Tag Archive for: advanced non-small lung cancer

Dr. Michael Kelley: Why Is It Important for You to Empower Patients?

/in , /by

Dr. Michael Kelley: Why Is It Important for You to Empower Patients? from Patient Empowerment Network on Vimeo.

Why is it important to empower patients? Expert Dr. Michael Kelley from Duke University School of Medicine discusses key concepts and communication methods that he utilizes with his patients to collaborate with them in their cancer care.

See More from Empowering Providers to Empower Patients (EPEP)

Related Resources:

Dr. Christina Baik

 Dr. Krina Patel: Why Is It Important for You to Empower Patients?

Dr. Krina Patel: Why Is It Important for You to Empower Patients? 

 Dr. Eugene Manley: Why Is It Important for You to Empower Patients?

Dr. Eugene Manley: Why Is It Important for You to Empower Patients? 

Transcript:

Dr. Michael Kelley:

The key concepts that I try to work on in order to empower my patients is, one is to let them know that we’re a team, that I work for them, and that the information that I have, I want to make sure that they have. And any information that they have, like what symptoms they’re experiencing, or any tests that were done that I didn’t order, that all that information gets put together and we discuss that together as a team and make a plan to go forward so that there is access to all the information and there’s complete transparency and open lines of communication.

So that to me is the core of empowerment, is that, there is a conjoined team-like effort which is being exerted to the benefit of the patient and what the patient’s goals are. And the characteristics of that relationship are, as I said, are communication and information and mutual respect for each other so that when you work together you’re going to get a much better result than if you’re working separately.

Can Veterans in Rural Areas Facing Lung Cancer Access Experts Via Telemedicine?

/in , , , , , , , , , , , , , /by

Can Veterans in Rural Areas Facing Lung Cancer Access Experts Via Telemedicine? from Patient Empowerment Network on Vimeo.

Are there telemedicine options for veterans living in rural areas? Expert Dr. Michael Kelley from Duke University School of Medicine discusses the rural residence rate of veterans, consultation services, and second opinions.

[ACT]IVATION TIP

“And you can actually get a second opinion where you have a video visit with the expert as well. So these things are all available. So patients can ask for these for a second opinion. And there’s somebody else in the VA who would be an expert that we would connect the patient with.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

 Breaking Barriers: Enhancing Veteran Support in Lung Cancer Care

Breaking Barriers: Enhancing Veteran Support in Lung Cancer Care

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Transcript:

Lisa Hatfield:

I live in a more rural area of the country, if you have a patient who lives in a more rural area or maybe goes to a smaller VA facility for healthcare and they’re diagnosed with non-small cell lung cancer, can they access maybe through telemedicine visits, somebody who is more specialized in that type of cancer within the VA system, or how is that handled for veterans?

Dr. Michael Kelley:

Yes. So about a third of enrolled veterans live in rural areas. So this is very common for us. That’s 33 percent and the nation is about 14 percent. So it’s about two-and-a-half times likely that a veteran will be in a rural area. So VA has very mature advanced telehealth capabilities. We have tele ICU. We have tele emergency room services. And we have teleoncology. So there’s a national teleoncology service. It basically provides an expert in your cancer type at your VA. And this is mostly serving rural veterans.

I think the last number I saw was 44 percent of the veterans that are served by the national teleoncology service are in rural areas. So I practice in South Dakota and Arkansas, and I live in North Carolina. And I do only lung cancer. So this is a service that I think my colleagues also participate in around the country. And we’re able to get the expertise to the patient rather than the patient coming to the expertise.

Lisa Hatfield::

That’s very helpful for patients. I know I have a different type of cancer, a blood cancer, but being able to access at least the expertise of a specialist makes a big difference in my care. And, of course, my local oncologists are great, but they’re willing to work with my specialists. So I appreciate that the VA has such a brilliant advanced system for that. That’s a really impressive statistic that many patients, veterans use that telehealth option.

Dr. Michael Kelley:

Yeah, so in addition to the direct care, we also provide consultation services. So you mentioned that your local provider is willing to work with an expert. So we do that as well. So we can have what are called e-consults, electronic consults, where the local oncologist who might be a generalist is able to ask a question to an expert.

