Talking FACS
Host: Dr. Jennifer Hunter, Assistant Director for Family and Consumer Sciences Extension, University of Kentucky
Guest: Holly Stilz, Physician’s Assistant, UK Healthcare in Cardiothoracic Surgery
Special Edition Series – Cancer Conversations Episode 12
0:00 Welcome to Talking FACS and thank you for tuning into Cancer Conversations on Talking FACS; a podcast collaboration between the University of Kentucky Markey Cancer Center and the UK College of Agriculture, Food and Environment's Cooperative Extension Service.
We will share with you the latest developments in cancer prevention, diagnosis, treatment and research from the experts at Markey Cancer Center; Kentucky's only National Cancer Institute designated Cancer Center.
Talking FACS is hosted by the UK Family and Consumer Sciences Extension Program. Our educators share research knowledge with individuals, families and communities to improve quality of life.
O:41 Dr. Jennifer Hunter: Hello and welcome to Talking FACS. This is your host, Dr. Jennifer Hunter, Assistant Director for Family Consumer Sciences Extension at the University of Kentucky.
Today I'm pleased to have joining me, Holly Stilz, a Physician Assistant with UK Healthcare in Cardiothoracic Surgery. Welcome, Holly.
0:58 Holly Stilz: Thank you so much.
0:59 Dr. Jennifer Hunter: Today, we are discussing Lung Cancer Awareness Month, which is during the month of November. And you're going to start us off and just share a little bit about lung cancer in the state of Kentucky.
1:11 Holly Stilz: Sure. Thank you so much for having me on here. Lung cancer awareness is very important. Each year, lung cancer takes more lives combined than breast, colorectal and prostate cancer. And Kentucky actually has the highest rate of incidents and mortality in the country for lung cancer.
So, while lung cancer screenings have become very popular, lung cancer has actually been found in what we call incidental findings.
1:42 Dr. Jennifer Hunter: So, what would be an example of an incidental finding?
1:44 Holly Stilz: Sure. So, normally we find lung nodules when a patient is seen by a provider or in the emergency room for a problem that may or may not even be related to a lung cancer or a pulmonary or lung complaint. And patients end up being evaluated with some type of imaging and an abnormal finding, such as a lung nodule or a mass is found on that imaging.
2:07 Dr. Jennifer Hunter: So, it could be that an individual goes to see their regular doctor, as you said, maybe the emergency room for a completely different reason and has something like a CT scan or just a basic X-ray; what would show a lung nodule?
2:21 Holly Stilz: So, lung nodules can't be found on chest X-ray, but even some of those, if they're very small, are missed. So, lung cancer screening has become very popular because it uses low-dose CAT scans, which evaluate the chest, for those small abnormal findings.
2:38 Dr. Jennifer Hunter: So, you work specifically with a with the Lung Nodule Clinic. So, I'm assuming here that if an individual is found to have a lung nodule through some type of diagnostic test, they would then be referred to a clinic such as yours.
2:51 Holly Stilz: Correct. So, I created the Lung Nodule Clinic to sort of meet the needs of Kentuckians, given the fact that you know lung cancer is very prevalent here. And it's also estimated that about 1.5 million people each year will be diagnosed with a lung nodule.
Now, we work very closely with the emergency room here at Kentucky as well as the radiology department to streamline the process and identify those with a lung nodule. We also work with outside referring providers who get referred in to the clinic.
And when we get a referral, you would get access to a nurse navigator and myself who will streamline the process and the whole goal would be to determine what needs to be done with the nodule; whether it is a high index of suspicion for a lung cancer which would require you know prompt diagnosis and further evaluation with a referral to multidisciplinary specialist, such as an oncologist or an interventional pulmonologist. Or if it's benign, these need to be followed over time to ensure that there are no changes.
4:02 Dr. Jennifer Hunter: So, if an individual does have a finding of a lung nodule on some type of diagnostic test, it is not necessarily cancerous, but they would come to your clinic to kind of determine what it might be and what their next steps are.
4:14 Holly Stilz: Correct. So, a lung nodule, if it's found, can obviously be a malignancy or it could also be things that are benign; meaning it could be some type of scarring or inflammation.
And here in Kentucky, there are certain things in the environment, such as a fungus called histoplasmosis, which is very prevalent which could also cause these abnormal findings or lung nodules.
4:38 Dr. Jennifer Hunter: So, even if an individual does have a benign lung nodule, is that something that is followed over time as well?
4:42 Holly Stilz: Absolutely. So, another reason I created the lung nodule program was the fact that there's a wide variation in how these lung nodules are managed. And if detected early lung cancer is very treatable.
So, the goal is to identify these abnormalities at an early stage, watch them over time, and if changes occur, we will do further testing to determine if it's lung cancer. Because if caught early, lung cancer is actually very treatable.
Now, that being said, there is actually a wide variation in how nodules are managed, which is why some lung cancers getting missed and there's a huge drop-off between the different stages of lung cancer and how they're treated and the overall survival.
5:28 Dr. Jennifer Hunter: So, if someone is in the UK Healthcare System and has a diagnostic finding of a lung nodule, I'm going to make the assumption that they are probably automatically referred to your clinic.
But we have listeners that are all across the state in all 120 counties and also beyond the state of Kentucky. But for those folks within the state of Kentucky, if they wanted to access the Lung Nodule Clinic, if they knew that they had had a finding and wanted someone that could provide that expert opinion and continue to follow them and work with them, is that something that they can self-refer to or do they need to work with their general practice doctor to have a referral to the clinic.
6:05 Holly Stilz: So, we actually get a lot of patients off referrals, which is nice. I've seen patients who have seen their primary care doctor and they've been followed for a very long time and they find out about the Lung Nodule Clinic and they just sort of want an expert opinion or a second opinion, just to be sure that it is being followed appropriately.
So, we absolutely can have patients self-refer outside providers and of course, those that are found within UK Healthcare.
6:33 Dr. Jennifer Hunter: And so to access, you mentioned briefly earlier about a nurse navigator. Can you talk a little bit about that role and what that individual does?
6:40 Holly Stilz: Sure. Our nurse navigator’s name is Leslie Hubbard and she is basically the point of contact and the liaison who has open communication between the patient and the referring provider.
It’s basically somebody who will be there every step of the way, along with myself, who is going to walk them through the process and to streamline the process and to be there for support.
Because when a patient has the potential of a lung cancer diagnosis, it's very stressful. So, we are there one on one with a nurse navigator, Leslie, and myself to help the patient every step of the way.
7:18 Dr. Jennifer Hunter: Excellent. This is an amazing resource that we have here in the State of Kentucky that I previously was not aware of. So, I appreciate you being here today and sharing more with our listeners.
I do also want to let our listeners know that you're going to provide us with additional information that we can link in the show notes, if they would like to learn more about the Lung Nodule Clinic. Thank you so much for being with us.
7:387 Holly Stilz: Thank you for having me.
Thank you for listening to Cancer Conversations on Talking FACS. Our goal is to connect you with the latest advances in cancer research in the Commonwealth.
If you enjoyed today's podcast and have a suggestion for a future show topic, please messages on the UK Markey Cancer Center Facebook page at facebook.com/ukmarkey. Or visit our website at markey.uky.edu for more information.
You can find University of Kentucky Family and Consumer Sciences Extension Programs at your local extension office or online at fcs.uky.edu. Building strong families, building Kentucky. It starts with us.
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