But the first thing to understand is there's a long list of not cancer reasons you could have a nodule in your lung. We're fortunate enough here at UChicago Medicine to have a robotic endoscope that lets us get to parts of the lung we've never been able to get to before. All kinds of fantastic information there. And then they just go home. Whether they, you know, the fact that they can't eat the night before because we do general anesthesia for many of our cases. Our list of accepted insurance providers is subject to change at any time. Interventional Pulmonology & Advanced Bronchoscopy; Lung Cancer; Lung Transplant; Pulmonary Embolism; Pulmonary Hypertension; Sleep Disorders; . Email: ipscheduling@jhmi.edu. Or you're going to go to radiation or whatever. Occupational lung disease. And so those are our mainstays of imaging. So let's start off with our questions. And prior to that, I was a private practice pulmonary critical care doctor for six years. Physician: Interventional Pulmonology - McHenry, IL / Lake Forest, IL. Getting an expert opinion about what could this nodule actually be. And we get the tissue that we need. Really, really good questions today. Interventional Pulmonary; Hospitals. But if it shows anything of any concern, especially if it's your first one, that may require a follow-up scan in a shorter interval or one with slightly higher radiation. Is following a nodule ground glass opacity with yearly CT standard? All rights reserved. And we have a series of other tests we can do. [LAUGHTER] So Dr. Wagh and I have our partner, Dr. Mergue. It's a wonderful website. Chicago Chest Center/ The University of Illinois Chicago. We don't want that to happen. And then there are other types of imaging techniques, like PET scans, other images that we use to evaluate lung nodules. There's nobody else here. What's that chance? So I have two from viewers that I have to pass along. I can't even imagine what that would be like if you're worried that you have cancer, and then you're told you have to wait for an extended period of time. Dr. Wagh, let's hear a little bit about you. Another question from a viewer, and this is Carla. That ground glass, if it gets larger or denser, then it's changing. So Dr. Wagh, it was interesting because this is almost like a video game. As an Interventional Radiology Technologist you will perform diagnostic imaging studies as assigned, assist with minimally invasive image-guided vascular procedures, apply principles of radiation protection, exercise professional judgement in . A lung mass can be a frightening discovery. All rights reserved. We can talk about imaging modalities. It was pretty fascinating to see what you could do inside of a person's lung with a very, very minor, very minor invasive procedure. And we want to remind our viewers that today's program is not designed to take the place of a visit with your physician. You will still be the same stage. Dr. Hogarth was the first doctor in the Midwest to use the Monarch by Auris a robotic bronchoscopy navigation system with 3-D imaging technology built into a robotic scope that allows him to reach deeper into the lung than ever before to detect and/or biopsy nodules and masses. And you can speak with your physician about that. Our pulmonary and allergy physicians see clinic patients in the Center for Lung Health, located in room 3C in the UI Health Outpatient Care Center (OCC), which is at 1801 W Taylor. Get an online second opinion from one of our experts without having to leave your home. Anchored at Northwestern Memorial Hospital, Canning Thoracic Institute is a regional destination for those who need highly specialized thoracic care. Rush University Medical Center in Chicago, IL is ranked No. His contributions to the field of procedure-related training has been recognized by his peers and professional societies. It's a wonderful, wonderful place. Now, a question. MDA, Interventional Pulmonary Course 2023, 2/23/2023 7:00:00 AM - 2/24/2023 4:45:00 PM, The activity is designed to review the current concepts and recent advances in interventional pulmonology as it pertains to the cancer patient, and to introduce new technologic advances that are poised to revolutionize the diagnosis, staging, and management of lung cancer. And smoking is certainly a problem, a historical problem that we're working to deal with every day. And you want to have something reliable in what to do next. First, do no harm. And I would say the only other thing, as a pulmonologist, is if you smoke, try to stop. It's a wonderful, wonderful place. It's usually about a half day's worth of time. But also don't ignore it, and don't delay it. You want to be calm and cool. And the national standard is roughly five weeks. Because in some cases, our plan for you is to get a follow-up CAT scan, is to do watch and wait. Critical