
Delivering Coordinated Care To Lung Cancer Patients Speeds Time From Diagnosis To Treatment
A 68-year-old Boca Raton woman saw her primary care physician for a routine physical examination. Her chest X-ray showed an abnormality in the right lung, and further tests showed small lymph nodes in the center of her chest, suggestive of lung cancer.
For her – as well as her family members and physician – the test results became an immediate cause for concern, raising the all-important question: What should we do next?
In the past, physicians in Boca Raton, Delray Beach and other Palm Beach County communities would typically refer a patient to a thoracic surgeon to start the evaluation process. The surgeon would then review the imaging and recommend a procedure called endoscopic ultrasound guided biopsy (EBUS) to sample the lymph nodes in the center of the chest. These biopsies would be reviewed by a pathologist resulting in a diagnosis of lung cancer.
With that information the thoracic surgeon would then send the patient to the offices of a radiation oncologist and a medical oncologist to obtain their opinions as to the best overall treatment. After seeing the patient, those specialists would typically need time to review the imaging with the radiologist and the biopsy samples with the pathologist.
Finally, the three specialists would need to speak with each other to arrive at a lung cancer treatment plan. As a result, it often took weeks after the initial physician’s referral before a patient could begin treatment, raising another big question: Why does this process take so long?

Is There a Better Way?
Fortunately, this woman’s physician referred her to the Lynn Cancer Institute’s Thoracic Multimodality Specialty Clinic at Boca Raton Regional Hospital for an expedited, coordinated evaluation by specialists in three different disciplines: thoracic surgery, radiation oncology and medical oncology.
“All too often, patients spend weeks in suspense, worrying about their condition,” says Harold Richter, M.D., who is board certified in medical oncology and hematology. “Our multimodality specialty clinics at Lynn Cancer Institute are designed to accelerate the assessment process, determine the best possible personalized treatment plan, and provide peace of mind to the patient, family members and referring physicians.”
In this case, the patient came to the Thoracic Multimodality Specialty Clinic, where she simultaneously met all three oncology specialists. That same day at the Thoracic Tumor Board, all three physicians, along with their colleagues also specializing in lung cancer, reviewed her imaging and pathology with the actual radiologist and pathologist. She and her family members also met with the psychosocial worker and nutritionist, who are integral to the institute’s coordinated approach to cancer care.
Leaving the Thoracic Multimodality Specialty Clinic this patient had an appointment for an immediate surgical procedure. Within two weeks she began concurrent chemotherapy and radiation delivered at the Institute’s Sandler Pavilion on the campus of Boca Raton Regional Hospital. Today, she remains cancer free and volunteers helping other patients at the Lynn Cancer Institute.

Delivering Personalized Care
Lung cancer treatment plans should be personalized to the specific requirements of individual patients, according to Louise E. Morrell, M.D., a board certified medical oncologist who specializes in Cancer Genetics and who also serves as Medical Director of the Lynn Cancer Institute.
“Everyone’s body has a different size, shape and metabolism along with a unique genetic DNA signature,” she says. “Every cancer, is different in terms of its size, location, appearance and genetic ‘fingerprints.’ Some cancers are more aggressive than others, and the treatment plan needs to reflect those differences as well. That’s why a coordinated, multimodality approach is so important to determining the most appropriate treatment for each patient.”
The Thoracic Multimodality Specialty Clinic is a resource to help patients and physicians address the medical complexities of lung cancer, adds Dr. Harold Richter. “Our team brings together varied perspectives to help sort out that complexity and create a unique patient treatment plan.”
The Lynn Cancer Institute research team is also present, evaluating whether the patient qualifies to participate in cutting- edge clinical trials. As a result, a patient can be assured of state-of-the-art, quality, expedited evaluation and treatment for lung cancer, whether newly diagnosed or seeking a second opinion.
That’s a dramatic contrast to the traditional hurdles facing anxious patients and family members and even some physicians who may wonder about the meaning and implications of abnormal test results. “Patients look to their physicians for guidance in finding the best quality, expedited care for what appears to be a lung cancer,” says Dr. Morrell.

A Better Patient Experience
Along with delivering high-quality coordinated care, the lung cancer specialists at Lynn Cancer Institute are dedicated to providing a better patient experience. “Both patients and family members appreciate being able to talk with all the specialists at one time and get answers to their questions,” says Dr. Morrell. “Being able to walk out of the meeting with a consensus treatment plan saves time, reduces anxiety and provides a clear path forward.”
In addition to the Thoracic Multimodality Specialty Clinic,the institute offers five other multispecialty clinics that take a coordinated approach to patients with breast, gastrointestinal, genitourinary, skin and neuro-oncology malignancies. Each multimodality team is comprised of physicians and healthcare professionals who specialize in that specific cancer. They coordinate their knowledge and skills to develop a personalized plan of care for each patient.
For an appointment or more information, call 561-955-6627.
Locations: LCI Sandler Pavilion, 701 N.W. 13th St., Boca Raton, FL 33486, 561-955-6627; brrh.com; Medical Oncology Delray, 6282 Linton Blvd., Delray Beach, Fl 33484, 561-495-8307; Radiation Oncology Delray, 16313 S. Military Trail, Delray Beach, FL 33483, 561-955-7200
Specialties: Lynn Cancer Institute, Louise Morrell, M.D., Director
Lung Cancer Team Specialists
Thoracic Surgery: John Roberts, M.D.
Medical Oncology: Edgardo Santos, M.D.; Albert Begas, M.D.; Harold Richter, M.D.
Radiation Oncology: Rashmi Benda, M.D.; Samuel Richter, M.D.; Michael Kasper, M.D.
Social Services: Barbara Pearl, MSW, LCSW; Darci McNally, MSW, LCSW
Lung Research: Edgardo Santos, M.D., Director; Arlene Padolina, RN; Viviana Boronat, M.D.
Genetics: Louise Morrell, M.D.
Pathology: Miguel A. Brito Jr., M.D.
Molecular Pathology: Evans Roberts III, M.D.
Radiology/Imaging: Yale Pollak, M.D.
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