According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the U.S. At least 8.6 million Americans qualify as high risk for lung cancer and are recommended to receive annual screening with low-dose CT scans.
At Winship Cancer Institute of Emory University Lung Cancer Program, a highly coordinated multidisciplinary team provides advanced care and clinical trials option with cutting edge new therapies for lung cancer patients.
Seth D. Force, MD and Suresh Ramalingam, MD, with Winship Cancer Institute of Emory University’s lung cancer team, answer your questions about lung cancer treatment and planning your cancer care with your cancer treatment team.
Learn More About the Winship Cancer Institute of Emory University Lung Cancer Program
Selected Podcast
Lung Cancer Treatment: Planning Your Cancer Care Plan with Your Cancer Care Team
Featuring:
Learn more about Seth D. Force, MD
Suresh S. Ramalingam, MD, is certified by the American Board of Internal Medicine in Internal Medicine and Medical Oncology and is an active member of American Society of Clinical Oncology, the American Association for Cancer Research, and the International Association of Lung Cancer Study. Dr. Ramalingam plays an active role in the Eastern Cooperative Oncology Group as the Chair of the Thoracic Malignancies Committee and as the Deputy Chair of Therapeutics Studies.
Learn more about Suresh Ramalingam, MD
Seth Force, MD and Suresh Ramalingam, MD
As a fellow at Barnes Hospital at Washington University School of Medicine, Dr. Force worked with Dr. Joel Cooper, who is credited with performing the first successful lung transplant. Since becoming the surgical director of Emory's adult lung transplant program in 2003, Dr. Force has improved the service's transplant survival rates by revamping its protocols and procedures.Learn more about Seth D. Force, MD
Suresh S. Ramalingam, MD, is certified by the American Board of Internal Medicine in Internal Medicine and Medical Oncology and is an active member of American Society of Clinical Oncology, the American Association for Cancer Research, and the International Association of Lung Cancer Study. Dr. Ramalingam plays an active role in the Eastern Cooperative Oncology Group as the Chair of the Thoracic Malignancies Committee and as the Deputy Chair of Therapeutics Studies.
Learn more about Suresh Ramalingam, MD
Transcription:
Bill Klaproth (Host): When you get a lung cancer diagnosis; you want the best specialized care and the newest, most effective treatment and here to talk with us about planning your cancer care plan with your cancer care team is Dr. Seth Force, a thoracic surgeon and Dr. Suresh Ramalingam a medical oncologist at Winship Cancer Institute at Emory Healthcare. Dr. Ramalingam, can you tell us about the resources you provide in order to deliver a comprehensive and coordinated approach to treating lung cancer?
Dr. Suresh Ramalingam, MD (Guest): Sure, lung cancer is a complex disease and no two patients with lung cancer are the same. So, at Winship and Emory, we focus on identifying what is unique about each individual’s cancer and shape the patient’s treatment based on that. So, our services are very comprehensive. We start with early detection of lung cancer for patients at risk in the form of screening CT scans. We also have an outstanding team of various specialists who form the multidisciplinary team for lung cancer that includes specialists like Dr. Force for surgical, who have surgical expertise, radiation, pathology, medical oncology, radiology and having this elite specialized team look at specific patient cases to provide a consensus approach results best outcome. We also do genomic testing of tumors to understand what is unique at a molecular level within the tumor and then are able to provide the specific treatments that are likely to work for that patient and in every specialty related to managing lung cancer like surgery, radiation and medical oncology; we have access within our teams to provide the cutting edge treatments and also have top notch clinical trials that provide a view and a path to the future treatment of lung cancer, so we approach lung cancer in a very comprehensive and a multidisciplinary manner at Emory.
Bill: And then who is a good candidate for the lung cancer care clinic?
Dr. Seth Force, MD: Well the patients that we will see in our lung cancer care clinic, can be patients who have already been diagnosed with lung cancer. They may or may not be seeing a cancer specialist and are seeking a second opinion. This may be their first opinion about treatment of their lung cancer or it may be patients who are at risk for lung cancer or were found to have an abnormality on an x-ray or a CAT scan and are seeking an evaluation and our opinion as to whether we are concerned about that and what would be the next steps to evaluate those abnormalities to try to prove or disprove that they are something concerning like a lung cancer. The earlier we catch these lung cancers, the better the outcomes, the more minimal in terms of surgically and even looking at chemotherapy and radiation. But the more minimal we can kind of set the treatments to get these patients through their treatment and back to life as soon as possible.
Bill: So, Dr. Force, you just mentioned the earlier you find the cancer the better. So, at Emory, the patient will see up to four physicians in one trip, so I guess the main benefit of that is saving time, right? The patient is able to formulate a plan and start treatment right away?
