Detecting lung cancer sooner
By: Phyllis Cooper, RN, BSN, OCN, CCRP, Lung cancer navigator

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As an oncology nurse navigator who works with lung cancer patients, I am always happy to meet those whose disease has been found early. Lung cancer can be very sneaky and doesn’t usually make itself known in the earlier, more curable stages of the disease. These discoveries are often made “incidentally” during a routine medical screening or when some other health issue is being examined and a CT scan is done. When a nodule is found during one of these screenings, it is very important that it be assessed and appropriately managed.

A pulmonary nodule is a small spot on the lung less than three centimeters (just a little more than an inch) in diameter. Nodules often do not cause pain or present any signs or symptoms. Most patients, in fact, are surprised to learn they have a pulmonary nodule.

The good news is that most of these nodules are not cancerous; they could be the result of an infection or scar tissue build-up from a previous infection. But because some can be cancerous, they are worrisome for patients and physicians and require follow up.

Under the philosophy that early detection is critical to successfully treating cancer, Novant Health Presbyterian Medical Center created a Lung Nodule Evaluation Program (LNEP) to ensure these incidental findings were properly addressed. We’re proud to be a leader in the field, as our program is one of only a few nationwide devoted to systematic and scientific assessment, treatment and surveillance of incidentally found lung nodules that are potentially cancerous.

LNEP is a collaboration of experts in radiology, pulmonology and oncology. Here is how the program works:

• A pulmonary nurse practitioner and I review all suspicious chest CT scans completed at Novant Health facilities in the Charlotte area. A follow-up recommendation is provided based on national guidelines and the radiologist’s conclusion.
• The primary care physician or ER physician is notified of CT scan results.
• The nurse practitioner contacts the primary care physician or ER physician to confirm that the patient is an appropriate candidate to be followed in the Lung Nodule Evaluation Program. With the doctor’s permission, the nurse practitioner contacts the patient.
• A timely consult with a pulmonologist (lung specialist) is scheduled for the patient. This appointment allows the patient to meet with the doctor, have risk factors assessed and get recommendations for appropriate treatments, interventions and follow up.
• If the nodule is found to be cancerous, the patient is connected with our Multidisciplinary Thoracic Oncology Program, where he or she receives recommendations for a plan of care.

The nurse practitioner and I are available to help patients quickly and smoothly navigate this process. Our goal is to lessen the stress and worry that a finding like this can cause and to ensure that the highest quality of care is provided at every step along the way.

Prompt diagnosis and treatment of early lung cancer gives us the best chance for a cure. The Novant Health team is committed to working together to bring the very best care to our community, and the Lung Nodule Evaluation Program is just one more way of doing that. For information about the Lung Nodule Evaluation Program, call 704-384-8253 or click here.