Beth Hilty, research assistant, prepares a test to check for the presence of an immune stimulatory protein that is being studied for use against lung cancer.

The program, which has been developed over the past year, includes clinical, research and educational components. It aims to address a massive health problem in Kentucky:

• About 3,600 Kentuckians were diagnosed with lung cancer last year.

• Lung cancer kills more Kentuckians per year than breast, colon, pancreas and prostate cancers combined.

• Lung cancer accounted for about one-third of cancer-related deaths last year in Kentucky.

• Kentucky has 1.4 percent of the U.S. population, but 2.3 percent of all lung cancers. In the general population of the United States, 54 of 100,000 deaths are due to lung cancer; in Kentucky, that number skyrockets to 83.

• The five-year survival rate for patients with lung cancer is only 14 percent. A key reason is that lung cancers typically are diagnosed at later stages.

A key part of the UK program is a clinic that serves as a "one-stop-shop" in which lung cancer patients can see all of their specialists in one clinic on one day.

"This clinic truly is a team approach," said Timothy Mullett, M.D., director of the program and chief of general thoracic surgery at the UK Chandler Medical Center. "In this forum, we can consider all aspects of the patient’s disease, their associated risks and treatment options. It also allows us an opportunity to discuss innovative research protocols that are appropriate for that patient."

With input from the primary care physician, a team of specialists is available to review all cases. This team includes two pulmonary and critical care medicine physicians, a medical oncologist, a radiation oncologist, a thoracic surgeon and a palliative medicine specialist. The specialists meet to review all cases, both those of patients seen that day and continuing cases.

"I like to think of it as having seven minds thinking about a patient’s problem at the same time," said Susanne Arnold, M.D., associate director of the center and a medical oncologist. "Each patient’s case is unique, so a treatment plan must be individualized. The multidisciplinary approach helps us consider all of the possible treatment options and make a complete plan for each patient."

For the patient, the cohesive team approach means consolidated care. "Patients can be seen by several physicians and have tests all in the same day at one centralized location. That means they don’t have to make as many trips, and they get answers more quickly," Arnold said.

The Multidisciplinary Lung Cancer Program participates in national research studies on lung cancer, as well as pharmaceutical company-sponsored drug treatments.

"In this way, we bring the most innovative lung cancer treatments available anywhere to Kentuckians, in hopes of improving survival from this devastating disease," Arnold said.

A pulmonologist involved with the program, Edward Hirschowitz, M.D., assistant professor, Department of Internal Medicine, Pulmonary and Critical Care Medicine Division, UK College of Medicine, also has an active research program focused on novel treatments for lung cancer. Using a combination of gene therapy and immunotherapy, researchers hope to initiate treatments that will enhance the ability of the immune system to recognize the tumor cells as foreign and provide stimulatory proteins to augment the number of tumor-fighting cells available.

Clinical trials for gene therapy treatments of lung cancer at UK will begin in about two years. Trials that investigate the efficacy of the treatments are five years away.

The program will incorporate an education element as well. "Most – about 85 percent – of our patients come to us with advanced lung cancer. This program will help us step up our education efforts and early detection programs so we can provide better, more effective care," Mullett said.

The program will focus efforts on early detection of lung cancer. "Because patients whose lung cancer detected at an earlier stage have improved survival rates, we feel that studying the high risk populations in Kentucky with an intensive early detection program may reduce the overall mortality that Kentuckians face," Mullett said. 

By Vikki Franklin
and Maureen
McArthur