And because we are such a large system, we have an expert in everything. And I literally mean everything. So we have an expert lined up to be able to respond to every question and from any disease that is in the realm of oncology or hematology.

Lisa Hatfield:

Okay. And will that typically happen during a visit, or is it up to the patient to request that e-consult if they would like one?

Dr. Michael Kelley:

So it’s typically up to the provider, if they think they need a second opinion or they need help interpreting this, interpreting an opinion. But the patient can always ask as, you know, that you can ask their provider, talk to their provider, which I understand from a patient’s perspective can be sort of a sensitive issue is, “Hey, I don’t trust you. You’re my doctor, but I don’t trust you. Can you ask someone else for an opinion?” But you can do it in a way which is very respectful, obviously, and it’s totally okay with us, that, I’m always happy to ask a colleague to look at a case if a patient asks.

And you can actually get a second opinion where you have a video visit with the expert as well. So these things are all available. So patients can ask for these for a second opinion. And there’s somebody else in the VA who would be an expert that we would connect the patient with.

Lisa Hatfield:

Thank you for reassuring patients that it’s okay to do that. I know sometimes we’re afraid of offending our providers, but as you said, it’s okay to politely say, “This is very scary for me. I would like to know if there’s any way to do an e-consult with another physician.  So yeah, thank you for reassuring patients that that’s okay to do that.

Dr. Michael Kelley:

Yeah. There should be nothing that any patient ever asks or brings up with us that is offensive to us. Your concern is our concern. So don’t be afraid to ask for it. My biggest concern is that you won’t let me know when you have a concern.

Share Your Feedback

Create your own user feedback survey

Breaking Barriers: Enhancing Veteran Support in Lung Cancer Care

/in , , , , , , , , , , , , , /by

Breaking Barriers: Enhancing Veteran Support in Lung Cancer Care from Patient Empowerment Network on Vimeo.

Are there VA services to help veterans with the financial and mental stress of lung cancer? Expert Dr. Michael Kelley from Duke University School of Medicine discusses transportation and financial barriers to care, Community Outpatient Based Clinics, and support services for mental stress and anxiety.

[ACT]IVATION TIP

“…if you have a concern or a barrier, please talk to your care team. There are many resources that VA has that will try to address any challenge that you’re facing.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

 Can Veterans in Rural Areas Facing Lung Cancer Access Experts Via Telemedicine?

Can Veterans in Rural Areas Facing Lung Cancer Access Experts Via Telemedicine?

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Transcript:

Lisa Hatfield:

Given that transportation and financial coverage for travel are major barriers to lung cancer care for veterans, what strategies or interventions do you believe could be implemented to alleviate these challenges and reduce associated anxiety and stress for veterans?  And maybe a better way to ask that question is, are there any resources within the VA system to help veterans deal not only with the financial impact, but also with the emotional impact of a lung cancer diagnosis?

Dr. Michael Kelley: 

Yes, so there are certainly some resources. So some veterans are eligible for travel pay based on their distance and some other factors that I’m not an expert in, so I won’t try to enunciate those. But there can be other resources. Sometimes the American Cancer Society will have travel funds. There is a volunteer service at most VA hospitals, and sometimes they have funds. The way to access all those different options is generally through a patient navigator that might be a social worker at a particular VA hospital. Talk to your provider or the provider’s team about any barriers that you’re experiencing around transportation or other barriers, but transportation, and they can redirect you to the appropriate person on the team who would be able to discuss that with the veteran.

There is another approach that VA is taking for transportation is that the…that question implies that the veteran has to travel to the care and what VA is doing is bringing the care to the veteran. So right now we deliver most of our cancer care at medical centers and we are in the process of pushing that care into our clinics called CBOCs, Community Outpatient Based Clinics. So these services will make it much easier for more veterans to access closer to where they live which would reduce that transportation barrier.

