An annual CT scan has been part of life for Grace Strine for the last ten years. In 2010, she suffered from a bad case of bronchitis while living in Maryland and decided to go visit her doctor.
“They found nodules in both of my lungs,” said Grace. “I had two in one lung and three in the other. So, I started getting annual scans. Right before I moved to Pennsylvania, though, my doctor told me the scans were no longer required.”
When Grace moved to Littlestown in Adams County, she began seeing a WellSpan physician. Despite her having been released from needing an annual CT scan, her new physician suggested that it might be a good idea to get checked.
Grace underwent a CT scan in June 2020 and then again in October. Over those three months, the nodules appeared to be stable, but something looked off.
“The nodules hadn’t changed, but it looked unusual,” said Linda Farjo, a nurse practitioner and Diagnostic Support Specialists provider. “So, I called Grace, who said that she had had these nodules for a long time and didn’t think she needed any follow-up. I educated her on lung nodules and the importance of comparison from her baseline imaging. During our conversation, she was able to recall where she had her chest CTs in Maryland”.
That conversation with Grace ended up being the difference maker. The diagnostic team was able to track down the location where she had her original scan done, and when comparing those results, noticed that the nodule had slowly been growing over time. The Diagnostic Support Specialist (DSS) Advanced Practice Provider (APP) ordered a Thoracic consultation, which was scheduled within nine days from the chest CT. The DSS APP requested a copy of images be uploaded to Wellspan in order to be readily available for consult with Dr. Nikhilesh Korgaonkar, a thoracic surgeon at Wellspan.
“He was so good at explaining everything to me and walking me through my options and his recommendations,” said Grace. “He told me that he wanted to take my case to his team to discuss options. That was the first time I’d ever heard about a whole team looking at my case, and it just gave me so much confidence. It’s a great feeling to know that you have a whole team of experts brainstorming to make sure you get the best care possible.”
The nodule in Grace’s lung was found to be cancerous.
Every year, millions of patients have an incidental pulmonary nodule identified on chest imaging studies. In 2018, there were over 5,300 new lung nodule findings determined by WellSpan Health radiologists in Adams, Lancaster, Lebanon and York Counties. While most of these nodules prove to be benign, roughly 3-3.5% are found to be cancerous.
WellSpan Diagnostic Support Specialists, part of the WellSpan Medical Group, deliver innovative, incidental lung nodule care.
The practice makes sure there is timely and direct patient communication within two business days of imaging results, and then also go on to initiate an evidence-based diagnostic plan for patients with high-risk findings, and actively manage the process to improve the time it takes to get a diagnosis for the patient. For low-risk findings, the team will initiate a follow-up imaging plan of care with ongoing evaluation and monitoring for up to three years.
“We are the only practice in the state that operates this way, providing a well-coordinated lung nodule care experience that is supportive to the patient, family and primary care physicians,” said Dr. Robert Rice, medical director of the oncology service line. “We are finding a better way to help our patients, by streamlining care, making sure our providers are being kept informed along the way and knowing that their patients are getting the right test and the right referral at the right time.”
WellSpan Diagnostic Support Specialists take a whole-team approach to patient care, collaborating with the WellSpan Diagnostic Physician Advisory Team to make sure they come up with the best plan of care for patients. If there is a diagnosis of cancer, a warm handoff to WellSpan oncology services in the patient’s community will occur.
Dr. Korgoankar recommended that the nodule that was growing in Grace’s lung be removed. The surgery, which took place at the end of November, was a success and Grace is now cancer-free.
“That direct contact that Grace had with our Diagnostic Support Specialists is what led to us finding out that the nodule in her lung was growing and needed to be removed,” said Dr. Korgaonkar. “That direct contact, those conversations they have with the patient, where they can talk through problems and figure out solutions, can truly end up saving lives. Without that conversation, Grace’s story may have ended differently.”
“After the nodule was removed, I felt great, which is amazing for a 72-year old woman,” said Grace. “My experience at WellSpan was absolutely wonderful. The surgeons, the nurses, the whole team just made me feel confident. They are all very busy, but they always took the time to make sure I was as comfortable as possible.”
For more information on high quality imaging services available at WellSpan, visit WellSpan.org/Imaging.
