WEBVTT 00:00:00.000 --> 00:00:13.580 Welcome to today's episode of Medically Speaking. Today I have a great guest with us, Dr. Brian 00:00:13.580 --> 00:00:19.680 Goodman. Brian is one of our thoracic surgeons here at Self Regional, and we have a great 00:00:19.680 --> 00:00:24.780 conversation today that I look forward to having. So we'll just start with, Brian, why 00:00:24.780 --> 00:00:27.060 don't you just tell me a little bit about yourself and your background? 00:00:27.460 --> 00:00:35.500 Sure. I grew up in South Florida, and from there, headed north. I went to medical school 00:00:35.500 --> 00:00:43.400 in Vermont. I guess at the time, I was really into skiing. I don't know. Spent some time 00:00:43.400 --> 00:00:49.420 in the north. After completing medical school, I did residency at Allegheny General in Pittsburgh. 00:00:51.100 --> 00:00:56.100 Then I did a cardiothoracic surgery fellowship at the Ohio State University. 00:00:56.100 --> 00:01:02.880 And from there, I had kind of the luck of being invited to Harvard, 00:01:02.880 --> 00:01:09.140 where I did clinical fellowships in minimally invasive thoracic surgery 00:01:09.140 --> 00:01:12.100 and thoracic surgical oncology at the Brigham and Women's Hospital. 00:01:12.100 --> 00:01:18.280 And so then after I finished my training, I worked at Geisinger in Pennsylvania 00:01:18.280 --> 00:01:26.520 and WVU in West Virginia before getting tired of the snow 00:01:26.520 --> 00:01:30.420 and coming back home, coming back down south. 00:01:30.420 --> 00:01:33.360 And I've been at Self Regional for about three and a half years, 00:01:33.360 --> 00:01:35.300 and it's been pretty awesome. 00:01:35.300 --> 00:01:40.200 Well, Brian, listen, you have really built a great reputation for yourself 00:01:40.200 --> 00:01:41.080 here in this community. 00:01:41.080 --> 00:01:45.580 And, you know, I hear often stories from patients 00:01:45.580 --> 00:01:47.800 where you've really made a difference in their lives. 00:01:47.960 --> 00:01:51.740 And, you know, we're certainly glad that you're here in Greenwood and serving the community here. 00:01:51.740 --> 00:01:56.360 One of the neat things that you brought here, maybe we can just talk about this for a minute, 00:01:56.360 --> 00:02:07.460 is our approach at Self Regional to lung cancer and specifically the pulmonary nodule clinic that you started when you first moved here. 00:02:07.460 --> 00:02:15.860 Why don't you tell us a little bit about the pulmonary nodule clinic and the types of cases that you see here and a little bit about your practice. 00:02:16.300 --> 00:02:30.460 Sure. So as far as my practice goes, thoracic surgery is a specialty that deals with essentially the treatment of non-cardiac, both benign and malignant diseases of the chest. 00:02:30.460 --> 00:02:37.460 And that includes lung, esophagus, chest wall, mediastinum, which is the central compartment of the chest, and the diaphragm. 00:02:37.460 --> 00:02:44.840 Lung cancer is probably the overwhelming focus of my practice. 00:02:45.640 --> 00:02:55.560 And when I arrived here, one of the problems or kind of issues that was facing the community 00:02:55.560 --> 00:03:02.020 was that there were kind of all of these pulmonary nodules that were being found and being sent all over the place. 00:03:02.020 --> 00:03:06.360 And pulmonary nodules are really pretty common. 00:03:06.360 --> 00:03:10.760 About actually 50% of people over the age of 50 will have them. 00:03:10.760 --> 00:03:14.580 95% of the time, they're benign. 00:03:14.580 --> 00:03:15.560 They're nothing to worry about. 00:03:15.640 --> 00:03:20.840 living in the south actually the way that i'll talk to patients about it is it's kind of like 00:03:20.840 --> 00:03:26.300 you know everybody knows how to deal with moles or things on your skin right and so you know if 00:03:26.300 --> 00:03:30.720 it's a tiny mole and it's been there forever you're like oh man that's just a mole but if it 00:03:30.720 --> 00:03:34.400 you know everybody knows all the criteria if you catch your eye you get it looked at and you make 00:03:34.400 --> 00:03:41.100 sure so most moles are not skin cancer well most nodules are not lung cancer so it's not a perfect 00:03:41.100 --> 00:03:45.820 correlation but i think it kind of makes sense to people because that's just part of living in the 00:03:45.820 --> 00:03:53.680 south and um the problem is these things show up all the time um it's estimated that about 30 percent 00:03:53.680 --> 00:03:58.700 of imaging studies that are performed