So that’s one thing. And then you also asked about other types of barriers like anxiety or stress. Many of our practices now have embedded mental health. So that’s one resource which may be available for you. So again, talk to your provider team if you have stress or anxiety and you’d like to talk to someone about that. It should not be a stigma to have a discussion with someone about any of the thoughts that you’re having or reactions to the diagnosis. There are big decisions that have to be made.

It’s understandable that you might want to talk to someone, and so we do provide that service and these are professional mental health people, but there’s also a palliative care team at every medical center. The palliative care team is really good about going through and spending a lot of time talking with you about decisions that you would want to make in the situation about care decisions about how you might want to weigh those decisions. That can also be a resource for veterans. So my activation tip in this area is, if you have a concern or a barrier, please talk to your care team. There are many resources that VA has that will try to address any challenge that you’re facing.

Share Your Feedback

Create your own user feedback survey

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

/in , , , , , , , , , , , , , /by

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans from Patient Empowerment Network on Vimeo.

How can veterans with lung cancer access support services for clinical trials? Expert Dr. Michael Kelley from Duke University School of Medicine discusses clinical trials at VA locations, support services to help access clinical trials, and proactive patient advice for transportation costs to clinical trials. 

[ACT]IVATION TIP

“So sometimes the clinical trial will pay for transportation costs. Sometimes the clinical study will pay, and sometimes no one will pay. So you do have to ask whether that is provided, and if not, are there other resources that could be used to help pay for any transportation that would be needed?”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

 Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

 Are There Lung Cancer Clinical Trials Studying Veterans?

Are There Lung Cancer Clinical Trials Studying Veterans?

Transcript:

Lisa Hatfield:

So if a patient finds a clinical trial that’s outside of the VA, will the VA help coordinate that being a part of that clinical trial if it’s outside of the VA? And the other question I would have about that, are clinical trials done at all of the VA facilities or if a person sees one that’s done, maybe they go to a smaller facility, they have to go somewhere else, can they go to that larger facility for the clinical trial?

Dr. Michael Kelley:

Yeah, great questions. So several different answers to that. So there are…some VAs do clinical trials and some don’t. And any clinical trial is not open at every VA. So if it’s open at some VAs, it may not be open at other VAs. So if the veteran finds a clinical trial at another VA and they’re willing to travel to that other location, there are generally no barriers to doing that and to enrolling in that clinical trial at the other VA.

But let me start with the first part of your question is, well, how do I find a clinical trial? So this is, I think, a barrier that we’ve all realized, and we’ve set up a service that is called the Clinical Trial Navigation Service. So a provider can ask this service to talk with the veteran and to help find a clinical trial that might be appropriate for them and then to report that back to the provider. So they can talk about what geographic area would be appropriate for the veteran and then other characteristics of the veteran and their medical care that would help inform if there’s a clinical trial available.

In the VA or outside the VA, we’ve initially partnered a lot with the National Cancer Institute at the NIH Clinical Center in Bethesda, Maryland where they will actually provide transportation for people to enroll in clinical trials at that center.

So that’s one of the areas we’ve been working with and then a few other organizations or systems. So that is one thing is you have to find the clinical trial. And the other part of your question was, you know, will VA help the patient get there? Okay. So sometimes the clinical trial will pay for transportation costs. Sometimes the clinical study will pay, and sometimes no one will pay. So you do have to ask whether that is provided, and if not, are there other resources that could be used to help pay for any transportation that would be needed.

Share Your Feedback

Create your own user feedback survey

Are There Lung Cancer Clinical Trials Studying Veterans?

/in , , , , , , , , , , , , , /by

Are There Lung Cancer Clinical Trials Studying Veterans? from Patient Empowerment Network on Vimeo.

Are veterans with lung cancer under study in clinical trials? Expert Dr. Michael Kelley from Duke University School of Medicine discusses benefits of clinical trials, an early stage non-small cell lung cancer clinical trial, and proactive patient advice about clinical trial access.

