And as always, we'll take your questions during our 30 minute program. A ground glass nodule almost looks like some wispy smoke on the CAT scan, if you will. Star ratings and comments come from a number of survey questions. And these procedures all have their own benefits, but also their own complications. So Dr. Wagh and I have our partner, Dr. Mergue. I love math and science, and I love to problem solve, so I started out in engineering. No, for sure. And so think of it like a sponge. Get a Second Opinion. Go ahead, Ajay. Also, if you want more information about UChicago Medicine, take a look at our website at uchicagomedicine.org. And at that point, they'll meet the anesthesiologist, the nursing staff. But we also want to explain to you what we're going to do to actively follow you. We're still operating. But a doctor may see something on a chest x-ray. And thank you to our viewers for your great questions. We want to remind people, very important, do not forego medical care during COVID. And Dr. Hogarth, we'll start with you. . And how minimal it actually is? And usually we discuss medications, if the patient is on a blood thinner. And then once that's completed, we send the patient to the post procedural area, where they recover for a couple hours. The Section of Pulmonary and Critical Care Medicine has been a model of exemplary patient care, research, and post-doctoral training for more than 20 years. Sure. Our doctors will actually even join us from the places where they're doing the work. Meaning, it's technically a cancer, but it's never going to necessarily bother you. And then at that point, we would bring the patient back to the our laboratory. And we have a series of other tests we can do. University Pulmonary and Critical Care (UPCC) physicians and nurse practitioners specialize in the diagnosis and treatment of inpatient critical care patients who are typically hospitalized as well as diagnosis and treatment of pulmonary (lung) conditions in an outpatient setting. First, if you smoke, please quit. So that you get an answer as to what this nodule actually is. That's good to know. I'm in the studio all by myself, as you can see here. Is that-- should you be frightened? And it's something solid. The whole key thing, too, is that this is an ongoing dialogue between us and the patient. Getting an expert opinion about what could this nodule actually be. 1:25 . These are not questions. Patients will typically have primary or metastatic tumors of the chest, mediastinum or . You know, and I want to talk a little bit more about biopsies here in just a minute. The University of Chicago Medicine. Dr. Wagh, let's hear a little bit about you. With this new curriculum, physicians learn by using simulation technology, interactive step-by-step instructions and problem-based teaching which create an engaging and authentic learning environment. We don't want that to happen. You know, in fact, just to even further hammer home that point. Really, really good questions today. We're going to get to a little bit more detail of that one here in just a moment. Elizabeth says, I've had several bronchoscopes done by Dr. Hogarth, he's amazing. The fact it's a low dose is because you are being screened, there is no other reason we're scanning you. And I think what we want to do is offer a pathway here in our program for patients to get everything they need. So we need to get going and do something about it. Our collaborative program emphasizes complex procedural skills and overall clinical excellencegiving you the experience and confidence you need to be a leader in the field. For help with MyChart, call us at 1-844-442-4278. And that would be annually until they kind of exit out after that 15 years. Phone: (773) 702-9660, Mailing Address: I'm actually in the endoscopy suites. Comments that do not apply, risk patient privacy, or are not appropriate are not posted. And either one of you can jump on this one. Funding for Educational Activities The Interventional Pulmonology Center at Barnes-Jewish Hospital and Washington University School of Medicine, in conjunction with the Siteman Cancer Center, uses the following specialized technology to offer patients advanced diagnoses and expert care: . This is a safe place. And it is, would my annual low dose CT lung cancer screening show nodules? Learn more about clinical trials and find a trial that might be right for you. And either one of you can do that. Name Rank Section; Adegunsoye, Ayodeji: Assistant Professor Pulmonary / Critical Care Bag, Remzi But of course, there's biopsies. And we're also going to just keep radiating you. He sees patients in clinic on Fridays. Dr. Wagh is focused on using minimally invasive techniques for diagnosing and treating a wide range of lung and chest