Hospital Takes Team Approach With New ‘Lung Nodule Center’

Starting Wednesday, Wheeling Hospital officially begins taking a team approach to evaluating lung nodules in patients.

During a press conference Monday, radiation oncologist Dr. Jondavid Pollock, cardiothoracic surgeons Drs. Victor Maevsky and Mehdi Akhavan-Heidari and pulmonary specialist Dr. Richard Ryncarz talked about the facility’s new Lung Nodule Evaluation Center. Another cardiothoracic surgeon, Dr. Ahmad Rahbar, also will be part of the team.

The doctors said most lung nodules are discovered when a patient is being evaluated by their family physician for some other condition. In the past, a patient having such a nodule may not have received attention immediately. Now, however, the hospital aims to provide additional review and, if necessary, treatment within a few days.

”This will keep patients where they should be – here in Wheeling,” said Pollock, who noted the team, for now, will meet once a week to discuss cases and more often as it expands.

Ryncarz said 15-20 percent of his patients are referred to him for lung nodule evaluations.

”You would be surprised the number of patients who have nodules, benign and malignant,” Ryncarz said. ”The goal is to figure out who needs addressed immediately and who can be safely followed with serial catscans and for how long.”

Ryncarz said a lung nodule in simple terms is ”a spot on a lung.” Akhavan-Heidari attributed the increase in discovery of incidental cases to today’s higher resolution CT scans. He said a nodule that needs additional evaluation will typically be larger than 1 centimeter.

Doctors also must consider a nodule’s shape or whether it has a certain pattern of calcification. For example, nodules that are not round or have finger-like structures may need to be tested. And physicians will also take a patient’s age, gender and medical history into consideration, such as a past history of lung cancer.

”The most important risk factor is the size. The bigger the size of the nodule or mass, the bigger the chance of malignancy,” Akhavan-Heidari said.

Evaluation procedures can include a repeat X-ray, CT scan, biopsy or surgery. Maevsky said being able to evaluate nodules sooner is important because the mortality rate for lung cancer is ”extremely high.”