[ACT]IVATION TIP

“…if you have a diagnosis of cancer you’re facing and you’re getting your care from the VA, please ask your provider if there’s a clinical trial that might be appropriate for you. That might be at the VA, or that might be somewhere else and both of those would be appropriate to consider to understand what the advantages and disadvantages would be for you, including being able to improve the knowledge that would help future people who also face the same diagnosis.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

 Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Transcript:

Lisa Hatifeld:

Dr. Kelley, can you speak to ongoing clinical trials and research specifically for veterans, or are there any clinical trials or research studies that are available that focus on lung cancer treatments specifically tailored to veterans?

Dr. Michael Kelley:

Yes. So we’re very interested in ensuring that veterans have access to all components of clinical care. And for many individuals who have a diagnosis of cancer and enrollment in a clinical trial is considered appropriate and part of standard clinical care to consider. So there are some studies which are designed by VA for veterans. There’s one ongoing now that is comparing surgery with radiation for early stage non-small cell lung cancer. That study is going to, I think, inform the entire country and maybe the entire world about what the differences are in terms of the outcomes and tolerability of those two treatments.

They’ve both been around quite some time now, and they’re used extensively throughout the world, but they’ve never been compared directly. So the veteran population is helping to answer a very important question, and it is designed specifically for veterans. The population of veterans who have cancer, in particular lung cancer, who are enrolled in VA, tend to have more other diseases in addition to the lung cancer, so more diabetes, hypertension, heart disease.

And when initial drugs or other treatments get approved, they’re oftentimes used in a very select population that don’t have any other diseases. They’re healthy people with cancer, and that means that we don’t know necessarily whether it’s safe or effective to use those treatments in people that have what are called comorbidities or other diseases.

And so veterans can oftentimes not have their treatment informed by the medical studies that have been completed to an exacting degree. So what we’ve done is to design some studies that are specifically for veterans to expand on that knowledge and make sure that we understand what is safe and effective in veterans. So my activation tip is that, if you have a diagnosis of cancer that you’re facing and you’re getting your care from the VA, please ask your provider if there’s a clinical trial that might be appropriate for you.

That might be at the VA, or that might be somewhere else and both of those would be appropriate to consider to understand what the advantages and disadvantages would be for you, including being able to improve the knowledge that would help future people who also face the same diagnosis.

Share Your Feedback

Create your own user feedback survey

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

/in , , , , , , , , , , , , , /by

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer? from Patient Empowerment Network on Vimeo.

Do Black and Latinx veterans face lung cancer disparities? Expert Dr. Michael Kelley from Duke University School of Medicine discusses past and current health outcome disparities and comparisons of molecular genetic alterations between Black and white veterans.

[ACT]IVATION TIP

“…if you are experiencing a challenge in working with the VA healthcare system, regardless of what community you are in, please communicate that to someone at the VA. That could be your provider, that could be the patient advocate. Every VA hospital has a patient advocate or that could be someone else at the medical center. We want to know how we can help you in what problems you’re experiencing.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

 Are There Lung Cancer Clinical Trials Studying Veterans?

Are There Lung Cancer Clinical Trials Studying Veterans?

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Transcript:

Lisa Hatfield:

Dr. Kelley, what specific challenges do veterans from the Black and Latinx communities face when trying to access lung cancer healthcare services?

Dr. Michael Kelley:

So in VA, there are several different ethnic and racial populations, and we’ve looked at the outcomes of Black and white veterans. Latinx veteran population is still relatively small, so we don’t have good statistical power to be able to draw strong conclusions there. But the comparison between Black and white is very clear in VA in lung cancer in terms of the outcomes.

And the result is, is that Black veterans do just as well, or better than white veterans at every stage of lung cancer. That is quite different than it is in the rest of the country. So that is one area that I think VA as an integrated healthcare system with wraparound services is able to brag about that we are able to provide all the care that is necessary to derive that outcome.

That wasn’t always the case. In the early 2000s, there was a difference in surgery rates for Black veterans with early stage lung cancer. And we were studying this, and what we saw was that, that difference went away about 2009 or 2010, and it hasn’t come back since we last looked at it. We don’t know what caused it, and we don’t know why it went away, but we’re glad to see it did go away. There are a long list of other possible challenges that veterans in Black or Latinx communities might face. These may be overlapping with those that everyone faces, but VA probably has a service to help with it.

