimally invasive procedure, without removing large portions of healthy lung tissue. The device integrates localization and cutting in one instrument, eliminating the need to swap tools mid-procedure. Prana holds 28 patents across 15 patent families in seven geographies. The device was built partly in collaboration with J&J, which remains an investor.

Dr. R. Sean Churchill, managing director of cultivate(MD) Capital Funds and an investor in Prana, frames the gap the device addresses directly. “Prana Surgical has addressed the current treatment shortcomings head-on with the development of a minimally invasive, lung biopsy device, which delivers a substantially larger tissue biopsy specimen to allow for immediate diagnosis and treatment,” he explained.

First Patients Were In Melbourne, Not Houston

Prana completed its first five clinical procedures using the Prana System in January, 2026, at St. Vincent’s Hospital Melbourne, not at one of the many world-class thoracic surgery centers in Houston where the technology was developed. The nodules in those early cases ranged from 4 to 10 millimeters, and were the peripheral, hard-to-reach kind where conventional biopsy tools most often fall short.

The Australia decision was strategic and partly reactive. Prana submitted its FDA clearance application the day before the U.S. government shutdown in late 2024, having accelerated its timeline specifically to get under the wire. Rather than wait on a turbulent regulatory environment that included FDA layoffs and bureaucratic instability, Nathan ran clinical and regulatory de-risking simultaneously. Both tracks converged in April 2026 with FDA clearance of the Prana System.

Wright described the early Australian results as a meaningful signal: “Technologies such as Prana have the potential to give physicians a less invasive way to obtain the information they need to act earlier and with greater confidence, while preserving the widest range of treatment options for patients.”

Prana has raised approximately $14 million to date, roughly $10 million in equity from investors including J&J, Texas Medical Center Venture Fund, New World Angels, and cultivate(MD), plus $4 million in non-dilutive grants from CPRIT, the Cancer Prevention and Research Institute of Texas. The company is now executing a staged U.S. clinical introduction, working with a limited number of thoracic surgeons before broader commercial deployment.

The 15-Year View

Nathan sees three shifts required to move lung cancer where breast and colon cancer already are: age-based screening rather than smoking-history-based criteria, the rise of targeted therapies driven by tissue biopsy and genetic testing, and a growing, minimally invasive surgical toolkit to match what screening programs are finding. “Those are the three things that it’s gonna take to really shift lung cancer,” she said.

Lung cancer is, for now, Prana’s beachhead market. The company’s IP broadly covers use in other solid organs, such as the liver and breast. Nathan is candid that those applications are in the company’s future, though capital discipline keeps the focus narrow for now.

Her C-suite is entirely female, the full-time team is majority female, and she reports that investors and clinical partners have taken her seriously throughout the building process. She wonders, though, what later-stage financing will look like. “I do wonder what it will be like as we continue to grow and get into later-stage financings,” she said, an honest, unresolved question that connects directly back to the women’s health funding disparities this article opened with.

A Nature paper and an FDA clearance in the same month are a good signal that the conversation is finally catching up to the death toll. Whether the clinical infrastructure, the reimbursement system, and the research funding follow is the question that will define the next decade of lung cancer care in women, and whether Prana’s lumpectomy moment becomes a turning point in medical care.