conditions, including stage lung cancer, chronic respiratory illness, complex airway disorders, pleural disease (pleurisy, pneumothorax, pleural tumors) and more. We get thousands of survey responses each year. Well, that's nice. Thanks again for being with us today. So we do want to remind our viewers, we'll take your questions for our experts. We're fortunate enough here at UChicago Medicine to have a robotic endoscope that lets us get to parts of the lung we've never been able to get to before. at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, See All Healthcare Professionals Information, Molecular and Genomic Diagnostic Laboratories, Chronic Obstructive Pulmonary Disease (COPD), World Association for Bronchology and Interventional Pulmonology, International Association for the Study of Lung Cancer, American Association for Bronchology and Interventional Pulmonology, Chair, CHEST/AABIP/AIPPD panel for The Use of Tracheostomy during COVID-19 Pandemic Expert Panel Report, Chair, Education Committee for the American College of Chest Physicians, President, American Association of Bronchology and Interventional Pulmonology, Member, Program Committees for the International Association for the Study of Lung Cancer programs and CHEST, Editor, World Association for Bronchology and Interventional Pulmonology Newsletter, Distinguished CHEST Educator designation (top 4% of international faculty), Geoffrey McLennan Memorial Award for Advancements in Interventional Pulmonology, University of Medicine and Pharmacy "Carol Davila", AMITA Health Saint Francis Hospital Evanston, University of California San Francisco Medical Center, BCBS Blue Precision HMO (specialists only), United Select (HMO & EPO) (specialists only), Humana Medicare Advantage Gold Choice PFFS. But there's many other tests. Interventional pulmonology is often important in the screening, diagnosis, and treatment of lung cancer. These are not questions. I kiss my spouse. And the national standard is roughly five weeks. We use that CAT scan, build a three dimensional map of your lungs, and we drive to the spot where that's at. Fellows. Because initially when you're faced with something like that, everything kind of just goes over your head. I recently completed an interventional pulmonary fellowship, which brought me here. We're giving you the least amount of radiation, even for what's called a diagnostic scan. So Dr. Wagh, it was interesting because this is almost like a video game. We work collaboratively with pulmonary medicine, critical care, allergy, thoracic surgery, medical oncology, radiation oncology, otorhinolaryngology and transplant specialists to provide you with a seamless care experience. Yes, so a patient typically comes in basically just for a few hours during the day. I mean, I think we are living in a strange time. Learn more about clinical trials and find a trial that might be right for you. Although residents and fellows are paid by the University, the salaries and benefits are essentially the same for all trainees within a given postgraduate year of training. But you know, I think that there's so many different possibilities when it comes to management that we're quickly learning how to utilize technology, even in telehealth, to help patients get what they need. That's always the question people want to know. So that's nice. We offer online appointment scheduling for video and in-person appointments for adult and pediatric primary care and many specialties. 5841 South Maryland Avenue, I'm actually in the endoscopy suites. Fellowship, 2004, The University of Chicago, Pulmonary and Critical Care And we're very serious about that. The responses are used to improve patient experience and recognize staff members for the care they provide. Dr. Hogarth, do you want to start on that one? Get a Second Opinion. And either one of you can jump on this one. But a doctor may see something on a chest x-ray. 11234 Anderson St, Loma Linda, CA 92354. . We offer online appointment scheduling for video and in-person appointments for adult and pediatric primary care and many specialties. And our complication rate is the lowest amongst the three. That is not acceptable to make you wait. I'm grateful to participate in Dr. Hogarth and Dr. Perdue's team. And that's sort of when we take a look at the CAT scan very closely. Oh, less than 5%, OK, let's slow down a little bit. 4 Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina. And the patient goes afterwards to a post-procedural area, where they recover. Interventional Pulmonary; Hospitals. If you think about it, the lung is mostly air. Make sure everything looks right, that it would be safe to proceed. Our commitment is to outstanding clinical care, to mentoring and . Occupational lung disease. The University of Illinois