And so my activation tip for you is, is that if you are experiencing a challenge in working with the VA healthcare system, regardless of what community you are in, please communicate that to someone at the VA. That could be your provider, that could be the patient advocate. Every VA hospital has a patient advocate or that could be someone else at the medical center. We want to know how we can help you in what problems you’re experiencing.

Lisa Hatfield:

Are there any differences in the characteristics of the cancer for these populations for the Black and Latinx communities that you have seen?

Dr. Michael Kelley:

We have looked at a lot of comparisons between Black and white groups of veterans, not so much around Latinx because of the smaller numbers. There are not a lot of differences in terms of molecular genetic alterations. And so there are some differences in the geography. So the Black African Americans veterans tend to live more in the Southeast, where actually there’s the largest collection of military veterans who are enrolled in VA care anyways.

But in terms of the outcomes, we don’t really see any outcomes. There are some other differences in medical care that are appropriate, such as a variation of normal in terms of the white blood cell count that happens in some individuals predominantly in of African descent. And those individuals might be at risk for having their chemotherapy doses reduced, because their white count goes down more than other individuals. But in general, we don’t see a lot of differences between those populations medically.

Share Your Feedback

Create your own user feedback survey

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

/in , , , , , , , , , , , , , /by

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer from Patient Empowerment Network on Vimeo.

Do veterans with lung cancer face barriers to precision medicine and targeted therapies? Expert Dr. Michael Kelley from Duke University School of Medicine discusses past and current access to precision medicine, the National Precision Oncology Program, and proactive patient advice to ensure you receive essential testing and optimal care.

[ACT]IVATION TIP

“…if you have advanced lung cancer, ask your provider, what testing has been done on my tumor, what are the results, and what does that mean for my treatment?”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

 Are There Lung Cancer Clinical Trials Studying Veterans?

Are There Lung Cancer Clinical Trials Studying Veterans?

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Transcript:

Lisa Hatfield:

Dr. Kelley, what specific challenges do veterans face in accessing precision medicine? And how can these challenges be mitigated to ensure equitable access to advanced treatments?

Dr. Michael Kelley:

So before 2016, the first cancer moonshot, there were major challenges in, not only in the VA, but across the country to access to precision medicine in the oncology field. We launched in that year, and if really now provide access to cutting-edge precision oncology technology, which is a lot of molecular testing and the expertise to be able to interpret the results of that test to apply it to individual patients. So I think we have advanced to the point where this should not be a barrier anywhere in the VA system, but I would say that only about half of veterans are enrolled for VA care.

And outside of VA there still are areas that have a variety of different barriers to getting the testing done on the tumor samples in a way which informs the treatment decision-making for patients. So this is very important. My activation tip for this is to be sure to ask your provider whether your tumor has been tested for molecular tests, and if so, what the results of those tests are, and how that impacts the treatment of your cancer.

Lisa Hatfield:

Dr. Kelley, can you speak to your research around barriers to prescribing targeted therapies for patients with non-small cell lung cancer with highly actionable gene variants, and what should patients and their care partners be aware of related to these barriers?

Dr. Michael Kelley:

So one of the key pieces of information that your providers need to know in order to, how to treat your advanced stage lung cancer is what are the molecular alterations in your tumor, and what types of proteins are expressed on the surface of the proteins that allows them to make good choices around immune therapy and another group of therapies called targeted therapies, and that can make major differences in your care and your outcome.

So when we first started using this type of testing, in particular the genetic testing of tumor samples, there was a lot of complexity in the results that was not well understood by the oncology providers, because it was new and very complex. So VA has instituted a program to provide that testing and the expert consultation service to be able to interpret those results.

And so when we set up that program, which is called the National Precision Oncology Program, we did a study, looking to see how many patients who should have gotten a targeted drug actually got that drug. And the results were similar to what has been reported in other healthcare systems. And that is, is that less than every patient was getting the targeted therapy, and it was about somewhere around a third of patients who did not get the therapy that would’ve been indicated by that test result.

