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E V ERY S T EP O F T H E WAY A former oncology nurse, Lung Cancer Nurse Navigator Jayne O'Malley, RN, OCN, is key to managing lung cancer patients' medical and social journeys from screening to diagnosis, treatment and survivor- ship. One-on-one support is essential as patients undertake the arduous process of recovering from lung cancer. O'Malley helps patients access resources, including support groups and social services. She coordinates appointments, confers with healthcare providers and explains paper- work. Additionally, she helps people find financial resources if they need assistance paying for treatment. "When I was in medical school at Duke University, I saw how instrumental cancer navigators were," says Cleveland Lewis Jr., MD, Medical Director of the Lung Cancer Disease Management Team at Orange Regional Medical Center. "At Orange Regional, as soon as a patient has been diagnosed, O'Malley contacts them. She follows the patient through surgery and thereafter. She takes time with each patient, discussing emotional concerns and even logistical issues, such as how to obtain transportation to appointments. She is great at her job." To learn more about Orange Regional Medical Center's cancer navigation services, call 845-695-5891. Lung Screening Trial, of 53,454 patients at high risk for lung cancer. These patients were randomly assigned to undergo three annual screenings with either low-dose CT or chest radiography. Although both screening methods resulted in a number of false positive results, low-dose CT screening demonstrated a 20 percent relative reduction in lung cancer deaths. The authors' conclusion: "Screening with the use of low-dose CT reduces mortality from lung cancer." Later studies confirmed the findings, while also acknowledging those at low risk would not benefit from the screen- ing. Additionally, a 2013 study published in The New England Journal of Medicine found that accurately estimating whether a lung nodule detected by low-dose CT is benign or malignant is possible, based on characteristics of the patient and proper- ties of the nodule. Today, the National Comprehensive Cancer Network, the American Cancer Society and the American Association for Thoracic Surgery, among others, recom- mend annual low-dose CT scans to screen for lung cancer in select patients. These candidates include people ages 55 to 79 who have smoked one pack a day for 30 years, lung cancer survivors and smokers age 50 and older with a more limited cigarette habit who have additional risk factors, such as family history of lung cancer. These guidelines include those who have quit smoking within the last 15 years. At present, the Centers for Medicare & Medicaid Services does not pay for lung cancer screenings, nor do most insurance plans. However, the United States Preventive Services Task Force (USPSTF) announced in December 2013 that low-dose CT was an important screen- ing tool for lung cancer. This grade B recommendation extended the upper age for screening to 80. According to the Affordable Care Act, Medicare must pay for USPSTF grade A Dr. Lewis and Daphne Garcia, PA, perform video-assisted thoracoscopic lobectomy in the operating room. Dr. Lewis speaks with Chris Costello, Orange Regional's Nurse Director for Same-day Surgery/Endo/PACU, to schedule surgical cases. M D N E W S . CO M ■ MD NEWS Mid Hudson | 7