Planning Lung Cancer Screening, Surgery Between Clinicians and Patients

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Strategic Alliance Partnership | <b>American Lung Association</b>

David Tom Cooke, MD, reviewed the importance of shared decision making as it relates to risk and benefit of cancer screening, as well as in more refined invasive care options.

The armamentarium for lung cancer detection and treatment has become impressive and diverse. Putting these tools to best use, however, take an informed and collaborative strategy between clinicians and patients.

In a segment from the latest episode of HCPLive and American Lung Association’s (ALA) monthly respiratory health podcast series Lungcast, David Tom Cooke, MD, professor and founding chief of the Division of General Thoracic Surgery at UC Davis Health, discussed the importance of shared decision making as a “partnership” between clinicians, lung cancer patients and their respective family—not only for reviewing the benefits of tests and interventions, but the potential risks each option entail.

When considering the specific roles of a thoracic surgeon such as himself, those decisions only increase in significance.

“Most patients in this country are diagnosed with lung cancer at stage III or IV, the most advanced stages,” Cooke stressed. “Most patients who are diagnosed with lung cancer after screening at stage I or II have the best chance for (achieving remission). But there are some potential risks of lung cancer screening—for instance, a false positive, where you identify an abnormality that turns out not to be lung cancer. And then there are risks with treatments. So whether it's surgery or radiation, it's all about informed decision making.”

Afterward, Cooke and Lungcast host Albert Rizzo, MD, chief medical officer of the ALA, discussed the evolving strategies of invasive treatment for lung cancer patients, including the decision-making that goes into lobar or wedge resections, as well as segmentectomies.

Additionally, the pair reviewed what Cooke described as a potential “monumental shift” in lung cancer surgical approaches including smaller wedges or segementectomies for smaller tumors—“giving people an equal chance for cure.”

“Now we could do this minimally invasively whether it's video assisted thoracic surgery, or robotic surgery, and now we have the ability to mark little tiny tumors with what's called navigational bronchoscopy,” Cooke said. “And that's using either electromagnetic navigation or robotic navigation, partnering with our interventional pulmonology colleagues. So, these are really exciting advances in the technology for eradicating lung cancer in appropriately staged patients.”

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