So we wanted to know what the reasons were, and I think we’ve addressed a lot of the reasons that we came upon. A lot of it is education and making sure that the information from those tests gets to the provider and gets to the patient, and that comes with an understanding of what those test results mean. So my activation tip is, if you have advanced lung cancer, ask your provider, what testing has been done on my tumor, what are the results, and what does that mean for my treatment?

Share Your Feedback

Create your own user feedback survey

What Impact Does the VA Have on Lung Cancer Care Coordination?

/in , , , , , , , , , , , , , /by

What Impact Does the VA Have on Lung Cancer Care Coordination? from Patient Empowerment Network on Vimeo.

How does the Veterans Health Administration impact lung cancer care coordination? Expert Dr. Michael Kelley from Duke University School of Medicine explains the different ways that veterans may receive lung cancer care and proactive patient advice to ensure all healthcare team members receive vital information.

[ACT]IVATION TIP

“…make sure that your providers are aware that you’ve had a test and that you see the results of that test, so that that way, you know that the test was done, and somebody has a report, and that way it’s more likely that that is going to be in front of your providers.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

 Do Veterans Face Health Disparities in Lung Cancer Care?

Do Veterans Face Health Disparities in Lung Cancer Care?

 What Should Veterans Know About Lung Cancer Screening and Risk?

What Should Veterans Know About Lung Cancer Screening and Risk?

Transcript:

Lisa Hatfield:

Dr. Kelley, how does the coordination of care within the Veterans Health Administration impact the treatment outcomes for veterans with lung cancer? And are there any barriers patients’ families should be aware of?

Dr. Michael Kelley:

So many types of lung cancers need to be treated in a way which involves different members of the healthcare team, and that care needs to be coordinated especially when part of the care is being received in different health systems. So part of it may be in the VA and part of it outside the VA, or if the patient’s not receiving any care within the VA, then there may be multiple different medical institutions which are contributing to the patient’s care, and that care needs to be coordinated and communicated. 

So when you have a test in one location, those results need to get to everyone else who’s involved in that patient’s care. So very important. We don’t make good medical decisions if we don’t have the best information about the patient, all the tests that were done. So my activation tip is, is to make sure that your providers are aware that you’ve had a test and that you see the results of that test, so that that way, you know that the test was done, and somebody has a report, and that way it’s more likely that that is going to be in front of your providers.

Share Your Feedback

Create your own user feedback survey

What Should Veterans Know About Lung Cancer Screening and Risk?

/in , , , , , , , , , , , , , /by

What Should Veterans Know About Lung Cancer Screening and Risk? from Patient Empowerment Network on Vimeo.

What lung cancer screening advice and lung cancer risks should veterans know about? Expert Dr. Michael Kelley from Duke University School of Medicine discusses two factors that drive lung cancer risk in veterans, studies about military exposures, and proactive patient advice for lung cancer screening.

[ACT]IVATION TIP

“…if you are eligible for lung cancer screening, then that should be available from VA. And if you have smoked ever in your lifetime, please talk to your primary care provider to ask if lung cancer screening is right for you.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

 Do Veterans Face Health Disparities in Lung Cancer Care?

Do Veterans Face Health Disparities in Lung Cancer Care?

 What Impact Does the VA Have on Lung Cancer Care Coordination?

What Impact Does the VA Have on Lung Cancer Care Coordination?

Transcript:

Lisa Hatfield:

Is there a standard for screening veterans for lung cancer who may have had exposures that create a greater opportunity for lung cancer? Is there a scan that may be done for them, or can they request that?

Dr. Michael Kelley:

Yeah, that’s a great question. So the criteria that are used in the VA for lung cancer screening are the same as they are in the rest of the country. And that’s because the risk of developing lung cancer from all the different possible risk factors is really driven by smoking. Smoking and age are the two factors that really drive the risk of lung cancer. There are some other proposals that are out there to use like lung function and maybe some other characteristics of the patient that we don’t really do right now, but there are some studies that are ongoing.

