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So you're going to get way more bang for your buck literally as a scan by coming here. Dr. Wagh, you mentioned as a pulmonologist you tell people stop smoking. Amit, I hope I'm pronouncing this correctly. And Dr. Wagh, maybe you can take this next one. Pass instruments out, take little pieces that we-- so you're not going to miss anything, you know, volume wise. Septimiu Murgu, MD, FCCP, Diplomat of the AABIP, Associate Professor of Medicine, Co-director of Bronchoscopy, Interventional Pulmonology Fellowship Program Director, Academic Offices: 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. 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. And you want to have something reliable in what to do next. But Dr. Wagh, can you talk to us a little bit about just-- I think as Dr. Hogarth just mentioned, if somebody comes in and sees a physician. 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. So Dr. Wagh, you touched on this a little bit before. But also don't ignore it, and don't delay it. About. Administration; Faculty; Sections & Centers; Clinical; Research; Training; River East Location; The University of Chicago . Today there are better insights into cancer and other lung diseases. This is a safe place. And so think of it like a sponge. And one of the reasons we do this yearly image, because it is so slow growing, if it's not changing year after year, then the probability that it's going to do anything to you becomes so low that we actually leave you alone. So first is just a discussion with you of what is the probability that this could be a malignancy for you. But what I can also tell you is it's cancer, here's what stage it is. And that's sort of when we take a look at the CAT scan very closely. However, not everyone who receives an abnormal CT scan should be rushed into surgery. [MUSIC PLAYING]. The collaboration with the Chicago Chest Center, the oldest established full service Interventional Pulmonology program in the state, gives our faculty and trainees expanded access to research and advanced procedures. Well, my name is Ajay Wagh. We offer online appointment scheduling for video and in-person appointments for adult and pediatric primary care and many specialties. That's good to know. It's so important. And smoking is certainly a problem, a historical problem that we're working to deal with every day. Our Lung Health Program is staffed by some of the best pulmonary specialists in the Chicago . Media. Well, we're very happy to have you. We want to find patients who have a history of smoking, quit within the past 15 years. You were fantastic. 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. Advanced technology and minimally invasive options are available. And then we go in with our scopes. Report Job. Some of them are blood based tests. So this is an actual question. The hospital is safe, the hospital is clean. During the three-year training period, the fellows have exposure to the various disciplines of pulmonary and critical care medicine. And that is how biopsies work. It's almost, you know, again it's like a video game, science fiction, it's pretty amazing. I do think that it's worth saying that complications are pretty rare with the scopes, the endoscopy that we perform. Emphysema and advanced emphysema. Referring . Dr. Wagh, you mentioned as a pulmonologist you tell people stop smoking. And that's a very important part for a cancer evaluation. Absolutely. And Janet wants to know how invasive is a lung biopsy? And it's important here. Fellowship, 2004, The University of Chicago, Pulmonary and Critical Care Yes, sir. And then I'll have Ajay go at it as well. And usually we discuss medications, if the patient is on a blood thinner. You know, in fact, just to even further hammer home that point. Go ahead, Ajay. Our fancy robot that's going to let us go everywhere in the lung is definitely covered by insurance. Phone: (773) 702-9660. And we keep spacing that interval of scan out if nothing has changed. So-- go ahead, Dr. Hogarth, did you have something you wanted in? We get thousands of survey responses each year. And they hear, oh my gosh, I've got a nodule. We offer online appointment scheduling for video and in-person appointments for adult and pediatric primary care and many specialties. Interventional Pulmonology at Hoag is an important part of the multidisciplinary approach to diagnosing and treating the complexities of lung cancer. Well, if you have a cancer, the next question is, what stage is it? In some cases, they are a precancerous lesion. Where it's basically put right through your chest into the lung nodule done through the radiology department. So I think first step is don't panic. 