Care Medicine; Pulmonology; Meet the Doctor . But you know, I think that there's so many different possibilities when it comes to management that we're quickly learning how to utilize technology, even in telehealth, to help patients get what they need. You know, and I want to talk a little bit more about biopsies here in just a minute. So follow-up scans could also be low dose as well. And hopefully, go home if nothing happens. And we had a question from a viewer that dovetails perfectly into what I'm kind of curious about. But a doctor may see something on a chest x-ray. I kiss my spouse. It is nationally ranked in 10 adult specialties and rated high performing in 1 adult specialty and . But I'm sure you'll enjoy UChicago Medicine. No, it's a great question. And we are going to be first and foremost interested in protecting you, as well as protecting ourselves and our staff. And because I enjoyed working with people, I followed that up with going into medicine, and it just seemed like a perfect fit. So we want to-- I mean, we want to do this for everybody. Interventional pulmonology is often important in the screening, diagnosis, and treatment of lung cancer. And without a doubt, the possibility of cancer is what scares everybody. I can meet with you virtually. The fact it's a low dose is because you are being screened, there is no other reason we're scanning you. And one that has a very low invasive potential. (Or create a 1/6 column and add a text field, modify the class so We can talk about imaging modalities. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. The hospital is safe, the hospital is clean. Age is usually 55 to 80. [MUSIC PLAYING] My name is Ajay Wagh. Chicago Chest Center - 2015. You can't eat after midnight. All kinds of fantastic information there. Dr. Hogarth is the founder and past president of the Society for Advanced Bronchoscopy. And if you can, just kind of set the stage for us and tell us a little bit about nodules and masses, and what are they and how do people even know that they have such a thing in their lungs. Interesting. So we need to get going and do something about it. You know, it's not just like, yeah, you do this. But generally speaking, a lung cancer-- when someone says to you, hey, we want to get a follow-up CAT scan, the reason they're suggesting that is that the nodule you have is so small or has characteristics that are so convincing that it's benign, that that two or three month interval that they've suggested-- if I'm wrong and it's actually a cancer, the amount that it's going to grow in that time period is so small that we've not lost anything. We look at the airways and other parts of our computer modeling to see if that's something that we can get to. We offer online appointment scheduling for video and in-person appointments for adult and pediatric primary care and many specialties. Nicole Greenlee. There's all kinds of different tests. Yeah, sure. We use that CAT scan, build a three dimensional map of your lungs, and we drive to the spot where that's at. It could be cancer. We are proud to have an interventional pulmonary laboratory with full-time dedicated . And was fortunate enough to start the bronchoscopy program here, and the Nodule program. And so that becomes one procedure, as opposed to multiple procedures. So look, there's three ways to sample inside the lung. Dr. Hogarth kind of briefly said something about the blood tests. 13 in the nation for Pulmonary and Lung Surgery. But one of the other things we were talking about, the patient journey. Because it's a difficult time in people's lives when they have something like this done. But what I can also tell you is it's cancer, here's what stage it is. You were fantastic. The whole key thing, too, is that this is an ongoing dialogue between us and the patient. Instead, you might have a little sore throat for a day or two. By utilizing minimally invasive techniques, interventional pulmonologists can provide accurate diagnoses and effective treatments while minimizing discomfort and improving outcomes for our patients. University of Chicago, Interventional Pulmonology; Board Certifications. And every patient is different. Well, we're very happy to have you. Critical tasks include fellowship recruitment, fellow administrative support, scheduling, and managing faculty and fellow performance . But in reality, if you're a patient, there's only two things. It's so important. No, don't panic. It is covered by insurance. But Dr. Wagh, can you talk to us a little bit about just-- I think as Dr. Hogarth just mentioned, if somebody comes in and sees a physician. No, it will show the nodules. We work collaboratively with pulmonary medicine, critical care, allergy, thoracic surgery, medical oncology, radiation oncology, otorhinolaryngology and transplant specialists to