In terms of military exposures, we can’t really quantify them at this point for lung cancer exposure, so we don’t really integrate that into the medical recommendations around lung cancer screening. But lung cancer screening let me just go to my activation tip is,is that if you are eligible for lung cancer screening, then that should be available from VA. And if you have smoked ever in your lifetime, please talk to your primary care provider to ask if lung cancer screening is right for you.

Lisa Hatfield:

Okay, thank you. That’s really helpful. Dr. Kelley, there is a stigma around military personnel being at higher risk for lung cancer than civilians. Is there an elevated risk for those in the military? And if so, why is that?

Dr. Michael Kelley:

There have been some reports in the medical literature of a higher risk, but those studies were small and initially didn’t control for some important risk factors, in particular, smoking. So smoking is the greatest risk factor for lung cancer. And if you’ve ever smoked, then you should be considered for lung cancer screening, but the military personnel have a higher rate of having smoked sometime in their life. Luckily, there’ve been a lot of people who’ve quit, and that has resulted in the current smoking rate of being about the same as the general population.

But the fact that they have smoked in the past, military veterans have smoked in the past does increase the risk. Military exposures, we don’t really take into consideration right now in terms of lung cancer screening or treatment, but if you do have a particular exposure that you’re concerned about, then please talk to your primary care doctor, and we can discuss with you whether there’s a screening test that might be appropriate. But generally, we don’t do that.

Share Your Feedback

Create your own user feedback survey

Do Veterans Face Health Disparities in Lung Cancer Care?

/in , , , , , , , , , , , , , /by

Do Veterans Face Health Disparities in Lung Cancer Care? from Patient Empowerment Network on Vimeo.

Are there any lung cancer disparities that veterans face? Expert Dr. Michael Kelley from Duke University School of Medicine discusses smoking rates of veterans, the quality of VA care versus the general population, potential environmental exposures during military service, and proactive advice for optimal lung cancer care.

[ACT]IVATION TIP

“… if you have cancer, then you should be taken care of in a way which addresses your needs regardless of what the availability is within the VA system. VA sometimes cannot take care of all patients with cancer, and in that case, VA will purchase a service in the community.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

 What Should Veterans Know About Lung Cancer Screening and Risk?

What Should Veterans Know About Lung Cancer Screening and Risk?

 What Impact Does the VA Have on Lung Cancer Care Coordination?

What Impact Does the VA Have on Lung Cancer Care Coordination?

Transcript:

Lisa Hatfied:

Dr. Kelley, can you discuss any disparities or differences in health outcomes among veterans compared to the general population when it comes to access to treatment? And are there systemic issues within the healthcare system that disproportionately affect veterans?

Dr. Michael Kelley:

So there are some differences between what types of cancers that veterans get and the general population, but there is not a bright line difference between those two groups. They’re really gradations, and if you have the same type of cancer and you’re in the VA versus outside the VA, the treatment approaches and prognosis should be the same.

And that’s actually what we see when you look at systematic studies of the quality of care of inside the VA compared to the rest of the country. The VA care, it looks the same or better almost routinely, and that is, I think, due to the uniform availability of services that are not only the medical care, but some wraparound services that are available to veterans.

There are some differences that we want to talk about. One is related to smoking. So military veterans have a higher rate of previous smoking. The current smoking rate is about the same as the general population, so it’s more likely that they will get smoking-related malignancies, and, of course, lung cancer is one of those cancers.

Military veterans also have exposures during their service to a lot of other physical, chemical, and other types of exposures, which can increase their risk of a variety of different types of cancers. And those can also show up in different subpopulations within the services depending on where they served. But many studies that explored some types of associations that were thought to be existent turned out not to show a difference.

So, for example, breast cancer and active duty military women is actually lower than it is in the general population. So there are some differences, but they go both ways. So I don’t want to make any general statements. But my activation tip is that, if you have cancer, then you should be taken care of in a way which addresses your needs regardless of what the availability is within the VA system. VA sometimes cannot take care of all patients with cancer, and in that case, VA will purchase a service in the community.

Share Your Feedback

Create your own user feedback survey

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

/in , , , , , , , , , , , , , /by

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families from Patient Empowerment Network on Vimeo.