that image the chest will find a pulmonary nodule 00:03:58.700 --> 00:04:04.460 and given that there are literally you know upwards of like four to five million chest 00:04:04.460 --> 00:04:10.520 imaging studies done a year you're talking about over a million incidental lung nodules and so 00:04:10.520 --> 00:04:17.400 it becomes very cumbersome in uh kind of trying to figure out you know how to manage these 00:04:17.400 --> 00:04:22.720 particularly if you don't do it all the time you're you know physicians are just looking at 00:04:22.720 --> 00:04:27.200 you know a report or a study and it says uh you know there's a pulmonary nodule and then what 00:04:27.200 --> 00:04:32.540 what size matters you know you know some of these as imaging technology has gotten better we can 00:04:32.540 --> 00:04:36.440 spot things that are one and two millimeters i mean we're talking the thickness of a credit card 00:04:36.440 --> 00:04:42.920 or two that have almost no clinical significance up to sizes that do matter and although there are 00:04:42.920 --> 00:04:48.660 algorithms and guidelines for this it's just it's cumbersome particularly for you know uh you know 00:04:48.660 --> 00:04:55.520 physicians who are already juggling tons of other patient related data and so uh we figured out that 00:04:55.520 --> 00:05:03.180 uh kind of a central clearinghouse in a central area of expertise that could actually take these 00:05:03.180 --> 00:05:10.040 things from diagnosis uh or finding them all the way to we're done with them this is what you know 00:05:10.040 --> 00:05:15.720 this is kind of what needs to be done either you know once or twice and then done or ongoing 00:05:15.720 --> 00:05:22.500 following it and so that that's been i think um really successful because it's kind of one-stop 00:05:22.500 --> 00:05:29.240 shopping um doing it kind of managing this as a surgeon you know the majority of these are not 00:05:29.240 --> 00:05:37.940 surgical issues, but the nice thing is I can own it completely in my practice, can do everything 00:05:37.940 --> 00:05:45.640 that needs to be done without having to refer a patient to anyone else, and through relationships 00:05:45.640 --> 00:05:51.980 that I have in the kind of cancer treatment pathway with, you know, pathology, medical and 00:05:51.980 --> 00:05:57.360 radiation oncology, and interventional radiology, when something does need to happen, it happens 00:05:57.360 --> 00:06:05.480 very quickly. And so we've really seen a lot of success with that. You know, some of the data 00:06:05.480 --> 00:06:13.920 that we've reviewed has actually shown that with increased rates of surveillance, and this kind of 00:06:13.920 --> 00:06:19.400 gets more into screening than actually the pulmonary nodule clinic, that you can just do 00:06:19.400 --> 00:06:25.140 more and find more earlier. And so the pulmonary nodule clinic is essentially doing that by 00:06:25.140 --> 00:06:31.620 serendipity you know because these are incidentally found nodules that were imaged elsewhere but what 00:06:31.620 --> 00:06:38.100 we really want to push for is to continue obviously seeing these patients with incidentally 00:06:38.100 --> 00:06:42.080 discovered nodules but what we really want to go after are these patients who meet 00:06:42.080 --> 00:06:50.920 high risk criteria and get them screened so that we can get them in great great points um so uh so 00:06:50.920 --> 00:06:57.060 that kind of leads me to my next question is uh around lung cancer screening specifically and um 00:06:57.060 --> 00:07:01.880 so what what are the current guidelines for lung cancer screening who should be screened who should 00:07:01.880 --> 00:07:08.660 be like considered at a higher risk uh and and should be getting checked out absolutely the uh 00:07:08.660 --> 00:07:13.460 the risk factors of the definition of high risk have been actually kind of re-evaluated but um 00:07:13.460 --> 00:07:19.040 Basically, age is probably the most important thing. 00:07:19.040 --> 00:07:25.520 And so generally we look at people age 50 is kind of what the criteria said. 00:07:25.520 --> 00:07:30.060 But in these parts, a lot of people will actually start smoking much earlier than that. 00:07:30.060 --> 00:07:38.600 And so it takes, we think, you know, 30 years of kind of ongoing, you know, 20 to 30 years of ongoing tobacco use. 00:07:38.600 --> 00:07:54.920 And so, you know, although the criteria for high-risk state age of, you know, 45, if you started smoking at 12, you could absolutely have, you know, 20 to 25 years of constant smoking by the age of 35. 