provide you with a seamless care experience. at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, See All Healthcare Professionals Information, Molecular and Genomic Diagnostic Laboratories, Sampling and Evaluating Lung Nodules and Masses: Expert Q&A, Advanced Diagnostic and Therapeutic Bronchoscopy, University of Tennessee College of Medicine. And Dr. Hogarth, I want to start with you. Well, I think that there's several possibilities. Get a Second Opinion. Because it has everything to do with the quality of the machine for the radiation that goes through. UChicago Faculty Physicians And teasing out what's what is what Ajay and I do. We get thousands of survey responses each year. You know, and I was only being partially facetious when I said panic is kind of the natural-- because I think for a lot of people that's just the natural reaction. And either one of you can jump on this one. But Dr. Wagh, can you talk to us a little bit about just-- I think as Dr. Hogarth just mentioned, if somebody comes in and sees a physician. We'll try to get to as many as we can over the next half hour. UK Pulmonary, Critical Care and Sleep Medicine offers the full scope of inpatient and outpatient services involving the diagnostic evaluation and clinical management of respiratory disorders. But to delay any amount of care. And that would be another area, I would imagine. So if we think you're at early stage cancer, that's great. No, it's a great question. It's so important. the Northwestern University Feinberg School of Medicine (Feinberg), Northwestern Memorial HealthCare, Children's Hospital of Chicago Medical Center, and the . Hogarth DK. The collaboration with the Chicago Chest Center, the oldest established full service Interventional Pulmonology program in the state, gives our faculty and trainees expanded access to research and advanced procedures. So there's no cutting. The question is, how quickly do cancerous lung nodules grow compared to other types of cancer? You can't eat after midnight. The Section of Pulmonary and Critical Care Medicine has been a model of exemplary patient care, research, and post-doctoral training for more than 20 years. Why aren't we just following the pathway down? And you two, and your teams, are really good at helping people through that situation. Because it has everything to do with the quality of the machine for the radiation that goes through. Dr. Hogarth was the first physician in Illinois to perform Bronchoscopic Lung Volume Reduction (bLVR) for severe emphysemausing both the Zephyr valve and the Spiration valve. Just to echo what Dr. Wagh said. Interventional Pulmonology Fellowship Program Director. There is strong subspecialty experience in pulmonary hypertension, interventional pulmonology, thoracic oncology, interstitial lung disease, bronchiectasis, and sleep medicine. I recently completed an interventional pulmonary fellowship, which brought me here. So if you have an abnormality, the other thing that sets this place apart is if you call a regular hospital and say, hey, I've got a lung nodule, can I see somebody? Section of Pulmonary/Critical Care It sounds like you're in a busy, busy place. In close collaboration with faculty from oncology, thoracic surgery, otorhinolaryngology, anesthesia and critical care medicine, the interventional pulmonology service is actively involved in the diagnosis, management and research of patients with histologically malignant and benign central airway disorders, pulmonary nodules and pleural disorders. You know, you said at the very beginning, I have a nodule, should I panic? And it also has a lot of great COVID information. Yes, sir. Because it's interesting how you do them in the lung. We're going to give you some strong recommendations. So I mean, we do have a regular process of lung cancer screening. But of course, there's biopsies. Our doctors will actually even join us from the places where they're doing the work. You will get seen within a week every time here. But you come in, we have a pre-procedural area where the patients get kind of their IV. And these procedures all have their own benefits, but also their own complications. . Can an 11 millimeter nodule be biopsied by that bronchoscope method through the throat? Oh, less than 5%, OK, let's slow down a little bit. You know, and I want to talk a little bit more about biopsies here in just a minute. Comments that do not apply, risk patient privacy, or are not appropriate are not posted. A ground glass nodule almost looks like some wispy smoke on the CAT scan, if you will. The University of Michigan as a . Who we treat. We also have literally the world's greatest nurse practitioner, Kimberly. Additionally, Dr. Hogarth is able to offer his patients unparalleled diagnostic accuracy by being the first in the United States to use the LungVision system