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Shannon Pulmonary Nodule Clinic: First of its kind in West Texas

Two departments have combined to create a sophisticated new clinic for patients with abnormal chest x-ray findings. The new clinic provides individualized observation and treatment plans to make sure you get the care you need.

Lung cancer is the deadliest cancer among men and women. One of the reasons why this disease is so deadly is that it does not cause symptoms until it reaches advanced stages. At Shannon, the departments of Thoracic Surgery and Pulmonary Medicine have joined forces to provide a single, dedicated clinic for evaluation and treatment of patients with abnormal chest x-ray findings—the Shannon Pulmonary Nodule Clinic. As the first of its kind in West Texas, the clinic’s goal is to save patients from unnecessary surgery, detect lung cancer at an early stage, and increase the survival rate and quality of life for patients.

“A pulmonary nodule is a small spot (less than 3 cm in diameter) found in the lung,” says Andrew Hume, MD, Shannon Clinic cardiovascular and thoracic surgeon. “The majority of these spots are found while conducting chest x-rays or CT scans for other reasons, because most nodules do not cause symptoms. Thus, most patients are surprised to learn that they have an abnormality in their lung.”

Most pulmonary nodules are benign and are usually the result of scar-tissue buildup from previous infections. However, because some can be cancerous, they are worrisome for patients. They do need to be followed appropriately to determine which course of action needs to be taken.

“Regular scans monitor patients’ lung nodules and lung spots, detecting changes that signal cancer while preventing unnecessary surgery on still-harmless nodules,” Dr. Hume says. “Early detection is critical to successfully treating cancer, so a rapid and accurate diagnosis is crucial to successful treatment. With careful monitoring of the growth of the nodules, more than 60 percent of patients will not need surgery.”

How the clinic works

Patients are evaluated at the Shannon Pulmonary Nodule Clinic within a week of referral. The initial evaluation includes a baseline chest CT scan. The scan uses one-half to one-fifth the radiation exposure of a typical CT scan. The thoracic and pulmonary team will then develop an individualized care plan for the patient and schedule prescribed follow-up scans.

“Patients are followed according to the characteristics of the nodule, which means they could be seen every three months, six months or once a year,” Dr. Hume says. “A recent study found 45 percent of pulmonary cancers show a period of shrinkage during close surveillance. This study stresses that growth rate cannot be the sole determinant for treatment.”

Follow-up visits allow thoracic specialists to detect any enlargement in the nodule and plan appropriate early intervention, thus improving the outcome for a suspected malignancy (cancer). Patients are usually followed for five years. Occasionally, patients will require more invasive work-ups, such as a needle biopsy or surgery. There are also defined protocols for screening high-risk patients who may not presently have a nodule.

For more information about the Shannon Pulmonary Nodule Clinic, call 325-481-2134.
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