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Members of the Upstate Thoracic Oncology Program celebrate its 20th anniversary.

Upstate team treating lung cancer with effective, multidisciplinary approach turns 20

The Thoracic Oncology Program at Upstate University Hospital turns 20 years old this month – and can celebrate a unique multidisciplinary approach that has helped thousands of patients live longer, better lives.

The team care approach allows multiple Upstate specialists to collaborate on a streamlined plan of care for the patient. The team includes medical, surgical and radiation oncologists, pathologists, imaging specialists, pulmonary specialists, specialized nurse practitioners, nutritionists, social workers and patient navigators. Collaboration saves the patient precious time when many decisions have to be made about treatment plans.

A multidisciplinary approach, which has been adopted by several other departments at Upstate, has been shown to significantly improve patient survival rates.

When Maxine Thompson, 67, was diagnosed with stage 3 lung cancer nearly five years ago, the news was “devastating.”

Thompson had a 40-year career at Upstate, most recently as chief diversity officer. One day at work she saw a poster about lung cancer screening and decided it was something she should do considering her past history as a smoker. (She smoked for two decades and gave up the habit 20 years ago.) But some respiratory issues at the time delayed the screening, life got busy and she put it off for about six months.

In May 2015, Thompson’s doctors diagnosed her with stage 3A lung cancer, despite having no symptoms. She and her husband canceled a birthday trip to Saint Maarten and settled in to plan her treatment. The TOP multidisciplinary team at Upstate was key in helping her family make critical decisions about her care.

“It was very comforting to have the people with the expertise putting their heads together to decide my care,” Thompson said. “I wasn’t just relying on one person’s expertise; I was relying on the whole team.”

Thompson and the TOP team agreed on an aggressive course of chemotherapy and radiation, as well as a clinical trial testing the addition of a new anti-cancer drug to standard chemotherapy and radiotherapy. Her treatment was completed over four months. When Thompson left Upstate a few years later – cancer free and healthy – she said she had a new perspective on the world.

“At my retirement party, I gave a shout-out to my treatment team for saving my life,” Thompson said. “I tell everyone that I’m living my best life right now. I appreciate life more now than I did before.”

Every Wednesday afternoon, a third-floor conference room at the Upstate Cancer Center is standing room only – packed with the area’s brightest minds treating lung cancer today. The team gathers to discuss lung cancer patients being treated at Upstate. They look at imaging and share details about the patient’s medical history, diagnosis and current health. They share ideas on what they see in the images, what course of action might be possible or best and come to a joint conclusion on what happens next for the patient. For some patients, surgery or chemotherapy is imminent; for others, doctors will follow up in a few weeks or a few months.

Those same conversations have been happening for 20 years, thanks to Leslie Kohman, MD, FACS, director of outreach for the Upstate Cancer Center and one of the founders of the thoracic oncology program’s multidisciplinary approach.

“The program looks and works pretty much the same as it did from the beginning,” Kohman said recently after presenting a celebratory 20th anniversary cake to the team. “The treatment of the patients and their evaluation and workup has changed enormously. But we’re having the same conversations with the same attention to the patients.”

Kohman describes the multidisciplinary approach as “amazing for patients and intellectually stimulating for doctors,” which has contributed to it being adopted by other Upstate programs that treat cancer in the breast, liver, gallbladder, pancreas, head and neck.

“This model produces better outcomes and longer survival rates for lung cancer patients,” she said. “Over the last 20 years, the one-, two- and five-year survival rates have improved several percentage points. That is a significant improvement.”

For Kohman, the program has been a highlight of her career.

“What makes me most happy is I’m not there every Wednesday anymore and it carries on just exactly the same with some of the same people – Dr. (Stephen) Graziano, Dr. (Jeffrey) Bogart and Dr. (Ernest) Scalzetti – who were there with me from the start,” she said. “There are newer people there who are getting mentored by senior people who think in a multidisciplinary fashion, which is the very best thing.”

Caption: Members of the Upstate Thoracic Oncology Program gather at the Cancer Center to celebrate 20 years of the program. From left to right are: Ritu Modi, MD, pulmonary critical care fellow; Leslie Kohman, MD, professor of surgery, founder of TOP; Carlos Martinez-Balzano, MD, assistant professor of medicine; Ernest Scalzetti, MD, professor of radiology, chief of chest imaging; Michael Archer, DO, assistant professor of surgery; Jason Wallen MD, MBA, FACS, FCCP, associate professor of surgery, division chief of thoracic surgery, director of TOP; Mark Crye, MD, assistant professor of surgery.