How can non-small cell lung cancer (NSCLC) be explained to veterans and families? Expert Dr. Michael Kelley from Duke University School of Medicine discusses key points that he communicates to patients and proactive patient advice to help ensure their best care.

[ACT]IVATION TIP

“…for the patient to be sure they understand the histologic type of cancer that they have. So what does it look like under the microscope, and what molecular tests have been done on their tumor, and what do those results look like and how do they impact the different therapies that would be offered to them?”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Do Veterans Face Health Disparities in Lung Cancer Care?

Do Veterans Face Health Disparities in Lung Cancer Care?

 What Should Veterans Know About Lung Cancer Screening and Risk?

What Should Veterans Know About Lung Cancer Screening and Risk?

 What Impact Does the VA Have on Lung Cancer Care Coordination?

What Impact Does the VA Have on Lung Cancer Care Coordination?

Transcript:

Lisa Hatfield:

Dr. Kelley, when explaining advanced non-small cell lung cancer to veterans and their care partners, what approaches or language do you find most effective in ensuring patients fully understand the diagnosis, its implications, and their available treatment options?

Dr. Michael Kelley:

Patients with advanced non-small cell lung carcinoma will usually see a medical oncologist because they’re going to be treated with systemic therapies, which are drugs typically, which are given by vein, sometimes by mouth. When the doctor is analyzing all the data that has been collected to come to the diagnosis, they will have a lot of details, and it’s important to know that there are different types of non-small cell lung carcinoma, and those different types will impact the treatments and sometimes the prognosis.

And also, there is variability in the symptoms that you might experience because of the locations within the body where the cancer has spread. So the really important points for the patient to understand, which are hopefully is communicated in a way from the provider, which is understandable, are, what is the histology? So what does it look like under the microscope? And also what molecular tests have been done on the tumor, and what do those results do in terms of the treatment decisions that are going to be made?

So my activation tip for this question would be for the patient to be sure they understand the histologic type of cancer that they have. So what does it look like under the microscope, and what molecular tests have been done on their tumor, and what do those results look like and how do they impact the different therapies that would be offered to them?

Share Your Feedback

Create your own user feedback survey

Dr. Andrew Hantel: Why Is It Important for You to Empower Patients?

/in , /by

Dr. Andrew Hantel: Why Is It Important for You to Empower Patients? from Patient Empowerment Network on Vimeo.

How does Dr. Andrew Hantel empower his patients in their treatment decisions? Dr. Hantel from Dana-Farber Cancer Institute and Harvard Medical School explains how he engages patients by understanding their personal values and the importance of making medical decisions in the context of their lives and communities.

See More from Empowering Providers to Empower Patients (EPEP)

Related Resources:

Dr. Christina Baik

 Dr. Krina Patel: Why Is It Important for You to Empower Patients?

Dr. Krina Patel: Why Is It Important for You to Empower Patients? 

 Dr. Eugene Manley: Why Is It Important for You to Empower Patients?

Dr. Eugene Manley: Why Is It Important for You to Empower Patients? 

Transcript:

Dr. Andrew Hantel: 

I empower my patients by having conversations where I’m asking them a lot about who they are and who they are in the context of their loved ones and their community. Because I think that when I’m talking to people about treatment for their disease and any medical decision that we’re making, it has to be in the context of what’s important to them and not necessarily what the risks and benefits are in the medical ease sense, but what are the risks and benefits in terms of who that patient is and wants to continue to be.

And that can mean that people don’t want to spend time in the hospital, want to you know kind of live and continue to live healthy until a certain milestone and really want to push to do anything to make it to that. It can be that they, you know, really want to focus on spending time at home with their loved ones and not having to come back and forth to the hospital.

And I think a lot of the way that we talk to patients is to kind of fall back on data of risks and benefits and side effects, but not necessarily connected to who that person is or wants to be. And so I think it’s important that we continue to kind of center these decisions around the person and who they are kind of in their community and amongst their loved ones, so we can make choices that continue to be beneficial for kind of who they are as a person.