Dr. Force: Yeah, I think there are two advantages. So, I tell the patients all the time, we don’t want to do one thing and then the next step the next thing and the next step the next thing. We want to – these cancers, we want to deal with these all at the same time. We want them to be seeing all physicians who may have a hand in their treatment all at once so that we can kind of render simultaneous opinions and there is no delay in diagnosis and treatment. And I think that’s important. I think the other aspect is, you know cancers – lung cancers are very complicated things. They are complicated, they are emotional, and I think it is better for patients to understand their disease and their treatment plan if they are meeting with all the members who are going to be treating them at the same time, so they can ask all their questions at that time and it becomes clear to them what their treatment pathway is going to be.
Bill: And Dr. Ramalingam, you had mentioned this multidisciplinary approach, you as well Dr. Force, so in addition then the patient has access to dieticians, social workers, therapists, survivorship care. That’s all part of this multidisciplinary care plan?
Dr. Ramalingam: Absolutely. As you rightly point out, it’s not just providing the treatments, there are many other aspects to it focusing on patients’ nutritional status, having a pharmacist who can talk to patients about medications, drug interactions, having social work support for patients to navigate through certain situations that may be challenging as they deal with the disease and also to have a patient navigator who can help them connect the dots from specialist to specialist or to help them point to the right direction for specific needs of a given patient. So, managing cancer, particularly lung cancer; our teams have all the necessary medical expertise and all the important supportive care, even things such as attending patients’ emotional needs in the form of having a clinical psychiatrist who specializes in taking care of cancer patients. Those are the kinds of resources that somebody that comes to Winship has access to and is therefore able to get a very comprehensive treatment plan as a result of that.
Bill: Now you just mentioned the patient navigator. Is every patient assigned a patient navigator that tends to them?
Dr. Ramalingam: We have a lung cancer specific navigator, who is available to any patient with lung cancer that comes to see us. And during the course of the patient’s journey, the navigators are a valuable resource. Another important thing to keep in mind is once the patients enter the system, within Winship and Emory, they have access to all the teams that come in person to meet with them or have a direct relationship with them. So, the nurses, the nurse practitioners, the physician’s assistants, the physicians; all are involved in the care and are able to help patients meet their needs.
Bill: And you also offer access to clinical trials. Can you tell us about that as well?
Dr. Force: I’m going to let Dr. Ramalingam kind of field that one. I think it is more in his purview.
Dr. Ramalingam: Absolutely. So, clinical trials are the means by which we provide patients opportunities to participate in futuristic treatments. In other words, what is the most promising option out there that is not approved and that is not in routine clinical practice. We, at Winship, have been doing clinical trials for a number of years and we are proud of the fact that nearly 75% of the FDA approved drugs in recent years have gone through clinical trials at Winship before they were FDA approved. So, in lung cancer, we have been in the forefront of developing what we call targeted therapies for patients. We have been at the forefront of developing immunotherapies for patients and we are always trying to figure out how do we improve the outcomes. What’s the treatment going to be five years from now and how can we provide our patients of today an opportunity to get those kind of treatment options. So, providing the cutting edge clinical trials option, we see as an important mission of ours to serve our patients.
Bill: So, how does a patient know then about these clinical trials? Is it up to them to ask their physician?
Dr. Force: Well, I think from my standpoint, I will let – I think that this is probably a question that Dr. Ramalingam and I can both answer. But certainly, many patients come to our clinics asking about these clinical trials, but really the onus is on the physician and we discuss these clinical trials amongst ourselves, amongst the physicians, and then when we see the individual patients in the office, we will identify patients who are appropriate for that. We will approach them to talk to the about the clinical trials and then kind of set them on the pathway for evaluating those clinical trials and seeing if it is something that they want to be part of and that is something that we utilize the nurse navigators as well as the entire oncology team to help identify and guide patients to choosing the right clinical trial to help with their cancer.
Bill: That’s wonderful. And I just want to quickly touch on this. Now this multidisciplinary approach. It’s not just for patients only, right because you work with the families as well because it can be very stressful for families going through this too so that’s correct in that you do work with families and loved ones as well as the patient?
Dr. Ramalingam: A number of resources are available to patients and caregivers at Winship. For instance, one example I would make is the patient support care groups where these meetings happen on a regular basis. There is at least one meeting every week for various cancers including lung cancer and this is a forum where patients and their caregivers participate in conversations, they share their experiences and are able to help each other and let us know where we can be of help where these are attended by some of our care team specialists including our navigators and these forums are to meet the needs of the entire family. Now there are certain situations where there may be some undue stress on a given family member or caregiver who may need additional help beyond the ones and we find the right resources to meet those needs as well, whenever possible.
Bill: And Dr. Force, maybe you can wrap this all up for us. What else should a patient know about the cancer care clinic at Emory Health?