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. And then at that point, we would bring the patient back to the our laboratory. So look, there's three ways to sample inside the lung. It's an oath both of us took. Program Director. What are some of the options to evaluate lung nodules and lung masses? Because initially when you're faced with something like that, everything kind of just goes over your head. Dr. Wagh, let's hear a little bit about you. So appreciate that. Why aren't we just following the pathway down? Dr. Wagh, let's hear a little bit about you. I love taking care of people, and I love to see them breathe better and feel better. There's all kinds of different tests. I work here, I go home, I kiss my children. Just type them in the comments section. And thank you to our viewers for your great questions. No, it's a great question. Obviously, if things change, then that's a discussion towards biopsy. Why aren't we just following the pathway down? Phone: 513-558-4831 Fax: 513-558-4858 Email: pulmonary@uc.edu I'm new here to the University of Chicago, and very thankful to be here. 5841 S Maryland Ave, MC 6076. And then there are other types of imaging techniques, like PET scans, other images that we use to evaluate lung nodules. Get a Second Opinion. Now, a question. We don't even have any camera people in here. It is nationally ranked in 10 adult specialties and rated high performing in 1 adult specialty and . So we do want to remind our viewers, we'll take your questions for our experts. [MUSIC PLAYING] Hello, and welcome to At The Forefront Live. . We just talked a moment ago, and you're pretty new here. I should point out, the amount of radiation you get from a CAT scan at a center like ours-- so it has everything to do with the quality of the scanners. There's nobody else here. Interesting. Or it could be a telemedicine visit. You will get seen three to four weeks from now. The University of Chicago Medicine 5841 S. Maryland Avenue Chicago, IL 60637 | 773-702-1000 Appointments: 1-888-824-0200. Make sure everything looks right, that it would be safe to proceed. And we had a question from a viewer that dovetails perfectly into what I'm kind of curious about. 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. It's got to be terrible. You know, you said at the very beginning, I have a nodule, should I panic? What happens? And the patient goes afterwards to a post-procedural area, where they recover. We look at the airways and other parts of our computer modeling to see if that's something that we can get to. Dr. Hogarth was the first doctor in the Midwest to use the Monarch by Auris a robotic bronchoscopy navigation system with 3-D imaging technology built into a robotic scope that allows him to reach deeper into the lung than ever before to detect and/or biopsy nodules and masses. So-- Phone: (773) 702-9660. And we kind of-- we have a nice staff who will kind of walk the patient through what they should expect. This isn't that twilight. So I want to get back to biopsies for just a moment. Open for more information. 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. Chicago Chest Center/Suburban Lung Associates offers a 1 year fellowship in Interventional Pulmonology in collaboration with the University of Illinois (UIC) Division of . So I always have to do this. River East Location . Some of the blood tests we have, have the ability to change that number. Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, Request an Appointment at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park. And Dr. Hogarth, we'll start with you. This is a safe place. Associate Professor of Medicine, Co-director of Bronchoscopy. That's always the question people want to know. You were fantastic. If your insurance company is not listed here, or if you have any other questions, please contact Managed.Care@uchospitals.edu. But we're also going to work with you. 11 millimeters is rather small. Or should we offer something else? In fact, U.S. News & World Report, 2022-2023, named Northwestern Memorial Hospital No. And we also try to figure out, is it a lesion that requires biopsy? It's a wonderful website. Paper copies of the Report are available, upon request, from the University of Chicago Police Department, 850 E. 61st Street, Chicago, IL 60637. You want to be calm and cool. I've been practicing for the last seven years as a pulmonary critical care physician, and I'm excited to be here. And again, in all seriousness, I think that shows really, you know, the work that you do with the patients. Yes, sir. We use that CAT scan, build a three dimensional map of your lungs, and we drive to the spot where that's at. Or suggest that the pre-test probability is lower. And teasing out what's what is what Ajay and I do. Communicate with your doctor, view test results, schedule appointments and more. And Dr. Hogarth, we'll start with you. It's got to be terrible. The fear always is that cancers are going to grow. If it bothers you to come near the Medical Center, fine, let's do it via the computer. Learn more about clinical trials and find a trial that might be right for you. Dr. Hogarth is also on several editorial boards for premier medical journals, and serves as a manuscript reviewer for multiple other journals. And how urgently must patients act? So I have two from viewers that I have to pass along. So we do want to remind our viewers, we'll take your questions for our experts. The Emory Sleep Medicine . And that would be annually until they kind of exit out after that 15 years. Yeah, there's several possibilities in that regard to evaluate these. And we keep spacing that interval of scan out if nothing has changed. 