Transcription:
What's New in TOBH Cancer Services?: Have You Gotten Screened Yet?

Denise Schnabel (Host): Hi, everyone. Welcome to Outer Bank's Health. The official podcast series of the Outer Banks Hospital and Medical Group. Each month, we will be featuring guests who will discuss not only health related topics, but community topics as well. We are your host, Denise Schnabel.

Wendy Kelly (Host): And I'm Wendy Kelly. Hey Denise, we have two members of our amazing cancer services dream team here today. Dream team on one end of our amazing podcast studio table is the distinguished Dr. Charles Trey Shelton. He's our radiation oncologist here at the Outer Banks Hospital. He's been a member of that team since 2013. He's a native of Eastern North Carolina and is passionate about rural healthcare in Eastern North Carolina. At the end of our table, is our leader of cancer services. She's been on the beach since 1995 and a member of the outer banks hospital cancer services team since 2012. She is Beverly Jones, RN. Welcome guys. Welcome, welcome.

Beverly Jones: Thank you for having us.

Wendy Kelly (Host): We're thrilled to have you guys here today because we're gonna talk about a really important topic, lung cancer screening. But first let's talk about a recent accomplishment that the cancer services team had. We have world cloud services, Dr. Shelton, why don't you tell us about that certification we just got?

Dr. Charles Shelton: So we have been certified as a cancer accredited program as a small community hospital of the size that we are, which is called Critical Access. And we are actually one of only eight. Critical access hospitals in the country, in the nation that are cancer accredited. And most recently we even carried that to the next level and became a breast care accredited program as well. And we're the only critical hospital in the nation that does that has those services as part of accreditation.

Wendy Kelly (Host): Really phenomenal that you're able to achieve.

Denise Schnabel (Host): And were there specific activities that we had to engage in Bev in order to get that accreditation?

Beverly Jones: So our process of course, started over a year ago with lots of crossing the T's and dotting the i's, with quality projects, and our genetics program and instituting integrative medicine in our wellness center for risk reduction for our patients who already have breast cancer and need to be able to have a opportunity to change their outcomes for a recurrence in the future. And a lot of other different aspects of the program that took us a long time to make sure we had all those pieces in place. And then on August 1st, we went through a, virtual survey with another provider who oversees. Or I don't know if you say it oversees, but she is employed by the NAPBC to do those surveys. And thankfully after, what felt like a grulling day, we were told that we would be fully accredited in for the NAPBC as a breast center.

Denise Schnabel (Host): That's great accomplishment.

Wendy Kelly (Host): And what it tells the community is that they can trust us with breast cancer care here locally in a, you know, 35, 40,000 population. That's just incredible that they don't have to travel to get that care.

Denise Schnabel (Host): Okay, so lung cancer screening. Why is it important to check in on your lungs to make sure there is nothing abnormal going on?

Dr. Charles Shelton: So I'm gonna contrast the two different things that we see in our community, so that we just talked about our breast accreditation. Breast is an example where we do really well. We currently screen probably 80% of women in the population who are appropriate for screening, in contrast to that, we've studied our lung cancer population for many years in the Outer Banks.

And we see almost the opposite. So what we see with lung cancer is the majority of patients come in with late stage cancer, which means it's almost so far gone. That's hard to offer the same strategies for treatment. And we think that a lot of that has to do with the fact that we don't have enough awareness about screening within our community and within our population.

Wendy Kelly (Host): And so we screen with low dose CT scans?

Dr. Charles Shelton: The screening, we kind of think of it like a mammogram for the lungs. In fact, we call it a Lungagram, and the lungagram really is a way of every year. Looking at your lungs internally to see if there's anything that is abnormal, you have to meet criteria for screening. So it is considered appropriate only for people that have smoked for example, in the past a certain amount of smoking or people that are former smokers who meet also certain criteria.

Wendy Kelly (Host): If you were a smoker or are a smoker, you should check in with your lungs. And the way to do it is with the low dose CT scans, we offer them here. Can you tell us Bev what the qualifications are for that?

Beverly Jones: Yes. You have to be between the age of 50 and 77. You would normally of course be asymptomatic, meaning you don't have any symptoms of possible lung cancer, such as a cough and congestion and that sort of thing. Tobacco smoking history of at least one pack a day. And then be a current smoker or be someone who's quit within the last 15 years. And then of course you need an order from your primary care doctor to get that lung, CT.

Denise Schnabel (Host): So you were talking about how with mammograms, it's very popular. Like, it's a thing. We do it, women do it. Men can do it too. Why do you think people are more hesitant to get a lung screen as opposed to a breast screen?

Dr. Charles Shelton: You know, I think a lot of it is there's a little bit of a stigma associated with lung cancer. So I think that doesn't help. I think a lot of it is just that this is a new thing, right? So mammograms have been around for ever since we can remember for 40 years or longer. Lung screening has only been really promoted and shown to have a benefit over about the last gosh, eight years or so. So in 2014, the us government basically came out with a recommendation after years of studying this that showed that if you screened the appropriate population, you save lives

And so since 2014 we have promoted screening, but it just really hasn't taken off. We haven't educated people enough I think in the communities. We haven't educated our providers enough to know that this is available at our hospital. And I think if we can do that, I think we'll see those numbers flip.

