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Local surgeons, primary care doctors, nurses and pathologists continued learning about managing the health of their patients with cancer and heard updates in cancer screening at the inaugural Community Oncology Symposium Wednesday night. The event was presented by Duke Cancer Network and Wilson Cancer Center.
Five doctors presented information at the Wilson Country Club on the importance of screenings and how screenings are changing for five different types of cancer.
Speakers included Dr. Keith Lerro, Regional Medical Oncology Center; Dr. Betty Tong, assistant professor, Department of Surgery, Duke University Health System; Dr. Jeff Jones, Carolina Radiology Consultants; Dr. Arthur “Skip” Hanson, Wilson OB/GYN; and Dr. Tian Zhang, assistant professor of medicine, Duke University Health System.
Medical director for Duke Cancer Network, Linda Sutton, noticed the attendance of primary care doctors from Wilson.
“If you live in this community, this is what you want to see,” Sutton said. “The doctors are committed to seeing what cancer patients need.”
Duke Cancer Center welcomed the guests and directed them to the options available at the symposium. Different pharmaceutical companies offered information through their representatives with exhibits and brochures on treatment for different cancers. A buffet meal was served, and dining took place as the presentations were made by the speakers and moderated by Dr. Keith Lerro and Dr. Margaret Metts.
Keith Lerro spoke about updates in colon cancer screening. With no screening for most cancers, colorectal cancer is one that can be detected through different types of screenings. In 2017, colorectal cancer had the second highest death rate of any cancer. The benefit of screening is to detect colon cancer at an early, curable stage.
High-risk patients are those with a personal history of colorectal cancer or polyps, a familial syndrome, irritable bowel syndrome or a history of abdominal radiation. The American Cancer Society says the average risk for this type of cancer occurs between the ages of 45 to 75.
Although there are different tests to screen for colorectal cancer, Lerro’s top choice is colonoscopy. However, he recommends a screening of some type even if it is one of the other testing methods.
“The best screening test is the one that gets done,” he said. Most private insurances cover colorectal cancer screening.
Betty Tong told the audience that lung cancer is not just a smoker’s disease.
According to the American Lung Association, 234,030 new lung cancer cases were expected to be diagnosed in 2018.
With the majority of lung cancers being diagnosed in its later stages, survival is better if the disease is diagnosed early.
Tong said not enough people are getting screened for lung cancer, but the screenings have come a long way. There are also different types of screenings for this type of cancer with recommended screening for ages 55 to 80 years.
Since smoking can increase the risk of lung cancer, smoking cessation programs are offered at Wilson Medical Center and Duke, with screenings at both the Durham and Raleigh Duke locations.
Tong said screenings are in the infancy stage at this point. “The next 15 years will be interesting to see how the field evolves.”
Jeff Jones said patient self-examination has fallen out of favor. Methods for detection of breast cancer include 3D mammography, ultrasound, and MRI. Beginning at the age of 40, a mammography is used to screen for breast cancer in women without symptoms.
Expectations of the breast cancer screening in Wilson are for 3D mammography and same-day results.
“We’re very proud of that,” Jones said.
Staff members don’t want women who are screened to wait for several days to hear their results from the screening, wondering if they have an abnormality. Their goal is for ancillary imaging and intervention, he said.
Art Hanson discussed different screenings for cervical cancer. With this type of cancer ranking below 10 in causes of death, screenings are still very important, he said. One study showed that 50 percent of patients who died from cervical cancer were never screened.
Although an annual pap smear has been the suggested screening for years, new guidelines recommend a pap smear every three years. With the recent research of HPV (human papillomavirus), different screenings have been recommended.
HPV has many forms. Most young women who develop a high-risk HPV will clear it naturally within a year. Women ages 30 to 65 with a high-risk HPV are most likely to experience the infection persistently, causing a higher risk for cervical cancer, he said.
But with 99 percent of cervical cancer being caused by a form of HPV, women of different ages may receive different testings. Different screenings include pap smears, HPV testing or co-testing.
Tian Zhang’s presentation about prostate cancer and screening revealed that one in six men will develop prostate cancer during his life. It is the most common cancer in American men.
There has been an uptick in prostate cancer in the last two to three years, Zhang said. The median age to have this type of cancer is 71 with the median age of death from it at 78 years. African-America males have a more aggressive grade of this cancer than other ethnic groups.
Screening depends on one’s age, race and history. Men ages 55 to 69 are encouraged to have a PSA (prostate-specific antigen) blood test every two years to monitor the level of the protein.
With several pharmaceutical exhibits, doctors had the choice to talk with different representatives about working with their products to better help their cancer patients. Bayer pharmaceutical representative Jennifer Petty explained from her booth that she is working with Lerro to bring Bayer’s drug Xofigo to Wilson for Stage 4 prostate cancer patients to alleviate pain and increase the chance of survival for these men.
Currently, the one-minute intravenous push is available in Raleigh, Durham, Chapel Hill and Greenville. Due to travel issues, receiving the six doses over a five-month period, the patients would spend more time traveling than they would for the treatment.
“Hopefully, that would be available at Wilson Medical Center,” Lerro said. The timing, however, has not been established.
Jones was enthused with the prospects of the symposium.
“The Duke Cancer Network is the first of many steps in the integration of the Duke Health System in the Wilson community,” he said.
Wilson Medical Center became a Duke LifePoint Healthcare facility in 2014.