20 on the Best Hospitals Honor Roll. Interventional Pulmonary - American Association for Bronchology & Interventional Pulmonology Dr. Kumar Gaurav joined Cancer Treatment Centers of America (CTCA), Chicago in October 2021. Chicago Chest Center/ The University of Illinois Chicago. And that's very important. We have a great team here, and I'm excited to be part of it. That's coming up right now on At The Forefront Live. And so think of it like a sponge. So when we're done, you go home. So that's nice. You shared really some good information with our audience. If you think about it, the lung is mostly air. And I was fortunate enough, I think, gosh, it's been over a year ago. Chicago Chest Center - 2015. Well, gentlemen, we're out of time. I am a Professor of Medicine here. And let's go through your CAT scan and let's have this discussion about what our next step is. I kiss my spouse. When we-- and I'll also say it depends. And thank you to our viewers for your great questions. You know, it's not just like, yeah, you do this. But there's many other tests. And we are lucky enough to have anesthesiologists who help take care of the patient during the procedure. If we keep scanning you, we're never going to see change. Go ahead, Ajay. And how urgently must patients act? Star ratings and comments come from a number of survey questions. It's so important. I'll also point out that our procedures, like Dr. Wagh said, are done under anesthesia. Randomly selected patients are sent patient satisfaction surveys after their visits. We can talk about imaging modalities. American Board of Internal Medicine, Pulmonary Disease; American Board of Internal Medicine, Internal Medicine . I'm new here to the University of Chicago, and very thankful to be here. UChicago Faculty Physicians But of course, there's biopsies. That's why we do it. Is the evaluation and procedure that we've been talking about, is that covered by insurance as well? But there's many things it could be. We want to remind people, very important, do not forego medical care during COVID. It's a wonderful, wonderful place. That's right. No, for sure. It could be cancer. We're giving you the least amount of radiation, even for what's called a diagnostic scan. BCBS Blue Precision HMO (specialists only), United Select (HMO & EPO) (specialists only), Humana Medicare Advantage Gold Choice PFFS. What's that chance? We are proud to have an interventional pulmonary laboratory with full-time dedicated . But many times, you might notice something on an x-ray that's not part of the screening pathway. Patients should bring recent X-rays, CT scans and PET scans either as a 'hard copy' or on CD to their appointment or make them available prior to the appointment. 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. And so part of our discussion is, what's the probability that this nodule that you have on your CAT scan-- is it actually cancer or not? Neeraj Desai, MD, MBA, FCCP, FACP Program Director. 1-877-DOM-2730, Department of Medicine And then if we do need to do a biopsy, making sure the correct biopsy gets done. There's a surgeon, who's going to go in and cut part of it out. We are taking questions from viewers. Right? And our complication rate is the lowest amongst the three. (Or create a 1/6 column and add a text field, modify the class so Because it has everything to do with the quality of the machine for the radiation that goes through. But one of the other things we were talking about, the patient journey. Star ratings and comments come from a number of survey questions. Interventional Pulmonology Secondary Specialty. 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. So ground glass nodules are a different biology. That is not acceptable to make you wait. And basically work very hard to make sure that patients get the answers that they need to help decide what's the best next path when they find an abnormal CT scan. And so part of our discussion is, what's the probability that this nodule that you have on your CAT scan-- is it actually cancer or not? Getting an expert opinion about what could this nodule actually be. Septimiu Murgu, MD, is a highly skilled interventional pulmonologist. The whole key thing, too, is that this is an ongoing dialogue between us and the patient. 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. You know, you mentioned that being covered by insurance. There's also what's called a needle biopsy. But we can. The probability, if it's low enough, we don't want to do invasive things to you. D. Kyle Hogarth, MD, is an expert in pulmonary diseases.He also specializes in the minimally invasive diagnosis, management, staging and treatment of lung cancer through bronchoscopy.Dr. In some cases, they are a precancerous lesion. And smoking is certainly a problem, a historical problem that we're working to deal with every day. Oh, let me reinforce that. And then they come to our lab. And Dr. Hogarth mentioned blood tests even, a few moments ago. And we are lucky enough to have anesthesiologists who help take care of the patient during the procedure. Hogarth DK. The program focuses on both procedures and the procedure related management of benign and malignant thoracic diseases. And we can help you do that, too. So typically we'll have a clinic evaluation. This isn't that twilight. Follow @uw_APCC. And so Dr. Hogarth, we have another question from a viewer. Interesting. And you can speak with your physician about that. We're still operating. It's either cancer or everything else. So if we think you're at early stage cancer, that's great. 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. 