Lung Cancer: Addressing the State’s Most Deadly Cancer

Fall 2013

Erna Boone, Dr. P.H.

Having tried practically every way possible to quit smoking, Jackie Turnbow almost refused a UAMS tobacco cessation program when he was approached about it prior to his cancer surgery.

“I thought it would be just more blah, blah, blah,” said Turnbow, 58, a Jonesboro native who now lives in the Missouri bootheel. “But once I got in there I was almost on the edge of my seat. It was an approach that I haven’t heard before.”

Turnbow, who quit smoking April 22, 2013, was the beneficiary of a new program that patients of lung cancer specialist Matthew Steliga, M.D., are told is part of their treatment in the thoracic oncology surgery clinic.

“We’re treating the patient, not just the tumor,” Steliga said of the program that began in 2012 and the only such program integrated within a UAMS patient care clinic.

Steliga joined UAMS in 2009 motivated by the desire to help a state whose lung cancer death rate is among the highest in the country. As a key member of the UAMS lung cancer team, he has unique expertise that » enables minimally invasive life-saving lung cancer surgeries for patients told elsewhere that their cancer is inoperable. The multidisciplinary team includes a pulmonary diagnostics specialist, hematologists/oncologists and radiation oncologists who meet on each patient’s case to determine the best treatment.

New Team

Steliga sought out other UAMS experts to deliver his clinic’s evidence-based smoking cessation program: Claudia Barone Ed.D., A.P.N., R.N., a professor in the College of Nursing and an advanced practice partner at the Center for Nursing Excellence, and Erna Boone, Dr.P.H., R.R.T., who chairs the Department of Respiratory and Surgical Technologies in the College of Health Professions.

Barone, a former dean of the College of Nursing, led the successful applications for two one-year Arkansas Cancer Coalition grants to support the cessation program through fiscal year 2014.

She and Boone also received formal training as tobacco cessation counselors. The two stalwarts of patient care and education are responsible for delivering the cessation service, which includes face-to-face counseling before a patient’s surgery, postoperative face-to-face counseling, follow-up phone counseling, and medication, such as nicotine patches.

Turnbow, who had kidney cancer that spread to a lung, recalls his first counseling session with Boone.

“We were just hashing it out, and somehow she drove home to me the mental aspect of smoking,” Turnbow said. “She reinforced my idea of just not taking that first cigarette again. I credit her.”

He was also influenced by Steliga, who told him he could add years to his life if he quit.

Steliga, who also received the formal tobacco cessation training, said most health care professionals tell their patients simply “don’t smoke, it’s bad for you.”

“That’s not telling them anything they don’t know,” Steliga said. “How about ‘Quitting is hard; you’re stressed out and that’s terrible. What can we do to make it easier on you? We have a program for you.’”

The cessation team reports a phenomenal, if still short-term, 70 percent quit rate among its patients. That compares to 4 percent after one year for those who try to quit on their own.

Urgent Matter

A sense of urgency permeates the team, with the latest state Department of Health survey reporting that the percentage of Arkansans who smoke climbed from 22 percent to 27 percent in 2011. Barone said surveyors called only cell phone numbers rather than the past practice of calling landlines and cell phones, which may have skewed the results.

In a ranking of states, Arkansas’ lung cancer death rate also moved from sixth in 2007 to third in 2009 (the latest year statistics are available), the national Centers for Disease Control and Prevention reports on its website.

Barone said the cessation program needs to grow beyond a single clinic to have the broad impact that is needed. She, Boone and Steliga say they hope that will happen given that UAMS’ Vision 2020 Strategic Plan calls for providing tobacco cessation programs for UAMS patients and employees.

Erna Boone, Dr. P.H.

Erna Boone, Dr. P.H., helps deliver an evidence-based tobacco cessation program.

“Quitting smoking is the single most important behavioral change to improve a person’s health, and it is still the No. 1 preventable cause of death and disability,” Barone said.

Word about the successful program is getting around to other UAMS doctors. Mollie Meek, M.D., chief of the Division of Interventional Radiology, said she hopes a similar cessation program can be made available in her clinic.

“We have a lot of lung cancer patients, and right now they have to find cessation programs on their own. It would be fantastic if we could make Dr. Barone’s program part of our patients’ treatment plans,” Meek said.

Steliga said tobacco cessation will also be integral to a lung cancer screening program that’s in development at the UAMS Winthrop P. Rockefeller Cancer Institute.