00:07:54.920 --> 00:07:59.940 And so I think there's a slightly broader definition of high risk here. 00:07:59.940 --> 00:08:11.200 But as far as the actual, you know, the way that it's defined by the studies and the criteria is age greater than 45 to 50 with 20 years of regular tobacco use. 00:08:11.200 --> 00:08:18.960 And we kind of at one point said, well, what does that mean? 00:08:18.960 --> 00:08:21.860 And we use pack years as a definition. 00:08:21.860 --> 00:08:26.800 So if you smoke a pack a day for 20 years, that's a 20-pack year history. 00:08:26.800 --> 00:08:33.340 If you smoke two packs a day for 10 years, that's a 20-pack year history, the same thing. 00:08:33.340 --> 00:08:42.220 Now, you know, a lot of people will, you know, when you ask them about it, they'll kind of nickel and dime you. 00:08:42.220 --> 00:08:46.920 You know, well, technically for three years I was really smoking only like seven cigarettes a day. 00:08:46.920 --> 00:08:49.840 But, you know, like we try to encourage people to round up. 00:08:49.840 --> 00:08:54.580 you know we're not we're not keeping track of this you're not going to get scolded we really 00:08:54.580 --> 00:09:00.400 would much rather overestimate your risk and your exposure than underestimate it and for those 00:09:00.400 --> 00:09:07.440 people who are identified as you know quote-unquote high risk and so uh just to summarize that that's 00:09:07.440 --> 00:09:15.200 age 45 or greater with 20 years of you know smoking history uh it's recommended that they 00:09:15.200 --> 00:09:22.820 get a non contrast lung cancer screening CT and this is a low dose of scan but 00:09:22.820 --> 00:09:29.540 very kind of high resolution and these scans are able to pick up very very 00:09:29.540 --> 00:09:42.140 small nodules and and really lung cancer is very easy to find because it's 00:09:42.140 --> 00:09:47.020 generally greater than a certain size we think that you know eight millimeters 00:09:47.020 --> 00:09:49.620 which is just slightly larger than a quarter of an inch is kind of the 00:09:49.620 --> 00:09:54.260 cutoff and that's very very easy to see what kind of complicates things 00:09:54.260 --> 00:09:57.240 sometimes when we find the smaller things that you can't really tell what 00:09:57.240 --> 00:10:01.640 they are yet but then you just kind of follow them and once you know something's 00:10:01.640 --> 00:10:07.140 there following it is easy it's just there are plenty of people who have 00:10:07.140 --> 00:10:12.040 never been imaged and so that's what we really want to try to focus on but for 00:10:12.040 --> 00:10:16.800 high-risk people, getting them in and getting them screened is super easy. I mean, it's literally 00:10:16.800 --> 00:10:22.720 about 30 seconds of time in the scanner. It's covered by insurance, and it's kind of an in-and-out 00:10:22.720 --> 00:10:32.820 thing, and we know that in populations that are screened, the incidence or the detection of lung 00:10:32.820 --> 00:10:39.400 cancer at an earlier stage is much higher. In kind of multiple studies that were done, 00:10:39.980 --> 00:10:48.220 they showed very clearly that there was up to a 25% increase in diagnosis at early stage. 00:10:48.220 --> 00:10:54.720 And when we talk about early stage lung cancer, we talk about lung cancer with survival exceeding 60%, 00:10:54.720 --> 00:11:00.000 whereas advanced stage lung cancer, long-term survival is around 7%. 00:11:00.000 --> 00:11:05.120 And so the numbers are so bad at the later stages. 00:11:05.200 --> 00:11:10.960 why when you combine them all together take all comers overall uh you know five-year survival for 00:11:10.960 --> 00:11:17.600 lung cancer is reported at about 25 still we're making significant improvements uh there's been 00:11:17.600 --> 00:11:23.360 an improvement of probably over 20 in the survival rates in the last five to ten years um with the 00:11:23.360 --> 00:11:28.640 you know more and more uh both screening and just incidentally finding things because people get 00:11:28.640 --> 00:11:36.800 image now more often but um so if you have a 20 pack year history of smoking cigarettes and you 00:11:36.800 --> 00:11:43.360 are over 45 years old you should get screened for lung cancer and the screening test is a 00:11:43.360 --> 00:11:49.720 non-contrasted ct scan and just for the audience that requires no iv no pain at all you literally 00:11:49.720 --> 00:11:53.400 just lay down on the table and they take pictures that's correct and