Screening to Help Catch Lung Cancer Earlier
Augusta Health Radiology has a screening process that will make a big difference for patients throughout our community who are at risk for lung cancer.
"When you have screening tests, often you find those cancers when they are very small and manageable to treat," says Brad Johnson, director of cancer services for Augusta Health. "Up until this screening test was available, the majority of cancers found were large, and tumor cells had broken off and traveled to other areas in the body, such as the bones and the brain, making the disease more widespread and, in turn, more difficult to treat or cure."
Making a Plan
Any patients who are at a high risk for lung cancer may come to Augusta Health and be screened as long as they have a doctor's order, notes Johnson. "An order guarantees the tests results are followed up on and nothing falls through the cracks," he notes.
If screening results are positive, a multidisciplinary team of Augusta Health professionals will begin working on that patient's case. First, follow-up diagnostic imaging scans and blood work are done to determine if lung cancer is actually present. Generally this will also include a biopsy, in which a small piece of tissue is collected and analyzed under a microscope. After those initial confirming tests take place, a board of professionals from disciplines throughout Augusta Health, such as surgeons, oncologists, pathologists, radiologists and more, will review the patient's case.
"Each of the medical specialties weighs in," says Johnson. "From there, they make a comprehensive plan that is given back to the patient and family. Patients then have to give informed consent on whether they want to follow that treatment plan. Patients have options."
Navigating Rough Waters
The staff at Augusta Health realizes that being diagnosed with lung cancer and going through treatment can be an overwhelming and stressful experience. Because of this, Augusta Health nurse navigators are assigned to patients to aid them throughout the process.
"We're really here to help," says Leigh Ann Solometo, RN, BS, CBCN, a lung cancer nurse navigator for Augusta Health. "We're here to guide the patients and be a support person for them and their families. We want to streamline the process and make it easier as they go through our system."
This role plays out in many ways, from helping set up appointments to attending appointments with patients to make sure they hear everything the doctor has to say. Solometo even takes notes during appointments and gives them to the patient afterwards, so the patient can focus on what the doctor says.
"A lot of the time it's just being an extra set of ears, there's so much information to digest," says Solometo. "And if they have questions later, they can call me."
Both Johnson and Solometo agree that the new lung cancer screening program will have a positive effect on the community.
"We're in a fairly moderate risk area of the state, but historically most of the lung cancer seen at Augusta Health is in the more advanced late stage IV," says Johnson. "While we won't necessarily see a drastic increase in overall lung cancer incidence, we do hope the new lung CT screening test will allow physicians to find cancers early when there is only one single, very small tumor, such as stages 0 or 1, versus finding large tumors, multiple masses and cancers that have spread to other parts of the body. Earlier diagnosis equals better chance of survival."
After the Lung Screening
If cancer is detected, Augusta Health has the services to treat the patient. "In the past, patients would have to go elsewhere to get surgery or bronchoscopy," says Laura Gonzalez, MD, director of interventional pulmonary services at Augusta Health. "Now we have everything here that patients could need."
If post-screening imaging suggests the need for a biopsy, there are several ways Dr. Gonzalez and the pulmonary services staff approach it. Traditionally, a radiologist would use a needle to do the biopsy, but if the nodule is too small, that doesn't work. For these cases, Dr. Gonzalez uses navigational bronchoscopy and, if necessary, confocal laser endomicroscopy. The latter involves passing a small microscope through a sheath, in the lungs in order to better view the affected area. The microscope allows Dr. Gonzalez to see actual cells and tissue in the lungs in real time.
"It's become more common because we're finding things that are smaller and smaller and more peripheral," she says. "We do several cases per week. Lung cancer is the No. 1 cancer killer in the U.S. and yet it's the most abandoned one. We need to get a hold on it."