Dr. Force: Well, I think a few things. We strive to really have easy access for patients. We know that these are stressful situations for patients whether they have been diagnosed with cancer or fear they may have cancer. So, we strive to get patients in as soon as possible. We can almost always see patients the same week they are referred, and I think patients should know that we are really accessible at any time to them. If they have questions, if they have concerns. The questions don’t really end once they leave our clinic, in fact sometimes patients are so overwhelmed by what we have to tell them that they really have a hard time processing what we are explaining to them, what we are telling them and that they should always feel free to call us. We are a team. We are on their team. Many of us have had loved ones who have gone through similar experiences and we understand what they are going through. And so, they should see us as kind of life partners with them on this sometimes unfortunate journey and they should always feel like they can access us at any time to help explain the process, to help clarify different points. And that we will always be looking for newer technologies, newer strategies to help deal with their disease.
Bill: So good to know Dr. Force, thank for sharing that with us and Dr. Ramalingam, thank you as well for spending some time with us today. For more information, please visit www.emoryhealthcare.org that’s www.emoryhealthcare.org . You’re listening to Advancing Your Health with Emory Healthcare. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): When you get a lung cancer diagnosis; you want the best specialized care and the newest, most effective treatment and here to talk with us about planning your cancer care plan with your cancer care team is Dr. Seth Force, a thoracic surgeon and Dr. Suresh Ramalingam a medical oncologist at Winship Cancer Institute at Emory Healthcare. Dr. Ramalingam, can you tell us about the resources you provide in order to deliver a comprehensive and coordinated approach to treating lung cancer?
Dr. Suresh Ramalingam, MD (Guest): Sure, lung cancer is a complex disease and no two patients with lung cancer are the same. So, at Winship and Emory, we focus on identifying what is unique about each individual’s cancer and shape the patient’s treatment based on that. So, our services are very comprehensive. We start with early detection of lung cancer for patients at risk in the form of screening CT scans. We also have an outstanding team of various specialists who form the multidisciplinary team for lung cancer that includes specialists like Dr. Force for surgical, who have surgical expertise, radiation, pathology, medical oncology, radiology and having this elite specialized team look at specific patient cases to provide a consensus approach results best outcome. We also do genomic testing of tumors to understand what is unique at a molecular level within the tumor and then are able to provide the specific treatments that are likely to work for that patient and in every specialty related to managing lung cancer like surgery, radiation and medical oncology; we have access within our teams to provide the cutting edge treatments and also have top notch clinical trials that provide a view and a path to the future treatment of lung cancer, so we approach lung cancer in a very comprehensive and a multidisciplinary manner at Emory.
Bill: And then who is a good candidate for the lung cancer care clinic?
Dr. Seth Force, MD: Well the patients that we will see in our lung cancer care clinic, can be patients who have already been diagnosed with lung cancer. They may or may not be seeing a cancer specialist and are seeking a second opinion. This may be their first opinion about treatment of their lung cancer or it may be patients who are at risk for lung cancer or were found to have an abnormality on an x-ray or a CAT scan and are seeking an evaluation and our opinion as to whether we are concerned about that and what would be the next steps to evaluate those abnormalities to try to prove or disprove that they are something concerning like a lung cancer. The earlier we catch these lung cancers, the better the outcomes, the more minimal in terms of surgically and even looking at chemotherapy and radiation. But the more minimal we can kind of set the treatments to get these patients through their treatment and back to life as soon as possible.
Bill: So, Dr. Force, you just mentioned the earlier you find the cancer the better. So, at Emory, the patient will see up to four physicians in one trip, so I guess the main benefit of that is saving time, right? The patient is able to formulate a plan and start treatment right away?
Dr. Force: Yeah, I think there are two advantages. So, I tell the patients all the time, we don’t want to do one thing and then the next step the next thing and the next step the next thing. We want to – these cancers, we want to deal with these all at the same time. We want them to be seeing all physicians who may have a hand in their treatment all at once so that we can kind of render simultaneous opinions and there is no delay in diagnosis and treatment. And I think that’s important. I think the other aspect is, you know cancers – lung cancers are very complicated things. They are complicated, they are emotional, and I think it is better for patients to understand their disease and their treatment plan if they are meeting with all the members who are going to be treating them at the same time, so they can ask all their questions at that time and it becomes clear to them what their treatment pathway is going to be.
Bill: And Dr. Ramalingam, you had mentioned this multidisciplinary approach, you as well Dr. Force, so in addition then the patient has access to dieticians, social workers, therapists, survivorship care. That’s all part of this multidisciplinary care plan?