then you get up and you go home 00:11:53.400 --> 00:11:57.180 that's correct and then you get a report back so it's a very simple screen a much less invasive 00:11:57.180 --> 00:12:02.340 like colon cancer screening where you have to get a colonoscopy and a whole day out of work and all 00:12:02.340 --> 00:12:07.320 that you literally can come in on your lunch break get a quick ct and go home absolutely yeah so it's 00:12:07.320 --> 00:12:13.380 quick and painless screening not to take anything away from screening for other cancers because 00:12:13.380 --> 00:12:19.120 obviously that's that's really important and uh you know things like mammography and uh and colon 00:12:19.120 --> 00:12:24.680 cancer screening and colonoscopy right um but to put things in perspective those are kind of much 00:12:24.680 --> 00:12:32.640 more you know uncomfortable screening tools but they're utilized uh pretty significantly 00:12:32.640 --> 00:12:39.800 overall screening rates for high-risk populations for lung cancer nationally five to six percent 00:12:39.800 --> 00:12:45.320 for people that meet criteria for people that meet criteria and way under screen well and here's the 00:12:45.320 --> 00:12:53.600 most striking thing the number of patients needed to be screened to save a life in the in the high 00:12:53.600 --> 00:13:02.820 risk lung cancer population is about 360. It is by far the lowest of any cancer screening. So 00:13:02.820 --> 00:13:07.520 the impact of lung cancer screening is greater than the impact of screening for basically like 00:13:07.520 --> 00:13:14.080 breast cancer, colon cancer, and anything else combined, but utilization is really low. So 00:13:14.080 --> 00:13:20.160 there's such a opportunity for impact if we can get the word out. Wow. That's, that's, I think 00:13:20.160 --> 00:13:25.900 that's really meaningful. So I'm just going to say that back too. So for every 360 people that 00:13:25.900 --> 00:13:31.040 meet those criteria of being over 45 with a 20-pack year history, for every 360 people that 00:13:31.040 --> 00:13:36.260 get a screen, you'll find a lung cancer and potentially save a life. Big deal. That's a 00:13:36.260 --> 00:13:42.280 big deal that we push this and really get screening out there. Brian, can you tell me a little bit 00:13:42.280 --> 00:13:46.900 more about, say, your involvement in our cancer committee? Let's just talk through that process 00:13:46.900 --> 00:13:51.920 for a minute. So, um, a lot of people don't know how that works. So if, if you were diagnosed with 00:13:51.920 --> 00:13:57.660 cancer, we have such a phenomenal cancer program and cancer team here that a lot of people probably 00:13:57.660 --> 00:14:02.700 don't know about. Tell us a little bit about your involvement on our cancer committee. And like, 00:14:02.700 --> 00:14:07.940 say, uh, if, if someone, if you were to say, do an imaging or you were referred to screening case, 00:14:07.940 --> 00:14:12.600 and you found a lung cancer, like what's the planning process for treatment for that cancer 00:14:12.600 --> 00:14:15.780 right here in Greenwood and talk about a little bit of the advanced care that we provide. 00:14:16.080 --> 00:14:24.920 Absolutely. So, um, so self regional is part of the American college of surgeons, uh, community 00:14:24.920 --> 00:14:32.220 cancer program. And, uh, that's a pretty rigorous, uh, accreditation process where you have to meet, 00:14:32.220 --> 00:14:41.100 you know, strict criteria. And, um, for the cancer committee here, I function as the, uh, 00:14:41.120 --> 00:14:46.860 cancer liaison physician, and so I'm in charge of basically all the kind of quality control 00:14:46.860 --> 00:14:55.540 measures and reviewing kind of how we perform in comparison to regional and national benchmarks. 00:14:55.540 --> 00:15:02.920 And so there are, you know, very strict criteria for kind of who we have available, services we 00:15:02.920 --> 00:15:10.780 have available how we basically see screen and process patients at the time 00:15:10.780 --> 00:15:17.900 in which it takes and the way things kind of move through according to kind 00:15:17.900 --> 00:15:23.160 of both national guidelines and the most current and most state-of-the-art 00:15:23.160 --> 00:15:29.780 treatments and you know self regional has has done a great job of doing this 00:15:29.780 --> 00:15:35.120 you know kind of on their own but with the oversight of the American College of 00:15:35.120 --> 00:15:42.180 Surgeons as a designated you know cancer center we have you know this is