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. You know, you mentioned that being covered by insurance. Only clean air in the lungs, please. And that's very important. Anchored at Northwestern Memorial Hospital, Canning Thoracic Institute is a regional destination for those who need highly specialized thoracic care. We're going to tell you a outlined plan that is backed up with data as to why we're doing this. Join one of the nation's most comprehensive academic medical centers, University of Chicago Medicine. The Section of Pulmonary and Critical Care Medicine offers the following training programs: Pulmonary and Critical Care Medicine. We use that CAT scan, build a three dimensional map of your lungs, and we drive to the spot where that's at. You're out. And I think we like to take things one step at a time. Open for more information. Let's have each of you start off by introducing yourselves to our audience, and tell us a little bit about what you do here at UChicago Medicine. But the first thing to understand is there's a long list of not cancer reasons you could have a nodule in your lung. And that's sort of when we take a look at the CAT scan very closely. There's nobody else here. And we have a series of other tests we can do. We will overbook you. And we had a question from a viewer that dovetails perfectly into what I'm kind of curious about. Chicago, IL 60637, Referring Physician Access Line: So we want to-- I mean, we want to do this for everybody. So, I really believe in great communication and teamwork. A lung mass can be a frightening discovery. Yes, sir. The mission of Duke Interventional Pulmonary Fellowship is to train the leaders in the field by exposure to high volume of complex cases, multi-disciplinary and thoughtful approach, and cutting edge research. I'm not happy that I have to tell you it's cancer. It's usually about a half day's worth of time. And it's important here. Meaning, it's technically a cancer, but it's never going to necessarily bother you. You will still be the same stage. Pulmonary, Critical Care & Sleep Medicine. So my name is Kyle Hogarth. Duchossois Center for Advanced Medicine (DCAM) - Hyde Park, Request an Appointment at Duchossois Center for Advanced Medicine (DCAM) - Hyde Park. We'll try to get to as many as we can over the next half hour. Sleep Medicine. You will get seen within a week every time here. Can you talk to us a little bit about what the patient experiences in this procedure? I mean, I think we are living in a strange time. And we can help you do that, too. If your insurance company is not listed here, or if you have any other questions, please contact Managed.Care@uchospitals.edu. We want to minimize radiation. 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. Learn more about clinical trials and find a trial that might be right for you. So something solid inside the lung needs an explanation, because there shouldn't be something solid in the lung. And prior to that, I was a private practice pulmonary critical care doctor for six years. Because it has everything to do with the quality of the machine for the radiation that goes through. But we're very careful about that. All rights reserved. Whether they, you know, the fact that they can't eat the night before because we do general anesthesia for many of our cases. Because an abnormal CT scan is terrifying. So that you get an answer as to what this nodule actually is. First, if you smoke, please quit. And either one of you can do that. We offer a university-based training experience at a state-of-the art community-based tertiary care teaching hospital nestled . And we have a series of other tests we can do. So ground glass nodules are a different biology. It's a wonderful website. And every patient is different. And what we've gained, of course, is for all of those scans, that nothing changed and you avoided an unnecessary invasive procedure. Program Coordinator. But we can. Patient survey responses are also used to make star ratings for each provider. 11 millimeters is rather small. Meet the Doctor. Please remember to check out our Facebook page for our schedule of programs that are coming up in the future. You can't eat after midnight. 13 in the nation for Pulmonary and Lung Surgery. So let's start off with our questions. So there's no cutting. Well, I think that there's several possibilities. For help with MyChart, call us at 1-844-442-4278. So this is an actual question. And as Dr. Wagh just said, we are able to do video visits and televisits. Communication is important with the patients. Some of them are just re-evaluating the CAT scan you have. 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. [MUSIC PLAYING] Hello, and welcome to At The Forefront Live. Before the appointment, all pertinent medical records from referring physicians should be faxed to (410) 367-3252. Our list of accepted insurance providers is subject to change at any time. So if the risk of cancer is low, but the risk of a complication is the same, I don't want to harm you, right? Where it's basically put right through your chest into the lung nodule done through the radiology department. And so I do think it needs to be corrected that you should not get a chest x-ray as a screening tool. So follow-up scans could also be low dose as well. Chicago Chest Center/Suburban Lung Associates offers a 1 year fellowship in Interventional Pulmonology in collaboration with the University of Illinois (UIC) Division of Pulmonary, Critical Care, Sleep and Allergy.