at Chicago/Chicago Chest Center offers a 12 month Interventional Pulmonology fellowship is spread across a spectrum of hospitals to allow for exposure to a wide variety of patients, diagnoses, interventions and multiple mentors. Yeah, there's several possibilities in that regard to evaluate these. Maybe Dr. Hogarth, you can start. Please remember to check out our Facebook page for our schedule of programs that are coming up in the future. But when it's time to get a follow-up scan, the reason, ultimately, for these ground glasses, why they settle into yearly, is precisely because they're slow growing. We also have literally the world's greatest nurse practitioner, Kimberly. Septimiu Murgu, MD, is a highly skilled interventional pulmonologist. It was way pre-COVID, but you showed me one piece of equipment that you had, Dr. Hogarth. Dr. Wagh, you mentioned as a pulmonologist you tell people stop smoking. What exactly goes on there, and why is that so critical? And then they just go home. Because why would I put you-- why would I cure you of something that's never going to harm you? This is a safe place. Yeah, there's several possibilities in that regard to evaluate these. And we are going to be first and foremost interested in protecting you, as well as protecting ourselves and our staff. And we had a question from a viewer that dovetails perfectly into what I'm kind of curious about. But that's part of what you do. Really, really good questions today. About. Additionally, Dr. Hogarth is able to offer his patients unparalleled diagnostic accuracy by being the first in the United States to use the LungVision system with the robot to maximize precision. In addition to his dedication to his patients, Dr. Hogarth is committed to teaching, receiving the resident teaching award in 2020 and has been named a Distinguished Chest Educator several years in a row. When there are no changes from scan to scan. And this is a little bit inside baseball. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. We want to minimize radiation. You need to raise a fit. Because in some cases, our plan for you is to get a follow-up CAT scan, is to do watch and wait. And of course, you came here at kind of an odd time, during a pandemic. And we also try to figure out, is it a lesion that requires biopsy? When we-- and I'll also say it depends. Follow @uw_APCC. Medical school: St. James School of Medicine Anguilla, Park Ridge, IL Residency: University of Illinois College of Medicine, Peoria, IL Professional interests: ARDS, sepsis and infectious lung diseases. Yes, sir. And you know, those patients typically are eligible for low dose lung cancer screening. His clinical and research interests include minimally invasive diagnostic and therapeutic interventions for patients suffering from benign and malignant airway obstruction. I mean, it's really amazing. Chicago Chest Center/ The University of Illinois Chicago. And we get the tissue that we need. Or is that the moment of panic at that point? In other cases, they are actually a cancer. We also have literally the world's greatest nurse practitioner, Kimberly. So we'll wake you up. We're giving you the least amount of radiation, even for what's called a diagnostic scan. And where this matters is, of course, if I go and prove that it's not a cancer, then rather than being cut open and proved it was not a cancer-- which is great it's not cancer, but you've been cut open. And we have a high success rate to get you an answer. And Janet wants to know how invasive is a lung biopsy? Communicate with your doctor, view test results, schedule appointments and more. We want to remind people, very important, do not forego medical care during COVID. Get a Second Opinion. It could be cancer. And I have been working at the University of Chicago since 1998. Because the chance it's cancer is so low, and every invasive procedure always carries a risk. It should be a CAT scan if you are eligible. And you say, well, wait. For more information about the Interventional Pulmonology Center or to request a referral . Maybe a 3% chance of cancer is acceptable to some, and terrifying to others, and everywhere in between. That's not hard to convince someone. 