not just 00:15:42.180 --> 00:15:46.020 kind of marketing where we say yeah we do this or that there's you know strict 00:15:46.020 --> 00:15:50.900 criteria and only certain places do it and so one of the things that we or kind 00:15:50.900 --> 00:15:58.720 of the way that we look at things is is you know how do we perform as far as you 00:15:58.720 --> 00:16:03.900 know time from initial presentation to diagnosis and then from diagnosis to 00:16:03.900 --> 00:16:08.440 first course of treatment we're actually constantly looking at this in a rolling 00:16:08.440 --> 00:16:12.100 fashion and one of my roles is to be constantly reviewing data and I have to 00:16:12.100 --> 00:16:15.680 report back to the to the hospital the committee and the American College of 00:16:15.680 --> 00:16:19.960 Surgeons quarterly on this and we're consistently meeting guidelines for this 00:16:19.960 --> 00:16:26.020 or exceeding them both you know regionally and nationally but in 00:16:26.020 --> 00:16:29.680 general if someone presents like to kind of walk through it someone gets sent to 00:16:29.680 --> 00:16:33.460 me in the pulmonary nodule clinic they have what appears to be a suspicious 00:16:33.460 --> 00:16:37.000 looking nodule they come to see me in the clinic we review the imaging studies 00:16:37.000 --> 00:16:40.540 together and that's really important to me to always you know put this put the 00:16:40.540 --> 00:16:45.340 scans up on the screen and explain to the patients exactly what's going on and 00:16:45.340 --> 00:16:51.820 kind of you know make sure that they leave knowing what I know mm-hmm and we 00:16:51.820 --> 00:16:55.940 review that and then if it looks suspicious because a lot of times at 00:16:55.940 --> 00:17:00.460 this time all we have is an imaging study and that's one of the things where 00:17:00.460 --> 00:17:07.360 I think we really excel is rather than say well you know let's watch it maybe 00:17:07.360 --> 00:17:10.480 we need to get a PET scan maybe we need to do this maybe we know with with you 00:17:10.480 --> 00:17:14.560 know 20 years of experience knowing a patient's history and being able to look 00:17:14.560 --> 00:17:18.340 at something I can say you know what I'm I think there's a real good chance this 00:17:18.340 --> 00:17:24.420 is a cancer and rather than kind of guess about it or hope let's just let's just move forward you 00:17:24.420 --> 00:17:30.220 know and so we can very quickly you know pretty much and very often on the first meeting get 00:17:30.220 --> 00:17:36.740 everything set up with biopsy PET scan pulmonary function testing if they're a surgical candidate 00:17:36.740 --> 00:17:43.420 determine all these things and then you know within a week 10 days have everything set up 00:17:43.420 --> 00:17:49.200 and have all that information once we have all that information the patient is then presented 00:17:49.200 --> 00:17:54.060 at the multi it's called multidisciplinary thoracic tumor board and that's a weekly discussion 00:17:54.060 --> 00:18:02.680 with pretty much all of the stakeholders who are involved in cancer care and the complete 00:18:02.680 --> 00:18:08.620 spectrum of cancer care so it's surgeons radiation oncologists medical oncologists 00:18:08.620 --> 00:18:23.560 Pathology, radiology, nurse navigators, social work, palliative care, basically everyone that could possibly play a role. 00:18:23.560 --> 00:18:36.720 And we discuss each individual case, discussing national guidelines and what the best way to proceed is for this individual patient. 00:18:36.720 --> 00:18:42.660 So each decision for treatment is tailored to the specific patient. 00:18:42.660 --> 00:18:50.360 So if you are 70 years old and have pretty severe lung disease 00:18:50.360 --> 00:19:01.660 and are already oxygen dependent and do not have a lot of physiologic reserve, 00:19:01.660 --> 00:19:08.220 then we're going to come up with a treatment that involves probably stereotactic radiation, 00:19:08.220 --> 00:19:14.040 which is kind of very straightforward, easy to tolerate treatment. 00:19:14.040 --> 00:19:23.400 And we're very fortunate here at Self Regional to have quite literally one of the most advanced linear accelerators 00:19:23.400 --> 00:19:26.740 for stereotactic radiation available in the world. 00:19:26.740 --> 00:19:30.440 And so that's just amazing that we have that. 00:19:30.960 --> 00:19:37.000 And so if that's the route, we get that sorted out and give those recommendations 00:19:37.000 --> 00:19:39.820 and then discuss with patients and their family and come to a decision. 