with the robot to maximize precision. Train with the experts at the University of Wisconsin Interventional Pulmonology fellowship program. protected veterans, and individuals with disabilities. The mission of Duke Interventional Pulmonary Fellowship is to train the leaders in the field by exposure to high volume of complex cases, multi-disciplinary and thoughtful approach, and cutting edge research. And either one of you can jump on this one. Today there are better insights into cancer and other lung diseases. And we are lucky enough to have anesthesiologists who help take care of the patient during the procedure. And then afterwards, once we settle on a date, the patient comes in. And we want to remind our viewers that today's program is not designed to take the place of a visit with your physician. Right? Media. Full-Time. And how urgently must patients act? After initially working as a hospitalist, he pursued a pulmonary and critical care fellowship at OHSU followed by an interventional pulmonary fellowship at the University of Texas MD Anderson Cancer Center. If your insurance company is not listed here, or if you have any other questions, please contact Managed.Care@uchospitals.edu. I'm grateful to participate in Dr. Hogarth and Dr. Perdue's team. Medical school: St. James School of Medicine Anguilla, Park Ridge, IL Residency: University of Illinois College of Medicine, Peoria, IL Professional interests: ARDS, sepsis and infectious lung diseases. He and I, and our other partner, Dr. Mergue, work very hard to make sure that if you need a procedure, it's the right procedure. Go ahead, Ajay. And that's kind of comforting, I think, for most patients. We're fortunate enough here at UChicago Medicine to have a robotic endoscope that lets us get to parts of the lung we've never been able to get to before. And I do also think it's worth mentioning that by doing the bronchoscopy, as opposed to choosing an alternative technique, such as a needle biopsy, we're also able to evaluate the lymph nodes in the chest. We just talked a moment ago, and you're pretty new here. Program accreditation is under the joint auspices of the American Association of Bronchology and Interventional . And thank you to our viewers for your great questions. University of Cincinnati Department of Internal Medicine Division of Pulmonary, Critical Care, and Sleep Medicine 231 Albert Sabin Way, ML 0564 Cincinnati, OH 45267-0564. This is from Therese. In addition to his dedication to his patients, Dr. Hogarth is committed to teaching, receiving the resident teaching award in 2020 and has been named a Distinguished Chest Educator several years in a row. Dr. Wagh, let's hear a little bit about you. Funding for Educational Activities Well, my name is Ajay Wagh. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. Star ratings and comments come from a number of survey questions. Before the appointment, all pertinent medical records from referring physicians should be faxed to (410) 367-3252. Randomly selected patients are sent patient satisfaction surveys after their visits. But of course, there's an 80% chance it's not cancer. Can an 11 millimeter nodule be biopsied by that bronchoscope method through the throat? We don't even have any camera people in here. It's an oath both of us took. Pass instruments out, take little pieces that we-- so you're not going to miss anything, you know, volume wise. And one of the reasons we do this yearly image, because it is so slow growing, if it's not changing year after year, then the probability that it's going to do anything to you becomes so low that we actually leave you alone. What you're never going to hear from us is to say, now there's nothing to do, leave. If your insurance company is not listed here, or if you have any other questions, please contact Managed.Care@uchospitals.edu. UChicago Faculty Physicians And as Dr. Wagh just said, we are able to do video visits and televisits. And we will kind of shepherd the patient along the way. No, it will show the nodules. During the three-year training period, the fellows have exposure to the various disciplines of pulmonary and critical care medicine. And so part of our discussion is, what's the probability that this nodule that you have on your CAT scan-- is it actually cancer or not? And they'll double check everything. Is the evaluation and procedure that we've been talking about, is that covered by insurance as well? If you don't need a procedure-- because there's no chance that this is cancer-- we would like to avoid doing anything invasive on you. The responses are used to improve patient experience and recognize staff members for the care they provide. I'm new here to the University of Chicago, and very thankful to be here. The 30 faculty, clinical associates and research associates along with a staff of more than 72, have devoted themselves to the pursuit of excellence in each of these important activities. So a little bit of a fan club going here, but that's awesome. Thoracic Imaging. Well, gentlemen, we're out of time. I mean, the first thing is first, is we do have lung cancer screening, which we offer patients CAT scans if they're eligible and have a smoking history. Because initially when you're faced with something like that, everything kind of just goes over your head. Or it could be a telemedicine visit. And we will kind of shepherd the patient along the way. Because I know this is a very complex situation. And one that has a very low invasive potential. 