Photo: Cardiothoracic surgeon Richard Thompson, MD, teams up with oncology specialists to bring hope to cancer patients at BryanLGH. He is the first in Nebraska to use a Da Vinci robot (in background) to remove a cancerous lobe from a patient’s lung.
From: BryanLGH Medical Center
Richard Thompson, MD, hit the ground running when he arrived in Lincoln in September 2011 to join the BryanLGH Heart program. Within two weeks’ time, his initiative to provide free lung cancer screenings to those most at risk was well on its way to becoming the first such event in Nebraska and only the second free lung screening effort in America. Prompted by past experience and results of a new study published in the New England Journal of Medicine that showed low-dose CT scans can reduce the mortality rate of lung cancer patients by 20 percent, Dr. Thompson moved quickly to convince BryanLGH Medical Center to provide free CT scans. And then he encouraged four practices — Lincoln Pulmonary & Critical Care, Lincoln Radiology Group, Nebraska Pulmonary Specialties, and BryanLGH Heart Institute — to donate time and resources to read the scans and provide initial follow-up visits for those needing additional evaluation or care. By the end of November, 644 people at risk for lung cancer had participated in the free screenings, with 236 having abnormal results. Leah McClement, RN, who was instrumental in organizing the screening program, says, “At this early date we have confirmed five new cases of lung cancer. If our findings mimic the national trend, we can expect to discover eight new cases of lung cancer as a result of our screening efforts.” She also notes a number of other serious medical conditions unrelated to lung cancer were discovered during the screenings. “This screening program was a tremendous benefit to the community and region,” says Dr. Thompson. “Lung cancer is notoriously difficult to detect in its early stages because of the lack of symptoms. However, if it is found early, tumors can be surgically removed before they’ve spread, which greatly improves a person’s chance for survival.”
One such patient whose cancer was caught early is 56-year-old George Wallace whose girlfriend encouraged him to take part in the screenings. A three-pack-a-day smoker, Wallace was completely without symptoms. But the CT scan showed a cancer the size of a penny on his lung. Dr. Thompson did a surgical resection, which proved to be the cure. Wallace didn’t even need chemotherapy because the cancer was found and removed at an early stage. He knows how lucky he is that the cancer was found so soon, as Dr. Thompson told Wallace that he probably would have started developing symptoms a year or two from now — and at that point the tumor would have been too large to remove.
The lung cancer stigma
Lung cancer does not get the attention or the funding for research that breast, prostate or colon cancers receive. And regular screenings for lung cancer typically are not covered by insurance plans as they are for those other forms of cancer. Dr. Thompson would like to see this change. “Doctors and patients — everyone needs to get involved to get more funding and coverage for lung cancer,” he says. “The problem is that there is more of a stigma with lung cancer, that it is the patient’s fault. Because they smoked; they should have known better, people say. First of all, these are our parents and our grandparents who most likely did not know of the dangers of smoking and may have quit, but the damage was already done. Secondly, my job is to help people, regardless of how they came to the condition they have.” Though heart disease risk may be decreased with improved lifestyle choices, the same is not true with lung cancer. Once a person has smoked, his or her lung cancer risk never goes back to where it was — it is always elevated, even if the person quit years ago.
Even though the free lung cancer screening was offered for a limited time, the multidisciplinary approach to lung cancer care will continue at BryanLGH as it has been shown the best outcomes come from places that have such care models. “Since the closest specialty lung cancer centers are in St. Louis and at the Mayo Clinic, we are committed to building a truly integrated thoracic oncology center of excellence here at BryanLGH, where we will bring new techniques in lung cancer surgery and the ability to participate in clinical trials,” Dr. Thompson explains. BryanLGH involves all the key players in the treatment of lung cancer, such as radiologists, pathologists, pulmonologists, oncologists, radiation oncologists and surgeons. “We actually sit down at a table and look at the images together, look at the pathology together, for every lung cancer case that comes into the BryanLGH system,” says Dr. Thompson. Every patient gets a plan of care by the end of such conferences. Physicians and patients outside of Lincoln will benefit, too, as telemedicine video conferencing will be used to allow physicians to present their own cases to those assembled at BryanLGH and receive the collective opinions of the multidisciplinary team.