00:19:39.820 --> 00:19:44.260 If we think that someone is a better candidate for surgery 00:19:44.260 --> 00:19:51.200 and can have their cancer completely resected with curative intent with surgery, 00:19:51.200 --> 00:19:54.220 we'll present that as our recommendation for them. 00:19:54.220 --> 00:19:57.100 And if so, then usually within just a few weeks, 00:19:57.100 --> 00:20:02.980 we'll get everything all the all the required pre-operative testing and lung function everything 00:20:02.980 --> 00:20:07.300 done go through the details of the surgery with the patient they want to proceed we get them to 00:20:07.300 --> 00:20:14.700 the or and and get it done yeah so i mean honestly the the multidisciplinary tumor board to me is one 00:20:14.700 --> 00:20:21.980 of like it's just awesome you have you as an individual you've got radiation oncology medical 00:20:21.980 --> 00:20:26.120 oncology, a thoracic surgeon for specific to lung cancer 00:20:26.120 --> 00:20:30.060 or other types of cancers have the specific specialist that's involved in that care. 00:20:30.060 --> 00:20:34.020 But to me there's no better way to do it. You have all the players 00:20:34.020 --> 00:20:38.200 like you said in one room looking at that one individual patient and tailoring 00:20:38.200 --> 00:20:41.960 the treatment to that patient's specific cancer. To me 00:20:41.960 --> 00:20:45.380 it can't get any better than that. And to have such 00:20:45.380 --> 00:20:49.860 high qualified medical staff like yourself 00:20:49.860 --> 00:20:57.660 and the others you mentioned it in a community our size is is really phenomenal and you know I'm very 00:20:57.660 --> 00:21:03.200 grateful you're here Brian and the work that you're doing is amazing and I know over the last 00:21:03.200 --> 00:21:07.940 several years we've really had some significant improvements in in our care of lung cancer 00:21:07.940 --> 00:21:13.120 patients I thought maybe we could talk about that for just a second and kind of how do we do 00:21:13.120 --> 00:21:17.140 itself regional if you look at like national statistics and like how are we doing in Greenwood 00:21:17.140 --> 00:21:21.640 with with treatment of lung cancer specifically or whatever like cancers 00:21:21.640 --> 00:21:26.020 absolutely you know as as I mentioned earlier as the cancer liaison physician 00:21:26.020 --> 00:21:30.940 for the American College of Surgeons here I I have to look at this stuff and 00:21:30.940 --> 00:21:35.260 we're constantly being evaluated on it and it's kind of a point of pride for us 00:21:35.260 --> 00:21:41.080 because not only are we meeting regional and national standards we exceed we're 00:21:41.080 --> 00:21:48.100 exceeding them we're literally you know outperforming you know much larger 00:21:48.100 --> 00:21:54.340 centers that have much larger budgets and much more with regard to resources 00:21:54.340 --> 00:22:01.080 so time from initial presentation to first course of treatment we're 00:22:01.080 --> 00:22:13.460 outperforming national centers and we are consistently meeting criteria for 00:22:13.460 --> 00:22:18.320 breast cancer colon cancer and lung cancer which all have kind of the most 00:22:18.320 --> 00:22:26.380 specific recommendations and kind of are the the keys to accreditation as really 00:22:26.380 --> 00:22:30.980 kind of the most commonly encountered cancers but the ones that also have 00:22:30.980 --> 00:22:36.420 kind of the most data of how things should be done and so if you compare you 00:22:36.420 --> 00:22:42.020 know the treatment of breast cancer or lung cancer at Self Regional to you know 00:22:42.020 --> 00:22:49.940 you pick the the market or the you know the institution academic so compared to 00:22:49.940 --> 00:22:56.360 MUSC in Charleston compared to Duke compared to Emory we meet or exceed the 00:22:56.360 --> 00:23:03.140 performance of those institutions and will provide you know quite literally 00:23:03.140 --> 00:23:10.820 the same exact care and from a thoracic surgery standpoint the the neat thing is 00:23:10.820 --> 00:23:16.640 it's a pretty small community nationally and you know so pretty much all of us 00:23:16.640 --> 00:23:21.260 know each other and particularly in the southeast region and so if someone ever 00:23:21.260 --> 00:23:26.300 does have a concern and wants to you know get set up to go you know go see 00:23:26.300 --> 00:23:32.700 someone at Emory or Charleston or or go to do it's an easy phone call because we 00:23:32.700 --> 00:23:38.600 kind of all know each other and most of the time I can you know I can count on 00:23:38.600 --> 00:23:42.920 one hand the number of times that someone has wanted to do that since I've 00:23:42.920 --> 00:23:45.860 been here because honestly I think there's just so much information 00:23:45.860 --> 00:23:49.980 available now that you know everybody kind of goes home and you know they 00:23:49.980 --> 00:23:50.980 They don't find it themselves. 