Tennessee Oncology

As mentioned, lung cancers are the leading cause of cancer death in men and women in this country, and 80 percent to 90 percent of those cancers are due to smoking.

If our society is serious about reducing death rates from lung cancer, we must implement a multifaceted approach with smoking prevention and cessation at the cornerstone of that effort. Public policy guidelines with high tax rates for cigarette consumption, prohibition of smoking in public places and mandatory tobacco education in our schools have been proven to be effective in reducing the number of smokers in areas where they have been implemented.

We also must continue to develop and validate technology and systems that improve the early diagnosis of lung cancer with the goal of increasing survival rates. There has been considerable interest in routine low-dose CT scanning to screen patients at high risk of lung cancer, but consensus on the real long-term benefits of this approach has yet to be reached.

The most treatable and curable lung cancers are discovered early, and although the five-year survival rates of stage I and II non-small cell lung cancer are still unacceptably low at 50 percent, survival becomes much worse with advanced stages of the disease.

Most of the time small lung cancers are discovered incidentally because someone had a chest X-ray when he or she went to an emergency facility, walk-in clinic or physician’s office with an unrelated problem.

The hospitals of Saint Thomas Health have implemented a focused program to quickly direct patients with incidentally discovered lung lesions to the next step in evaluation after discharge from the emergency department.

A patient in the emergency department with a chest X-ray or chest CT abnormality is given written and verbal instructions about appropriate follow-up. Once that patient returns home, they are contacted by a nurse navigator to ensure they have followed up with their physician in a timely fashion.

Over the past year, this program has resulted in the referral of 70 patients with previously unknown lung abnormalities to appropriate care providers through both Baptist Hospital and Saint Thomas Hospital, and the program soon will be fully implemented at Middle Tennessee Medical Center.

There are nearly 400,000 people diagnosed with lung cancer in the United States each year, and only 15 percent of those are diagnosed at an early stage. The hospitals of Saint Thomas Health remain committed to improving survival rates from all cancers and to improving the processes to make certain this occurs.