617-632-8036. The University of Cincinnati Interventional Pulmonology (IP) Service is one of the 34 fellowship programs recognized by the American Association for Bronchology and Interventional Pulmonology (AABIP). And you know, those patients typically are eligible for low dose lung cancer screening. That's always the question people want to know. It is covered by insurance. And obviously, you know, even with minimally invasive surgery, it's still a surgery. And then at that point, we would bring the patient back to the our laboratory. Because the chance it's cancer is so low, and every invasive procedure always carries a risk. The Interventional Pulmonology Fellowship began in July 1, 2000. Some of the blood tests we have, have the ability to change that number. An Interventional Pulmonology (IP) Advanced Practice Provider works in collaboration with Board Certified Physicians in the Department of Internal Medicine on the Pulmonology Service who specialize in the management of complex airway and pleural diseases. But also cat scanning. He also performs laser-assisted mechanical dilation of airway strictures, airway stenting and bronchoscopic treatments for benign and malignant airway lesions using photodynamic therapy, cryotherapy and electrosurgery techniques. Maybe a 3% chance of cancer is acceptable to some, and terrifying to others, and everywhere in between. Get an online second opinion from one of our experts without having to leave your home. You know, in fact, just to even further hammer home that point. Well, if you have a cancer, the next question is, what stage is it? We're open for business. Sure. Sleep clinic patients are seen here during the day . And using some of the tools that we have. 5 Interventional Pulmonology Program, The University of Chicago Medicine, Chicago, Illinois. 11234 Anderson St, Loma Linda, CA 92354. . Patients will typically have primary or metastatic tumors of the chest, mediastinum or . Karen says, your pulmonary department is the best. So ground glass nodules are a different biology. Yes, sir. We're going to do our work. Interesting. And either one of you can do that. The responses are used to improve patient experience and recognize staff members for the care they provide. It should be a CAT scan if you are eligible. Now, a question. That's right. River East Location . You know, and I was only being partially facetious when I said panic is kind of the natural-- because I think for a lot of people that's just the natural reaction. Yes, sir. Pass instruments out, take little pieces that we-- so you're not going to miss anything, you know, volume wise. I love taking care of people, and I love to see them breathe better and feel better. And you can speak with your physician about that. If you're concerned about cancer and there's an intermediate pre-test probability, based on a calculated evaluation, then we can potentially offer a blood test or something else that may potentially reduce the risk. Within the Department of Medicine, the Division of Pulmonary and Critical Care Medicine provides services at Loyola University Medical Center, Edward Hines, Jr. VA Hospital and RML Specialty Hospital. Now, solid nodules, depending on the size, there are guidelines that suggest the interval of scans. Phone: (773) 702-9660. That is not acceptable to make you wait. There's large databases that have been built off of the experience of radiology to be able to essentially plug-in and give a number. A lung mass can be a frightening discovery. And I think what we want to do is offer a pathway here in our program for patients to get everything they need. Loyola University Medical Center, Chicago IL: 2020: Ikuyo Imayama, MD: University of Illinois at Chicago, Chicago, IL: 2021: Mariam Anis, MBBS Northwestern Lake forest Hospital: 2021: Yu Maw Htwe, MBBS NYU Interventional Pulmonology Fellowship: 2021 Septimiu Murgu, MD, is a highly skilled interventional pulmonologist. Now, the low dose lung cancer screening has its own set of guidelines that helps us to monitor and follow any suspicious nodules. We want to minimize radiation. Can you kind of talk to us a little bit about that, and walk us through