00:23:50.980 --> 00:23:54.480 They talk to their kids, and they're like, oh, you know, we looked up this and that. 00:23:54.480 --> 00:23:59.080 And, you know, that looks like that's what you would get pretty much anywhere. 00:23:59.080 --> 00:24:03.880 But, you know, the handful of times that I have had people go elsewhere, 00:24:03.880 --> 00:24:07.820 they came back and said, well, we were told they would do the same exact thing, 00:24:07.820 --> 00:24:11.380 and it would make sense to just have it done right here in Greenwood, 00:24:11.380 --> 00:24:13.140 which for me that's awesome. 00:24:13.140 --> 00:24:14.720 You know, I mean, I saw that. 00:24:14.720 --> 00:24:18.140 You know, so when I was in Boston, people came from all over the world 00:24:18.140 --> 00:24:26.080 uh to get care there i mean particularly because there is a kind of a very strong focus on on 00:24:26.080 --> 00:24:31.760 treating you know a couple particular cancers there and so for that reason they they came from 00:24:31.760 --> 00:24:36.060 elsewhere but a lot of times they would uh you know they would come and have their surgery and 00:24:36.060 --> 00:24:42.660 then we would talk with their their oncology team at you know at home and go over everything with 00:24:42.660 --> 00:24:48.480 them and uh you know kind of post-op care and everything but the i mean the traveling and 00:24:48.480 --> 00:24:54.320 everything was it's just so cumbersome you know and so that was one of the things that was really 00:24:54.320 --> 00:24:59.140 attractive uh for me and coming here was being able to do that kind of stuff 00:24:59.140 --> 00:25:06.480 here you know in greenwood to see the insight that you know self regional and the the board and 00:25:06.480 --> 00:25:11.380 and uh the the people who kind of think about these things you know they they realize that 00:25:11.380 --> 00:25:17.620 there was a real need for this in the in the region and uh you know it it's very satisfying 00:25:17.620 --> 00:25:24.660 for me to be able to offer you know this kind of world-class care that you may have thought you 00:25:24.660 --> 00:25:30.380 needed to travel someplace else to go get right here and and that's that that that pretty much 00:25:30.380 --> 00:25:35.420 keeps a smile on my face every day you know i mean it's it's it's very satisfying that's awesome 00:25:35.420 --> 00:25:44.760 Well, you're doing a great job, and like I say, we certainly feel fortunate to have a, gosh, Harvard Fellowship-trained thoracic surgeon right here in Greenwood, South Carolina. 00:25:44.760 --> 00:25:51.640 That's one of those things that, you know, you don't, like, you know, I don't make a fuss about that. 00:25:51.640 --> 00:25:53.820 No, I know you don't brag on yourself. 00:25:53.820 --> 00:25:59.980 I appreciate your humility as well, but it is awesome to have that level of expertise and training right here in Greenwood 00:25:59.980 --> 00:26:04.540 and to be able to offer, you know, your skill set to the community for folks that need it. 00:26:04.760 --> 00:26:07.740 I did want to just maybe change the subject just a little bit. 00:26:07.740 --> 00:26:14.080 You know, so we've talked about lung cancer screening and kind of who meets the criteria. 00:26:14.080 --> 00:26:20.600 You know, when we think about kind of looking at lung cancer kind of through a health equity lens, 00:26:20.600 --> 00:26:25.520 just for just a second, I know you've been involved in our health equity advisory task force. 00:26:25.520 --> 00:26:30.180 And can you talk about that for just a minute, the health equity task force, 00:26:30.180 --> 00:26:39.100 and also specific to lung cancer and disparities nationally around perhaps different races 00:26:39.100 --> 00:26:42.700 maybe not getting the same level of screening or treatments as others? 00:26:42.700 --> 00:26:45.660 And then specifically, how are we handling that in Greenwood? 00:26:45.660 --> 00:26:46.560 Absolutely. 