Developing an Effective Lung Cancer Program in a Community Hospital Setting

Abstracts from the 9th International Lung Cancer Congress Abstract 04 Developing an Effective Lung Cancer Program in a Community Hospital Setting Richard J. Fischel, Robert Dillman, Susan Goldberg Hoag Memorial Hospital, Newport Beach, CA Lung cancer remains the largest source of cancer-based mortality in men and women. Although there are several highly acclaimed centers in the treatment of patients with lung cancer nationally, the vast majority of lung cancer care occurs in community hospital settings. The importance of proper lung cancer care in the community hospital setting cannot be overemphasized. We have had the opportunity to develop several highly successful community hospital–based lung cancer programs over the past several years. Using a multidisciplinary approach to the treatment of patients with lung cancer, we have been able to achieve survival results better than all state and national averages stage for stage, in some cases doubling national survival rates. Key components of a successful program include holding a weekly multidisciplinary lung cancer tumor board meeting with representatives from medical oncology, thoracic surgery, pulmonary medicine, radiology, radiation oncology, and nuclear medicine to discuss patient presentation, test results, treatment history, and plans for therapy. A dedicated thoracic surgeon committed to the program is essential. A surgeon skilled in video-assisted thoracic surgery procedures, in particular minimally invasive lobectomy, is an added bonus and demonstrates a dedication to modern technology and improved patient care. A nurse navigator is used to help patients through the process from detection to recovery and provide a personal bond that greatly improves patient satisfaction. Treatment guidelines provide continuity and guidance and a starting point for a group to develop specialized treatment strategies. Physician education by personal office visits or continuing medical education–style talks helps the medical doctors in the community know what you are doing. We offer doctors the opportunity to have their patients presented at the weekly meetings for numerous free second opinions. All patients are seen within 24 hours of referral, and all patients are sent back to the primary medical doctor, who is kept in the loop at all times. A computed tomography screening program (low cost if possible) adds to our program despite the controversy in the journals and press. Numerous early cancers have been detected and treated as a result of this program. A dedicated cancer center shows a commitment to cancer care and allows for many services to be offered at a single location, thereby greatly improving convenience for the patient and interaction among the physicians. Access to research protocols is essential to provide the most up-to-date care and offer the patients in your community the opportunity to be treated similar to that provided at major centers across the country. To summarize, several simple steps help to provide a quality lung cancer program in a community hospital setting, resulting in improved outcomes.

Clinical Lung Cancer September 2008

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