Getting answers for patients with a suspicion of cancer
Like clockwork, Katherine Moreno gets a cold every year. It always leads to bronchitis, then asthma.
“I don’t go anywhere without a box of Kleenex and an inhaler,” says Katherine, 62, a first-grade teacher who has suffered from allergies since childhood.
For years, she rode out the symptoms and recovered. But after a particularly bad episode four years ago, Katherine’s primary care doctor ordered a CT scan of her lungs. He was checking for pneumonia, but the scan showed something else. A suspicious nodule, slightly smaller than a pea, appeared on her left lung.
“That scared me,” Katherine says. “My doctor said it could be some sort of benign growth, but it could also be cancer.”
The doctor referred Katherine to a pulmonologist, who ordered a CT scan with contrast dye to provide a more detailed view of the troubling spot. This time, the image revealed a second, smaller nodule near her heart.
That’s when Katherine’s son, a pediatrician at a nearby children’s hospital, stepped in.
“He knew about MD Anderson’s reputation as the best place in the country for cancer care,” Katherine says. “He told me, ‘Mom, that’s where you need to be. They’ll take good care of you.’”
A commitment to helping patients get a definitive cancer diagnosis
Within days, Katherine arrived at MD Anderson’s Mary Ann Weiser Suspicion of Cancer Clinic, named for a dedicated MD Anderson doctor who died of colon cancer in 2006.
Carmen Escalante, M.D., recalls that patients had shared with Weiser how difficult it was to make an appointment at MD Anderson without a definitive cancer diagnosis.
“As a doctor who had cancer herself, that really bothered her,” Escalante recalls.
Weiser worked with MD Anderson’s leaders to launch the Suspicion of Cancer Clinic, which is now her legacy. The clinic sees patients who’ve received abnormal test results that may signal cancer.
“Our goal is to catch it early, if it is cancer,” explains Gloria Diana Iliescu, M.D., who heads the clinic. “The earlier we catch it, the more successful treatment will be.”
Easing fears by providing answers quickly when a cancer diagnosis is suspected
Located in the Internal Medicine Center, the clinic is only one of a few of its kind in the nation. It’s staffed by Iliescu, Escalante and Edwin Ostrin, M.D., Ph.D.
Together, the team cares for 20 to 30 patients each week.
Nurse practitioner Latira Chenevert is usually the first provider new patients see when they arrive for an appointment. They share their fears with her.
“They’re worried and scared,” Chenevert says. “Not knowing whether they have cancer causes them so much anxiety.”
Medical staff spend a full hour with each new patient, listening to their concerns and explaining next steps.
“We assure them that our goal is to give them answers as quickly as we can,” says Ostrin. “We don’t want to leave them in limbo.”
Katherine remembers being very nervous before her first appointment. But Ostrin, her doctor that day, calmed her fears.
“He explained that we’d continue to watch my nodules,” she recalls. “If they grew, well, we’d just deal with it."
Ostrin spelled out, step by step, how Katherine would be monitored and, if needed, treated.
“For the first time, I felt like I had a plan and was back in control of my life,” Katherine recalls.
Putting a plan in place if cancer treatment is needed
About 50% to 60% of patients who visit the Suspicion of Cancer Clinic discover they do, indeed, have cancer. When that happens, the clinic’s doctors stage their disease and refer them to surgeons or oncologists at MD Anderson.
Simply getting closure is a relief for most patients.
“People can handle adversity better than uncertainty,” Ostrin says. “We give them a diagnosis and a plan. They cope much better when they know what they have and what to expect.”
Clinic staff are available to patients throughout their entire diagnosis and treatment process.
“We tell them to come back and see us and let us know how they’re doing,” Chenevert says. “We were their first point of contact, so we’re kind of an anchor for them.”