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Lung Nodule Program Overview
Daya Upadhyay, MDAssociate Professor of Clinical Medicine, UCSF
Medical Director, Lung Nodule ProgramDirector, Translational Research in MedicinePulmonary, Critical Care & Sleep Medicine
University of California San Francisco, Fresno
Disclosures
Disclosures : None
CRMC Hospital
California Cancer Center
UCSF Fresno
Lung Nodule Program
Patient CareLung Nodule Clinic
Smoking Cessation
Careful speedy triage team
Diagnostic Radiology
PathologyThoracic Surgery
Social worker
Multi-disciplinary Team Approach
Interventional Radiology
Medical OncologyRadiation Oncology
Interventional Bronchoscopy
Nodule RegistryResearch Training
Endoscopy Team
Pulmonologists
Diagnostic TrainingResearchTherapeutic
Multidisciplinary Lung Nodule Program
No
of P
atie
nts
seen
eac
h ye
ar
Growth of Lung Nodule Program
0
400
800
1200
1600
51
439
786904 953
1230
1497
Associate DeanDr. Peterson
2009
72%
28%
OtherLung Cancer
Lung Nodule Program
Kathryn Bilello, MDProgram Director, PCCMFellowship UCSF‐Fresno;Clinical Professor , UCSF
Kathy Norkunas, RNCatrina Asanuma, RNKaren & Roxanna
Michael Peterson, MDProfessor of Medicine, UCSF, Chair of Medicine UCSF‐Fresno, Vice‐Chair of Medicine, UCSFInterim Associate Dean, UCSF
Karl Van Gundy, MDChief, Pulmonary, Critical Care &Sleep, UCSF‐Fresno; Clinical Professor , UCSF
Interventional BronchoscopyCoccidioidomycosis
Education & Training
Daya Upadhyay, MDDirector, Lung Nodule Program Director, Translational ResearchAssociate Professor, UCSF
Translational ResearchResearch Tissue Bank
Clinical Research
Thoracic Surgery Navigators, Coordinators
Pravachan Hegde, MDInterventional PulmonologistAssistant Professor, PCCMUCSF- Fresno
Fellows & Trainees
Binh Trinh, MD, PhDAssistant Professor, SurgeryMinimally Invasive Thoracic Surgery, UCSF‐Fresno
Patient CareLargest Lung Nodule Program in the US
UCSFCRMCCCC
Members of Lung Nodule Program and Thoracic Tumor Board: Medical Oncologist, Radiation Oncologist, Surgeons, Interventional Radiology, Endoscopy, Pathology, Social Worker, Compass Care
Multi-disciplinary Team
Expedite Triage System
Triage
Referral
CT Review
MD Visit Multidisciplinary Team discussion
Diagnostic Bx
Referral Surgery / Oncology
< 10 days
Early Diagnosis
Lung Nodules: 50% Cancer , 50% Valley FeverBlood TestLung Nodule Biopsy is required
Bronchoscopic Biopsy
Endoscopy
BronchoscopyFiberoptic Bronchoscope Rigid Bronchoscope
Interventional BronchoscopyState of Art Interventional Bronchoscopy Suite
1. Advanced diagnostic flexible bronchoscopy 2. Endobronchial ultrasound (EBUS)-guided
biopsy3. EBUS guided staging for lung cancer4. Trans Bronchial Needle Biopsy 5. Electromagnetic navigational bronchoscopy 6. Airway applications of balloon bronchoplasty7. Rigid bronchoscopy 8. Medical pleuroscopy 9. Pleural biopsy and pleurodesis
Diagnostic
Interventional BronchoscopyState of Art Interventional Bronchoscopy Suit
1. Management of benign and malignant airway and pleural diseases
2. Airway applications of balloon bronchoplasty
3. Argon plasma coagulation 4. Endobronchial brachytherapy 5. Cryotherapy 6. Electrocautery 7. Foreign body retrieval 8. Metallic and silicone stent placement 9. Nd-Yag laser
1. Management of Pleural Disease
2. Chest tube placement3. Transtracheal oxygen
catheter 4. Pleural catheter placement 5. Percutaneous dilational
tracheostomy
Therapeutic Procedures
Endobronchial Ultrasound-guided BiopsyEsophageal Ultrasound-guided Biopsy
For Mass or Mediastinal Lymphnode Biopsy For Diagnosis and Cancer Staging
Electro-Magnetic navigational Bronchoscopy
EBUS for Lung Cancer Staging
Endo Bronchial Stent Placement Intrabronchial Valve
Endobronchial brachytherapy
Foreign Body Removal
BronchoCath
Bronchial Blocker
Pleuroscopy
Training Fellows
Multi-disciplinary Tumor Board
Multi-disciplinary Tumor Board
Team of 6 Medical Oncologists with Dedicated expert in Lung CancerInfusion Center
Imaging facility
Dedicated Thoracic Surgeon who performs minimally invasive thoracic surgeries
Expert Radiation Oncologist
Expert Medical Oncologist
Thoracic Surgery
Binh Trinh, MD, PhDAssistant Professor, SurgeryMinimally Invasive Thoracic Surgery, UCSF‐Fresno
Dr. William Silveira
New Members
Dr. Omid Tehrani
Clinical Research
Research
Translational Research
Dr. Paul Mills Dr. Peterson
Epidemiology Research
Lung Nodule Research Database
Coccidioidomycosis
Dr. Upadhyay
Lung Cancer, MutationsMolecular Markers
Research Biorepository
...and many more……..
Improve quality of our patient careDevelopment of newer diagnostic and
treatment strategiesTraining new generation Save lives
Future Vision
Thank You