Denise Schnabel (Host): So you mentioned the qualifications Bev. How does one get signed up for the low dose CT scan?

Beverly Jones: So of course you can talk to your primary care provider. If you have seen our billboard in Curry tech, across the bridge, you can go to the Outer Banks Hospital website, and look for that connection there. There is a phone number. It will lead you to a phone number to call. We do have one of our cancer services, employees who answers that call and goes through the screening process with you to make sure that you qualify.

So if you already have a primary care, we will refer you to your primary care or talk to your primary care about doing that. And if you don't, we have another way that we can get around getting that order for you to allow you to be screened appropriately and correctly.

Denise Schnabel (Host): And we'll say it later, but it's tagobh.com/loveyourlungs. Love your lungs. Love your lungs, lungs hashtag.

Wendy Kelly (Host): So, there are some ways that we can strengthen our lungs. Stay active stay up to date on immunizations and most important to not start smoking or quit smoking. Dr. Shelton, can you tell us a little bit about a tobacco sensation program here?

Dr. Charles Shelton: Sure. So we are very proactive about this idea of lifestyle and how do you improve your lifestyle to lower your risks for certain things like cancer and like lung cancer? And so we offer a formal program for counseling and for smoking cessation through our wellness center. We also offer that as a component of the screening process. So one of the requirements is then when you get a low dose CT as a screening tool, you should also be counseled at that time about the risks of smoking.

And we should offer you ways to try to stop that. What I will also tell you is that looking at our population, we have a high incidence of smoking in our population more so. Than what you would expect. Some of that comes from, I think our state history that of course is tied to tobacco, but within Eastern North Carolina, we do see a higher percentage of smokers where this really makes sense to offer.

Denise Schnabel (Host): So anything else we should know about lung cancer, screening, cancer services, anything you wanna share?

Dr. Charles Shelton: I'd like to say the screening works. You know, we started doing this back in 2014 and the first four patients that we screened, we had, one of the screens came back as abnormal and that prompted further work up and it turned out to be an early stage one lung cancer, which I can't say I've seen since I had been here at the time. And that lady was operated on in Greenville and had a successful surgery and is still alive today. That's great. And his hands are free.

And so discovered is over the years, we have a high risk population where this really makes sense to offer. And by doing this, what we have found is that we have about a five times higher rate of cancer per population, than other areas do in North Carolina and in other areas of the country. And to me that says that we have a population that we haven't really adequately notified about their risk, and we need to do a better job of screening.

Wendy Kelly (Host): That's a good. . So when October issue of the Health Coach is all about this, if you need a reminder the URL. Denise mentioned the obh.com/loveyourlungs. And then of course you can always call cancer services. What's that phone number

Beverly Jones: Our main number to our medical oncology office is 252-449-7272. And whoever of course answers the phone at that moment can make sure that you are given to the appropriate person to have a conversation.

Denise Schnabel (Host): All right. Well, one last thing we would be remiss if we didn't bring it up. The Outer Banks Hospital recently broke ground on a brand new cancer center. I'm sure both of you are thrilled to have this state of the art facility in our community. Tell us about the new building and what are you gonna put in it? And what's the timeline?

Beverly Jones: Do you want me to start with that one? That's okay. So currently the radiation therapy center opened in 2019 on the area between what was the urgent care there in Nags Head and Lagos Mexican restaurant and The addition to that. And the second phase of that is to incorporate our medical oncology and our infusion suite, along with our cancer resource group, our oncology social worker navigator, all of those people, all in one building connected together and not being in separate places. So that it offers a patient, the ability to go to one place and have all their care taken care of.

Wendy Kelly (Host): And what about that amazing education suite that's gonna be in there? What are the plans for that?

Dr. Charles Shelton: Yes. What are the plans for that?

Beverly Jones: The plans for that are we have, of course it'll be more like a conference room along with an area for the lay navigator will be stationed in that area. So, we'll hopefully be able to, maybe we could restart our lunch and learns and that sort of thing we'll have cancer support groups probably will be held there where they're held in the cancer resource center now. And that's just not just for patients, but that's for caregiver support too. And of course, the lay navigator will be right that area. So prosthetics wigs, that sort of thing, wig fittings will still be available. And it is just gonna, it's a nice setup and we're excited, very excited.

Denise Schnabel (Host): The estimated time, do we have a timeline?

Dr. Charles Shelton: So We should have a physical structure in place by we're hoping January of 2023, the final product I'm guessing should be in place and open by summer, late summer, early fall of 2023.

Beverly Jones: Fall 2023. Yeah. Fall 2023.

Denise Schnabel (Host): And of course we think all of our donors who have donated graciously to help with that build we couldn't have done that without them.

Dr. Charles Shelton: Absolutely. Right. We have a very giving community. I think that shows with us having this type of comprehensive care program in a community of this size.

Denise Schnabel (Host): It's gonna be amazing. It really is.

Wendy Kelly (Host): Yeah. Something to be proud of. All right.

Denise Schnabel (Host): Well we thank you guys for coming and chatting with us today to find out more about Lungagrams visit. As we said, the obh.com/loveyourlungs. We also have a beautiful billboard in Kerratuck county. If you've seen it. If you've enjoyed this podcast shared on your social channels to hear more Outer Banks's Health, check out the library at the obh.com/podcast. This is your host, Denise Schnabel stay safe.