5841 S Maryland Ave, MC 6076. Co-Director, Lung Cancer Screening Program, at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, See All Healthcare Professionals Information, Molecular and Genomic Diagnostic Laboratories, Chronic Obstructive Pulmonary Disease (COPD), Sampling and Evaluating Lung Nodules and Masses: Expert Q&A, International Association for the Study of Lung Cancer, American Association for Bronchology and Interventional Pulmonology, Case Western Reserve University School of Medicine, BCBS Blue Precision HMO (specialists only), United Select (HMO & EPO) (specialists only), Humana Medicare Advantage Gold Choice PFFS. I kiss my spouse. That's going to be number one on the list. Yes, sir. His clinical interests include advanced and therapeutic bronchoscopy, lung cancer, pleural diseases, and critical care medicine. But generally speaking, a lung cancer-- when someone says to you, hey, we want to get a follow-up CAT scan, the reason they're suggesting that is that the nodule you have is so small or has characteristics that are so convincing that it's benign, that that two or three month interval that they've suggested-- if I'm wrong and it's actually a cancer, the amount that it's going to grow in that time period is so small that we've not lost anything. All rights reserved. You will not know we're doing this to you. The Department of Pulmonary, Critical Care, Sleep, and Allergy at UI Health provides the highest level of care and treatment for lung disorders and diseases. And we do it through your mouth. There's large databases that have been built off of the experience of radiology to be able to essentially plug-in and give a number. Pulmonary and Critical Care Fellowship Program; Interventional Pulmonology Fellowship Program; Office of Graduate Medical Education; ERAS - Electronic Residency Application Service Fellowship Application; Clinical Services. But you come in, we have a pre-procedural area where the patients get kind of their IV. You will never be told, you've got to wait around to be seen after someone's told you that you might have cancer. What are some of the options to evaluate lung nodules and lung masses? We evaluate whether or not it's a target that we can reach. Exactly. Now, these are complicated discussions. Or suggest that the pre-test probability is lower. A star rating is not given if a provider only has a small number of survey responses. Interventional pulmonology is a new field within pulmonary medicine focused on the use of advanced diagnostic and therapeutic techniques for patients with lung cancer, airway disorders, and pleural diseases. Age is usually 55 to 80. You will still be the same stage. I can't even imagine what that would be like if you're worried that you have cancer, and then you're told you have to wait for an extended period of time. Well, my name is Ajay Wagh. No, it's a great question. And there we perform our procedures. You will never be told, you've got to wait around to be seen after someone's told you that you might have cancer. James Katsis, MD is affiliated with Rush University Medical Center and specializes in Pulmonology Services in Chicago, IL James Katsis, MD - Rush University Medical Center Call (888) 352-RUSH (7874) You know, you said at the very beginning, I have a nodule, should I panic? His contributions to the field of procedure-related training has been recognized by his peers and professional societies. And Dr. Hogarth mentioned blood tests even, a few moments ago. Dr. Ajay Wagh and Dr. Kyle Hogarth will discuss the latest in lung nodule diagnostics, management, and treatment. We're going to do our work. American Association for Bronchology and Interventional Pulmonology (AABIP) Statement on the Use of Bronchoscopy and Respiratory Specimen Collection in Patients With Suspected or Confirmed COVID-19 Infection . UChicago Medicine and Ingalls Memorial offer a broad range of challenging clinical and non-clinical career opportunities doing work that really matters. What Dr. Wagh and I do is a procedure called bronchoscopy. Instead, you might have a little sore throat for a day or two. Associate Professor of Medicine, Co-director of Bronchoscopy. There's nobody else here. A ground glass nodule almost looks like some wispy smoke on the CAT scan, if you will. I don't know who wants to take that one. You know, you mentioned that being covered by insurance. You don't have to go get another procedure that's going to take time to then figure out what stage you are. So if you have an x-ray or a CAT scan, there is a chance that the word module or mass is going to show up in the report. I am a Professor of Medicine here. In 2007 and 2011, he received the Department of Medicines Outstanding Junior Faculty Clinical Service Award and in 2013 and 2014 the Department of Medicines Outstanding Clinical Service Award. There's also what's called a needle biopsy. And then I'll have Ajay go at it as well. But also don't ignore it, and don't delay it. Or you're going to go to radiation or whatever. Pass instruments out, take little pieces that we-- so you're not going to miss anything, you know, volume wise. If you're concerned about cancer and there's an intermediate pre-test probability, based on a calculated evaluation, then we can potentially offer a blood test or something else that may potentially reduce the risk. Just type them in the comments section. Future Oncol. And so those are our mainstays of imaging. And I hope you have a great week. Only clean air in the lungs, please. However, not everyone who receives an abnormal CT scan should be rushed into surgery. And we kind of-- we have a nice staff who will kind of walk the patient through what they should expect. Can you kind of walk us through that? So I'm excited to be here in the city, and part of this program. I can meet with you virtually. 