Author of

• 13817

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  P1.12 - Poster Session/ Community Practice (ID 232)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Community Practice
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 13825

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    P1.12-008 - Components of Creating and Implementing a Comprehensive Lung Cancer Program in a Community Setting (ID 2424)

    09:30 - 09:30  |  Author(s): C.M. Wilkinson
    • Abstract

    Background:
    Many communities do not have a comprehensive, evidence based approach to lung cancer diagnosis, staging and treatment. This is often secondary to lack of providers in the area with expertise in lung cancer as well as lack of appropriate diagnostic and treatment modalities. Herein we describe the creation and implementation of a comprehensive lung cancer program in a community setting.
    
    Methods:
    A regional health system that serves a population with a relatively high incidence of lung cancer, recruited an experienced general thoracic surgeon, with expertise in the diagnosis, staging and treatment of lung cancer. The community had a pre-existing cardiac surgery program, a cancer center that provided chemotherapy and traditional radiation, a PET scanner and 2 CT scanners.
    
    Results:
    The study period was 9/1-2012 to 4/1/2015 which spans the time after the introduction of the general thoracic surgeon in the community to present. Under the leadership of the thoracic surgeon, the following was accomplished: 1. An extensive outreach campaign to primary care physicians as well as directly to the community regarding lung cancer awareness, modern diagnostic, staging and treatment modalities. 2. Establishment of a pulmonary nodule clinic to provide expertise and continuity in the evaluation of pulmonary nodules. 3. The establishment of a lung cancer CT screening program, 4. Evolution of the tumor board from a once a month meeting, reviewing an average of 3.1 patients retrospectively and an average attendance of 3.6 attendees to currently meeting weekly, prospectively reviewing an average of 8.6 cases per meeting (>90% lung cancer) and an average attendance of 9.3 attendees including thoracic surgery, medical and radiation oncology, pathology, social work and a rotation of surgeons, pulmonologists and primary care physicians. 5. The procurement and implementation of Electromagnetic Navigational Bronchoscopy to the community to obtain tissue diagnosis of suspected lung lesions. 6. The procurement and implementation of Endobronchial Ultrasound for the minimally invasive pathologic staging of appropriate lung cancer patients. 7. The procurement and participation in the Society of Thoracic Surgery (STS) General Thoracic Surgery Database for registration of patient outcomes and national comparison. 8. The introduction of VATS lobectomies and complex open resections. 9 400 new thoracic surgical cases to the Regional Medical Center. 10. 54 cases of multimodallity therapy for lung cancer patients compared with 4 the previous two years. 11. The establishment of stereotactic body radiation therapy (SBRT) as a treatment alternative to surgery for medically inoperable stage I lung cancer patients.
    
    Conclusion:
    It is possible to create a de novo comprehensive lung cancer program in a community setting with the appropriate expertise and leadership. General thoracic surgeons with expertise in current lung cancer diagnostics, staging and treatment options are uniquely positioned to provide the expertise and leadership to create a comprehensive lung cancer program as they are integrally part of assessing pulmonary nodules, establishing diagnosis, rigorously staging lung cancer and treatments including surgery, radiation chemotherapy and multimodality regimens. This approach could serve as a paradigm for similar communities to bring current, evidence based lung cancer diagnostics and treatment to their region.