When the National\u00a0Cancer Institute\u2019s landmark\u00a0National Lung Screening Trial\u00a0(NLST) found that screening\u00a0with low-dose CT reduced\u00a0lung cancer mortality in high-risk\u00a0individuals by 20 percent\u00a0compared to chest x-rays,\u00a0it changed the landscape of\u00a0lung cancer screening, with\u00a0hospitals across the nation\u00a0launching programs to help\u00a0current and former smokers\u00a0improve their chances of\u00a0surviving this deadliest form of cancer through early detection.<\/p>\n
As a result of these\u00a0screening programs, however\u2014along with incidental\u00a0findings on chest X-ray or\u00a0CT scans obtained for other\u00a0purposes\u2014an estimated one\u00a0million pulmonary nodules\u00a0are being detected in the U.S.\u00a0each year. The challenge now\u00a0is to distinguish between\u00a0benign and malignant nodules,\u00a0expediting diagnosis for malignant nodules\u00a0while minimizing testing of those that are benign.<\/p>\n
\u201cIt\u2019s simply not feasible or appropriate\u00a0to take everyone with a lung nodule to the\u00a0OR and do invasive tests,\u201d says thoracic\u00a0surgeon David D. Shersher, MD. \u201cYou\u00a0need a strategy to identify who needs more of a workup, who needs to be followed, and who doesn\u2019t.\u201d<\/p>\n
At MD Anderson Cancer Center at\u00a0Cooper, that strategy entailed creation of\u00a0a dedicated multi-disciplinary\u00a0Lung Nodule Program,\u00a0spearheaded by Dr.\u00a0Shersher and medical\u00a0oncologist Polina Khrizman,\u00a0MD. In addition to their\u00a0respective specialties, the\u00a0disciplines that comprise\u00a0the program include pulmonologists ,\u00a0interventional pulmonologists,\u00a0radiologists, an imaging\u00a0navigator, a nurse navigator,\u00a0and other pulmonary and\u00a0cancer experts.<\/p>\n
So how do you distinguish\u00a0between a benign and\u00a0malignant nodule without\u00a0invasive testing?<\/p>\n
\u201cThere is a certain\u00a0appearance to nodules that are\u00a0concerning, which our lung specialist\u00a0radiologists recognize,\u201d\u00a0explains Dr. Khrizman. \u201cIt has\u00a0to do with size and shape\u2014if\u00a0it\u2019s well-circumscribed, ragged\u00a0or invasive\u2014and its growth pattern over time.\u201d<\/p>\n
\u201cWe also look at the patient\u2019s\u00a0age, smoking history, and environmental\u00a0exposure to things l ike a sbes tos,\u201d\u00a0she cont inues. \u201cAll these components\u00a0help us identify those nodules that are\u00a0more or less likely to be concerning. Patient\u00a0A may have a lung nodule that looks\u00a0suspicious, and we may recommend\u00a0biopsy right away. Patient B\u2019s nodule, by\u00a0its size and shape, isn\u2019t as concerning, so\u00a0we may recommend a CT in six months and follow-up in clinic.<\/p>\n
\u201cIt\u2019s very individualized, based\u00a0on different risk stratification\u00a0and what we see on imaging,\u201d she adds.<\/p>\n
\u201cSurgery is indicated when\u00a0concern is very high from a\u00a0clinical standpoint and there\u2019s\u00a0tremendous risk, such as when a\u00a0nodule is growing in size and PET\u00a0shows it\u2019s active,\u201d Dr. Shersher\u00a0says, noting that MD Anderson\u00a0at Cooper offers a range of\u00a0non-invasive testing, including biopsy\u00a0performed through the airway by the interventional pulmonary team.<\/p>\n
A unique aspect of MD Anderson\u00a0at Cooper\u2019s Lung Nodule Program is its emphasis on smoking cessation.<\/p>\n
\u201cWe\u2019ve built in a robust ,\u00a0evidence-based smoking cessation\u00a0program that\u2019s been shown to work over\u00a0the long term,\u201d Dr. Shersher says. \u201cWe\u00a0know it takes up to nine attempts to quit\u00a0smoking, and we have strategies that help people succeed.\u201d<\/p>\n
Drs. Shersher and Khrizman urge\u00a0community physicians to get their at-risk\u00a0patients screened for lung cancer\u2014those\u00a0between the ages of 55 and 74 who have\u00a0a 30 pack\/year smoking history and\u00a0currently smoke or have quit within the past 15 years.<\/p>\n
\u201cFor decades we struggled to find\u00a0a test to identify lung cancer early,\u201d Dr.\u00a0Khrizman says. \u201cNow we do, and it\u2019s improving survivorship.\u201d<\/p>\n
\u201cOur program is designed to guide\u00a0and manage patients through this\u00a0complex condition while keeping referring\u00a0physicians informed throughout the care\u00a0process,\u201d Dr. Shersher adds.<\/p>\n
For a direct physician-to-physician consultation about a patient, call\u00a0Dr. Shersher at 609.947.3658 or Dr. Khrizman at 215.422.2484. For all new\u00a0patient appointments, our schedulers can be reached at 1.855.MDA.COOPER.<\/p>\n","protected":false},"excerpt":{"rendered":"
When the National\u00a0Cancer Institute\u2019s landmark\u00a0National Lung Screening Trial\u00a0(NLST) found that screening\u00a0with low-dose CT reduced\u00a0lung cancer mortality in high-risk\u00a0individuals by 20 percent\u00a0compared to chest x-rays,\u00a0it changed the landscape of\u00a0lung cancer screening, with\u00a0hospitals across the nation\u00a0launching programs to help\u00a0current and former smokers\u00a0improve their chances of\u00a0surviving this deadliest form of cancer through early detection. As a result of … [Read more…]<\/a><\/span><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[55],"tags":[],"class_list":{"0":"entry","1":"post","2":"publish","3":"author-rmineo","4":"post-1764","6":"format-standard","7":"category-new-initiatives"},"_links":{"self":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1764","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/comments?post=1764"}],"version-history":[{"count":1,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1764\/revisions"}],"predecessor-version":[{"id":1765,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1764\/revisions\/1765"}],"wp:attachment":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/media?parent=1764"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/categories?post=1764"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/tags?post=1764"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}