00:26:46.560 --> 00:26:53.560 I think that the Health Equity Task Force is a great initiative that Self Regional has undertaken 00:26:53.560 --> 00:26:59.880 kind of with an awareness of of kind of our community and trying to uh address uh specific 00:26:59.880 --> 00:27:08.360 issues that uh may have uh been kind of uh either less obvious or just kind of raise awareness to 00:27:08.360 --> 00:27:13.160 things and so particularly here where we have a large african-american population there are 00:27:13.160 --> 00:27:21.240 certain issues that really um uh you know contribute to kind of increased uh both morbidity 00:27:21.240 --> 00:27:29.600 and mortality in black communities and really interestingly for me uh is uh tobacco use 00:27:29.600 --> 00:27:34.760 contributes actually to the three leading causes of death uh among black americans and so 00:27:34.760 --> 00:27:41.140 cardiovascular disease stroke and cancer and it really disproportionately affects the black 00:27:41.140 --> 00:27:48.080 community um the one of the most striking things i've uh statistics i've seen is that tobacco kills 00:27:48.080 --> 00:27:56.000 more african americans each year than aids alcohol car accidents drugs murder and suicide combined 00:27:56.000 --> 00:28:04.320 that's that's how significant uh these disease processes are in the black community and um it's 00:28:04.320 --> 00:28:09.440 uh it's interesting because even though african americans generally actually smoke less than 00:28:09.440 --> 00:28:17.760 non-african-american smokers they have higher rates of death from smoking related disease 00:28:18.080 --> 00:28:28.280 so the thinking on this is it is is an issue with access to care or access to 00:28:28.280 --> 00:28:37.340 screening kind of medical literacy and education and and things that we 00:28:37.340 --> 00:28:44.860 probably can move the needle on and so making sure that we do something to 00:28:44.860 --> 00:28:51.300 increase community education about this improve access to screening and care 00:28:51.300 --> 00:28:57.560 make it easier for people in our community to get in and get to see 00:28:57.560 --> 00:29:02.280 someone make it easy for them to get on medications and get titrated make it 00:29:02.280 --> 00:29:06.000 easier for them if they want to quit smoking to get access to things that can 00:29:06.000 --> 00:29:10.320 help them because the the data is very clear that these things are really kind 00:29:10.320 --> 00:29:19.500 of not taking advantage of it as much and so we you know as a whole as an 00:29:19.500 --> 00:29:25.320 organization there are other issues as well but obviously this one is very near 00:29:25.320 --> 00:29:30.120 and dear to me so the the Health Advisory Task Force is really trying to 00:29:30.120 --> 00:29:39.920 focus on you know what can we do to improve disparities in care that really 00:29:39.920 --> 00:29:48.100 have a significant effect on our community and and and we're like i said hoping to with initiatives 00:29:48.100 --> 00:29:56.460 kind of improve access that over time will will help avoid some of this basically excess 00:29:56.460 --> 00:30:05.160 mortality brian so if one of our viewers feels like they meet criteria for needing lung cancer 00:30:05.160 --> 00:30:11.480 screening in other words again just as a summary it sounds like over 45 with a 20 pack year history 00:30:11.480 --> 00:30:16.440 of smoking cigarettes that's correct um how do they go about getting a screening test the easiest 00:30:16.440 --> 00:30:21.080 way is probably just to ask their primary care practitioner to go ahead and refer them for that 00:30:21.080 --> 00:30:26.520 and once the screening test is done if there's no findings that really you know doesn't really need 00:30:26.520 --> 00:30:31.000 to go any further and if there is anything that needs to be looked at then they'd most likely be 00:30:31.000 --> 00:30:38.440 sent to me for review and if they don't have a primary care provider they can certainly just 00:30:38.440 --> 00:30:47.220 contact the thoracic surgery office 725-7900 and we'd gladly help them get it set up perfect 00:30:47.220 --> 00:30:53.200 perfect brian thanks for being with me today and telling the audience about your practice 00:30:53.200 --> 00:30:59.380 thoracic surgery or cancer care in greenwood in general and specific to lung cancer and lung 00:30:59.380 --> 00:31:02.720 cancer screening, and a little bit on healthcare disparities. 00:31:02.720 --> 00:31:03.720 So appreciate your time today. 00:31:03.720 --> 00:31:04.720 Thanks for joining us. 00:31:04.720 --> 00:31:05.720 Thank you. 00:31:05.720 --> 00:31:06.720 Thank you for having me. 00:31:06.720 --> 00:31:06.720 Excellent.