When Samuel Loftin's blood work showed an unusual level of liver enzymes, a gastroenterologist near his Alabama home recommended an ultrasound of his liver. When that test was negative, the doctor ordered an MRI, which showed two suspicious liver lesions, as well as an abnormality in his spine. Samuel's doctor said it was probably cancer and that spots on his spine meant it might have spread to his vertebrae. Samuel was referred to a nearby cancer center.
"My doctor set up the appointment, but it was three weeks away. I just couldn't wait that long," Samuel says.
He called MD Anderson and got an appointment right away at the Mary Ann Weiser Suspicion of Cancer Clinic. Created in 2001, the clinic is named for a former MD Anderson doctor who wanted to focus on detecting cancer at its earliest stages. Weiser always was looking for a challenge, according to colleagues.
"When patients try to come here without a clear diagnosis, it can be difficult for them to come in the front door," says John Patlan, M.D., in General Internal Medicine. "Dr. Weiser's goal was to make it easier for them."
After Weiser died in 2006, Patlan took over leadership of the clinic. Two years ago, the clinic received additional funding, and now it has a dedicated workspace in the Internal Medicine Center and a second doctor, Michael Perdon, M.D., in General Internal Medicine.
Patlan works in the clinic three days a week, and Perdon takes over on the other two days. Veronica Smith, a nurse practitioner, works full-time, and Maura Polansky, a physician assistant, works in the clinic one morning a week. Together, the team sees 15 to 20 concerned, but hopeful, new patients each week.
Patlan estimates they spend three or four hours with each patient beyond the initial one-hour clinic visit. That includes coordination of multiple diagnostic studies and phone calls to the patient and to other doctors.
Next-day appointments for Houston patients
Often, patients who live in the Houston area are surprised they can get an appointment at the Suspicion of Cancer Clinic the day after they call. When they arrive for their first appointment, Smith, the nurse practitioner is usually the first provider they see, and they share their fears with her.
"Dealing with the unknown causes them so much anxiety," Smith says. "Some patients say they feel better even if they find out they do have cancer."
About 70% to 75% of the Suspicion of Cancer Clinic's patients discover they do indeed have cancer.
For those patients, the doctors complete the staging of their disease and refer them to surgeons or oncologists.
"We're the first faces that they see here," Patlan says. "And we try to make this as positive and supportive an experience as we can."
Sometimes, the care team gets to deliver good news.
That was the case with Samuel. The last test he was scheduled to have was a biopsy on his back. But on the day of his appointment, he received a call telling him to come back to the clinic and talk to the doctor first.
That's when he got the news that he had only benign areas in his liver, and an old vertebral fracture. There was no cancer in the vertebra or the liver. Samuel was both surprised and grateful to get such good news.