Photo: Nurse navigator Ruth Van Gerpen, RN, talks with oncologist Cary Peterson, MD, during a multidisciplinary meeting.
Nurse navigator on board
In addition to the team of physician specialists, the integrated thoracic oncology center includes a new position — nurse navigator. Ruth Van Gerpen, RN, is the nurse navigator, whose role is to act as a key resource to patients throughout their diagnostic process, treatment and recovery. She says, “It has been my hope and my dream that this type of resource would be provided for our patients who have been diagnosed with cancer.” Having worked in oncology at BryanLGH for the past 28 years, the last 10 as a clinical nurse specialist, Van Gerpen understands the value of patients having someone they know — who is there, in person, to help them get the answers they need. They need someone they can depend on to provide information, education and support, as well as to work collaboratively with their many care providers. She says, “I have long seen my work with cancer patients to be that of a type of navigator, so the ability to truly focus on that role — and to expand it and to develop it even further — is very exciting for me and will be of such value to our patients.”
The full spectrum
Though Dr. Thompson has been instrumental in establishing the multidisciplinary model for lung cancer, 70 percent of his time is spent as a heart surgeon. While more than 200 lung cancer surgeries are done at BryanLGH each year, there are more than 450 heart surgeries. Dr. Thompson also is a veteran in this area as prior to coming to BryanLGH he had extensive experience in the full spectrum of cardiac, thoracic and major vascular surgery. He performed hundreds of heart surgeries in Pennsylvania where he had the highest outcomes in the state for both 2009 and 2010 as a result of having no deaths resulting from the coronary artery bypass graft (heart bypass) surgeries he performed.
A passion for improving lives
Dr. Thompson grew up in Pennsylvania and graduated from the University of Pennsylvania and while at the Wharton School of Business was on track for a career as an investment banker. “After a couple years, I realized I didn’t want to sell what others had created but instead wanted to create something myself that made a difference in people’s lives,” he recalls. Dr. Thompson’s passion for improving patients’ lives resulted in his attending medical school at Columbia University College of Physicians and Surgeons in New York and later deciding to become a cardiothoracic surgeon after conducting research on regenerating heart muscle while he was chief resident of general surgery at Duke University Medical Center. His interest in creating also has resulted in bringing new techniques to BryanLGH, as well as in continuing to improve existing procedures. Dr. Thompson and his team were the first in Nebraska to perform two new procedures in the lung cancer arena — VATS Radiotracer Localized Wedge Biopsy and robotic-assisted lung lobectomy — and new cardiac procedures are on the horizon.
Embracing the community
Outside of the hospital, Dr. Thompson is dedicated to his family (pictured on right) — wife, Jennifer, and children, Natalie (7) and Dylan (9). And with the same type of energy he has brought to BryanLGH, Dr. Thompson and his family are embracing what Lincoln has to offer. He says, “We like Lincoln because of its great outdoor activities and the nice friends we’ve made.” An avid Philadelphia sports fan, a trait his son now shares, Dr. Thompson enjoys attending his children’s soccer and baseball games as well as helping them practice in the backyard. He also enjoys tennis, golf, pheasant hunting and travel with his wife and family. Jennifer, a former 1st-grade teacher, now stay-at-home mom, also plays tennis and likes to spend time reading and helping in the children’s classrooms. “I’m excited about all the opportunities the community offers — both personally and professionally,” Dr. Thompson says. “There is so much yet to be discovered.”
To learn about these advancements in lung cancer treatment, call 402-483-3251, or visit www.bryanlgh.org/groundbreakingroboticsurgeryadvances.