2023 The University of Chicago Medical Center. And that would be annually until they kind of exit out after that 15 years. Well, it certainly can. We're not going to just say, you must do this. And you want to have something reliable in what to do next. Star ratings and comments come from a number of survey questions. Rush University Medical Center in Chicago, IL is ranked No. So I think first step is don't panic. Or suggest that the pre-test probability is lower. Schedule your appointment online for primary care and many specialties. They come into the sky lobby here at UChicago. But can you kind of walk us through what people can expect before, during, and after one of these procedures. Some of them are blood based tests. And we are lucky enough to have anesthesiologists who help take care of the patient during the procedure. And you two, and your teams, are really good at helping people through that situation. And one that has a very low invasive potential. And that would be another area, I would imagine. Yes, sir. We are taking questions from viewers. All kinds of fantastic information there. They come into the sky lobby here at UChicago. Every tumor, of course, has its own biology speed at which it grows. We'll get you a speech card. We're in very separate areas. Dr. Wagh, let's hear a little bit about you. Our list of accepted insurance providers is subject to change at any time. I apologize. And usually we discuss medications, if the patient is on a blood thinner. Because we will always see you. And there are potential treatments to help patients quit smoking as well. Referring Physician Access Line: . So if we think you're at early stage cancer, that's great. And that would be another area, I would imagine. And we're, of course, happy and eager to help. Our program's strength lies in the large and varied patient base . The fear always is that cancers are going to grow. Our 5-year integrated IR/DR training program consists of a subspecialty track system with 4-week-long rotations in the following sections: Abdominal computed tomography. Interventional Pulmonology. If you think about it, the lung is mostly air. But one of the other things we were talking about, the patient journey. So-- If we keep scanning you, we're never going to see change. We have been recognized by U.S. News & World Report as a high-performing hospital in COPD care. Thoracic Imaging. So a little bit of a fan club going here, but that's awesome. Interesting. But there's many things it could be. Program Overview. And we're also going to just keep radiating you. So if you have an x-ray or a CAT scan, there is a chance that the word module or mass is going to show up in the report. And it is, would my annual low dose CT lung cancer screening show nodules? Open for more information. Because an abnormal CT scan is terrifying. Dr. Hogarth is the founder and past president of the Society for Advanced Bronchoscopy. Pass instruments out, take little pieces that we-- so you're not going to miss anything, you know, volume wise. Interventional Pulmonology, Northwestern University, Feinberg School of Medicine, Chicago IL 2015-2016 Pulmonary and Critical Medicine, UC Davis Medical Center, Sacramento CA 2012-2015 Professional Memberships Why aren't we just following the pathway down? It offers a comprehensive program of quality patient care, research and education. of Colorado Health Sciences Ctr. Well, we're very happy to have you. And as Dr. Wagh just said, we are able to do video visits and televisits. [MUSIC PLAYING] Hello, and welcome to At The Forefront Live. Now, the low dose lung cancer screening has its own set of guidelines that helps us to monitor and follow any suspicious nodules. You know, you said at the very beginning, I have a nodule, should I panic? No, don't panic. The University of Michigan as a . Because I know this is a very complex situation. That's right. Open for more information. It's a wonderful, wonderful place. Along with his clinical practice, Dr. Wagh is an active researcher. There are characteristics of nodules that make them more concerning for cancer, as opposed to less concerning. And how minimal it actually is? And then there are other types of imaging techniques, like PET scans, other images that we use to evaluate lung nodules. So a little bit of a fan club going