that? We have been recognized by U.S. News & World Report as a high-performing hospital in COPD care. Just type them in the comments section. Why aren't we just following the pathway down? And that's very important. So let's start off with our questions. You will get seen within a week every time here. For an appointment in the Interventional Pulmonology Outpatient Clinic at the Holmes Hospital (3 rd floor), please . Mailing Address: Section of Pulmonary/Critical Care 5841 South Maryland Ave., MC 6076 Chicago, IL 60637. So my name is Kyle Hogarth. Referring . Even the show that we're doing right now, you two are remote. For help with MyChart, call us at 1-844-442-4278. We will overbook you. And I think that's the first key step. Sleep Medicine. Yes, so a patient typically comes in basically just for a few hours during the day. Meet the Doctor. So I'm going to have you answer the question, but also kind of explain what she's asking here. And you know, COVID makes it harder for patients to see doctors. And either one of you can do that. Learn more about clinical trials and find a trial that might be right for you. He also specializes in the minimally invasive diagnosis, management, staging and treatment of lung cancerthrough bronchoscopy. Fax: (773) 702-6500, Outpatient Practice: But when it's time to get a follow-up scan, the reason, ultimately, for these ground glasses, why they settle into yearly, is precisely because they're slow growing. Additionally, he authored a best-selling textbook on bronchoscopy as well as written numerous book chapters and clinical guidelines pertinent to the management of patients with lung cancer. Name Rank Section; Abou Baker, Nabil: Assistant Professor General Internal Medicine Addetia, Karima I remember when Dr. Hogarth showed this to me. Is that-- should you be frightened? So I mean, we do have a regular process of lung cancer screening. And so as Dr. Wagh just pointed out, in the same procedure, after we've just proved that is a cancer, we're going to then go sample your lymph nodes. Communicate with your doctor, view test results, schedule appointments and more. So I want to get back to biopsies for just a moment. So that you get an answer as to what this nodule actually is. The Emory Sleep Medicine . In fact, U.S. News & World Report, 2022-2023, named Northwestern Memorial Hospital No. Absolutely, yeah. That's not hard to convince someone. And these procedures all have their own benefits, but also their own complications. So if you have an x-ray or a CAT scan, there is a chance that the word module or mass is going to show up in the report. I'll also point out that our procedures, like Dr. Wagh said, are done under anesthesia. And that would be annually until they kind of exit out after that 15 years. Sure. Follow @uw_APCC. We're still operating. . Because initially when you're faced with something like that, everything kind of just goes over your head. 4 Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina. And you two, and your teams, are really good at helping people through that situation. I mean, I think we are living in a strange time. And I think we like to take things one step at a time. And we kind of-- we have a nice staff who will kind of walk the patient through what they should expect. Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, Request an Appointment at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park. But we're very careful about that. And the individual tumor biology is changing. And that's a very important part for a cancer evaluation. So you're going to get way more bang for your buck literally as a scan by coming here. Go ahead, Ajay. So if the risk of cancer is low, but the risk of a complication is the same, I don't want to harm you, right? Fellowship, 2004, The University of Chicago, Pulmonary and Critical Care But of course, there's biopsies. And Dr. Hogarth, I don't know if you can talk to us a little bit about how do you work with the patients? These are not questions. So if you need an appointment, give us a call at 888-824-0200. But I'm sure you'll enjoy UChicago Medicine. For help with MyChart, call us at 1-844-442-4278. We look at the airways and other parts of our computer modeling to see if that's something that we can get to. What are some of the options to evaluate lung nodules and lung masses? The question is, how quickly do cancerous lung nodules grow compared to other types of cancer? Open for more information. The University of Chicago Medicine 5841 S. Maryland Avenue Chicago, IL 60637 | 773-702-1000 Appointments: 1-888-824-0200. You shared really some good information with our audience. But we can. And we keep spacing that interval of scan out if nothing has changed. And so the lymph nodes are where cancer would spread to first.
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