Dr. Ramalingam: Absolutely. As you rightly point out, it’s not just providing the treatments, there are many other aspects to it focusing on patients’ nutritional status, having a pharmacist who can talk to patients about medications, drug interactions, having social work support for patients to navigate through certain situations that may be challenging as they deal with the disease and also to have a patient navigator who can help them connect the dots from specialist to specialist or to help them point to the right direction for specific needs of a given patient. So, managing cancer, particularly lung cancer; our teams have all the necessary medical expertise and all the important supportive care, even things such as attending patients’ emotional needs in the form of having a clinical psychiatrist who specializes in taking care of cancer patients. Those are the kinds of resources that somebody that comes to Winship has access to and is therefore able to get a very comprehensive treatment plan as a result of that.
Bill: Now you just mentioned the patient navigator. Is every patient assigned a patient navigator that tends to them?
Dr. Ramalingam: We have a lung cancer specific navigator, who is available to any patient with lung cancer that comes to see us. And during the course of the patient’s journey, the navigators are a valuable resource. Another important thing to keep in mind is once the patients enter the system, within Winship and Emory, they have access to all the teams that come in person to meet with them or have a direct relationship with them. So, the nurses, the nurse practitioners, the physician’s assistants, the physicians; all are involved in the care and are able to help patients meet their needs.
Bill: And you also offer access to clinical trials. Can you tell us about that as well?
Dr. Force: I’m going to let Dr. Ramalingam kind of field that one. I think it is more in his purview.
Dr. Ramalingam: Absolutely. So, clinical trials are the means by which we provide patients opportunities to participate in futuristic treatments. In other words, what is the most promising option out there that is not approved and that is not in routine clinical practice. We, at Winship, have been doing clinical trials for a number of years and we are proud of the fact that nearly 75% of the FDA approved drugs in recent years have gone through clinical trials at Winship before they were FDA approved. So, in lung cancer, we have been in the forefront of developing what we call targeted therapies for patients. We have been at the forefront of developing immunotherapies for patients and we are always trying to figure out how do we improve the outcomes. What’s the treatment going to be five years from now and how can we provide our patients of today an opportunity to get those kind of treatment options. So, providing the cutting edge clinical trials option, we see as an important mission of ours to serve our patients.
Bill: So, how does a patient know then about these clinical trials? Is it up to them to ask their physician?
Dr. Force: Well, I think from my standpoint, I will let – I think that this is probably a question that Dr. Ramalingam and I can both answer. But certainly, many patients come to our clinics asking about these clinical trials, but really the onus is on the physician and we discuss these clinical trials amongst ourselves, amongst the physicians, and then when we see the individual patients in the office, we will identify patients who are appropriate for that. We will approach them to talk to the about the clinical trials and then kind of set them on the pathway for evaluating those clinical trials and seeing if it is something that they want to be part of and that is something that we utilize the nurse navigators as well as the entire oncology team to help identify and guide patients to choosing the right clinical trial to help with their cancer.
Bill: That’s wonderful. And I just want to quickly touch on this. Now this multidisciplinary approach. It’s not just for patients only, right because you work with the families as well because it can be very stressful for families going through this too so that’s correct in that you do work with families and loved ones as well as the patient?
Dr. Ramalingam: A number of resources are available to patients and caregivers at Winship. For instance, one example I would make is the patient support care groups where these meetings happen on a regular basis. There is at least one meeting every week for various cancers including lung cancer and this is a forum where patients and their caregivers participate in conversations, they share their experiences and are able to help each other and let us know where we can be of help where these are attended by some of our care team specialists including our navigators and these forums are to meet the needs of the entire family. Now there are certain situations where there may be some undue stress on a given family member or caregiver who may need additional help beyond the ones and we find the right resources to meet those needs as well, whenever possible.
Bill: And Dr. Force, maybe you can wrap this all up for us. What else should a patient know about the cancer care clinic at Emory Health?
Dr. Force: Well, I think a few things. We strive to really have easy access for patients. We know that these are stressful situations for patients whether they have been diagnosed with cancer or fear they may have cancer. So, we strive to get patients in as soon as possible. We can almost always see patients the same week they are referred, and I think patients should know that we are really accessible at any time to them. If they have questions, if they have concerns. The questions don’t really end once they leave our clinic, in fact sometimes patients are so overwhelmed by what we have to tell them that they really have a hard time processing what we are explaining to them, what we are telling them and that they should always feel free to call us. We are a team. We are on their team. Many of us have had loved ones who have gone through similar experiences and we understand what they are going through. And so, they should see us as kind of life partners with them on this sometimes unfortunate journey and they should always feel like they can access us at any time to help explain the process, to help clarify different points. And that we will always be looking for newer technologies, newer strategies to help deal with their disease.
Bill: So good to know Dr. Force, thank for sharing that with us and Dr. Ramalingam, thank you as well for spending some time with us today. For more information, please visit www.emoryhealthcare.org that’s www.emoryhealthcare.org . You’re listening to Advancing Your Health with Emory Healthcare. I’m Bill Klaproth. Thanks for listening.