here, but that's awesome. So that's nice. Some of them are just re-evaluating the CAT scan you have. Interventional Pulmonology; Cystic Fibrosis; Pulmonary Vascular Disease; Pulmonary Hypertension; Hereditary Hemorrhagic . Before the appointment, all pertinent medical records from referring physicians should be faxed to (410) 367-3252. Yes, so a patient typically comes in basically just for a few hours during the day. But of course, there's an 80% chance it's not cancer. We just talked a moment ago, and you're pretty new here. That ground glass, if it gets larger or denser, then it's changing. That's going to be number one on the list. It should be a CAT scan if you are eligible. St. Peters Health Partners Medical Associates, P.C. Yes, sir. We are taking questions from viewers. We're going to give you some strong recommendations. Yeah. Because I know this is a very complex situation. But if it shows anything of any concern, especially if it's your first one, that may require a follow-up scan in a shorter interval or one with slightly higher radiation. Faculty and fellows conduct research in a wide range of topics such as devices in sleep medicine and interventional pulmonary, laboratory studies in IPF fibroblast pathology or building new lungs for transplantation. The fear always is that cancers are going to grow. And you know, COVID makes it harder for patients to see doctors. No, it's a great question. And then once that's completed, we send the patient to the post procedural area, where they recover for a couple hours. Administration; Faculty; Sections & Centers; Clinical; Research; Training; River East Location; The University of Chicago . Our fancy robot that's going to let us go everywhere in the lung is definitely covered by insurance. And we're, of course, happy and eager to help. It's an oath both of us took. He and I, and our other partner, Dr. Mergue, work very hard to make sure that if you need a procedure, it's the right procedure. You know, it's not just like, yeah, you do this. But that's part of what you do. Procedures performed include diagnostic bronchoscopy, linear array and radial endobronchial ultrasound (EBUS) guided fine needle aspiration, navigational bronchoscopy, bronchoscopic fiducial marker placement for radiation therapy, rigid . And what we've gained, of course, is for all of those scans, that nothing changed and you avoided an unnecessary invasive procedure. And then based on that discussion, we would set a patient up for a procedure. Yeah, and I want to tell people-- this is a very, very safe place. And that's a very important part for a cancer evaluation. That's why we do it. I'm not happy that I have to tell you it's cancer. So my name is Kyle Hogarth. UK Pulmonary, Critical Care and Sleep Medicine offers the full scope of inpatient and outpatient services involving the diagnostic evaluation and clinical management of respiratory disorders. What's that chance? Get an online second opinion from one of our experts without having to leave your home. We have a great team here, and I'm excited to be part of it. You know, and I was only being partially facetious when I said panic is kind of the natural-- because I think for a lot of people that's just the natural reaction. So ground glass nodules are a different biology. And I think that's the first key step. And between the four of us, we're all in clinic at any given moment. Sure, so a ground glass nodule is definitely a different thing than a very solid nodule. And without a doubt, the possibility of cancer is what scares everybody. What's that chance? So we need to get going and do something about it. But we can. And then they come to our lab. And this is a little bit inside baseball. Even the show that we're doing right now, you two are remote. That's another thing that you probably want to caution people about. And the city of Chicago is a great place and a lot of fun. Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, Request an Appointment at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park. And as you can imagine, a place like UChicago Medicine, we've got the highest quality CT scanners. He and I, and our other partner, Dr. Mergue, work very hard to make sure that if you need a procedure, it's the right procedure. But also cat scanning. So I'm going to have you answer the question, but also kind of explain what she's asking here. You should contact your insurance company to confirm UChicago Medicine participates in their network before scheduling your appointment. See, this just shows how important it is that we do these programs here. Communication is important with the patients. Because it has everything to do with the quality of the machine for the radiation that goes through. 840 S. Wood Street MC719 Chicago, IL 60612.