Lung Nodule Evaluation Program

Lung nodules are abnormal spots on the lung. Most are harmless and cause no problems. In a small number of cases (less than 5%), however, a lung nodule can be lung cancer. To efficiently identify lung nodules and determine whether they need follow-up treatment, Premier Health has created a Lung Nodule Evaluation Program.

Many lung nodules are found on X-rays, CT scans, or other imaging performed to investigate a separate medical issue. About 18% of lung nodules need follow-up care.

With this program, Premier Health is taking an extra step to have our imaging experts check for lung nodules in imaging studies performed anywhere in our system. If our physicians find a nodule, our Lung Nodule Evaluation Program will follow up with recommendations to monitor nodules and keep you healthy.

Evaluating and Managing a Lung Nodule

A key reason to identify lung nodules is to help detect lung cancer, or pre-cancerous tissue early. Early detection is an important aspect of lung cancer care at Premier Health, because it leads to better treatment results.

When our physicians find a lung nodule, you will most likely follow one of three paths:

1. If your lung nodule is small and thought to be harmless, our program will inform you about the nodule and either schedule a CT scan in a few months to make sure it hasn’t changed, or send you and your primary care physician (PCP) a letter to reassure you that no further action is currently needed. If an infection or inflammation is causing the nodule, a doctor may prescribe medicine to treat it.
2. If our doctors believe that you have a small risk of developing cancer, we will send you and your PCP a letter with follow-up recommendations. Those may include regular follow-up appointments for CT scans in three, six, 12, and 18 months to monitor whether the nodule is growing. The Lung Nodule Evaluation Program’s coordinator, an Advanced Practice Nurse, will contact you when it’s time to make an appointment.
3. If our team of doctors thinks your nodule is likely to be cancerous, we help you schedule a visit with a pulmonologist (lung specialist). The pulmonologist may recommend additional imaging, such as a PET scan, to a bronchoscopy study, or taking a tissue sample called a biopsy.
4. If your physician recommends a tissue biopsy, you may discuss with your doctor which is the best biopsy method for you: endobronchial ultrasound, CT-guided biopsy or the robotic-controlled Monarch^TM Platform. Miami Valley Hospital was the first in Ohio to use the Monarchfor the lungs, which can view your airways, even in hard-to-reach places and remove tissue for further study.

Lung Nodule Evaluation Team

The program’s Advanced Practice Nurse both provides and coordinates care for patients referred to the program. This person works closely with radiologists, who interpret CT scans and other images, and refers you to a pulmonologist when necessary. The program also notifies your PCP about your lung nodule and stays in close contact regarding your care.

If you are diagnosed with lung cancer, the Advanced Practice Nurse will connect you with a lung cancer nurse navigator and an entire team of lung cancer specialists.

Who Is At Risk For Lung Cancer

Several factors increase the risk of developing lung cancer:

• Smoking in the past or present. If you are a smoker and want to quit, sign up for a Premier Health smoking cessation class
• Age and family history of lung cancer
• Routinely breathing in harmful materials, such as tobacco smoke, radon, asbestos, or coal dust
• Lung nodule size (most lung cancers are at least 8 mm or larger) and shape
• A change in size of a lung nodule, as compared to past chest X-rays or CT scans

The Lung Nodule Evaluation Program team will take into account all of these factors when making recommendations for lung nodule surveillance or treatment.