Pulmonologists: Trusted Guides on the Lung Cancer Journey

Juhi Kunde, MA

Anil Vachani, MDAnil Vachani, MD, a member of LUNGevity’s Scientific Advisory Board, routinely sees patients who are suspected of having lung cancer. As a pulmonologist, or lung disease specialist, in the thoracic oncology program at the University of Pennsylvania, he is often the first doctor his patients see after an abnormality has been detected on their lung CT scan or X-ray.

“Many patients are referred to me because they have a small lesion or nodule in their lungs. They are often pretty worked up and anxious,” he explains. “I end up spending a lot of time educating patients, calming them down, and of course, assessing whether the lesion is likely to be cancer.”

Dr. Vachani wishes his patients knew that that most of the lesions he sees are actually benign. These small lesions are frequently caused by harmless scar tissue or an infection that can be cured with antibiotics.

When pulmonologists suspect that a lesion might be cancerous, they choose the optimal approach for each patient to get more information about their lesion. This is typically a needle biopsy, bronchoscopy, or surgery.

If the lesion is cancerous, pulmonologists discuss the diagnosis with the patient. “It can be challenging to have those conversations with patients,” notes Dr. Vachani. “But I also think those conversations inspire me to stay focused on the latest findings in the field of lung cancer treatment, so I can help my patients get the best possible outcomes.”

Because the field of lung cancer treatment is evolving rapidly, Dr. Vachani and other pulmonologists need to stay current on the latest surgical treatments, chemotherapies, radiation oncology treatments, clinical trials, and immunotherapies. In addition, they also stay up to date on which biomarkers to test for during biopsies, so that if a patient has a mutation that is targetable by a therapy the treatment can start as soon as possible.

“I act as a guide to set my patients on the right path for optimal treatment,” he says. “And I try to arm them with as much information as possible about their cancer—which subtype of lung cancer they have, what the cancer’s stage is, whether any key biomarkers are present, and so on.”

Once he has diagnosed a lung cancer patient, Dr. Vachani transitions the patient to an appropriate specialist. “I don’t usually follow these patients after diagnosis unless I can add more value to their care,” he explains. “So, once they are diagnosed, many of my patients are transitioned to an oncology team. However, if a patient has underlying lung disease, such as COPD [chronic obstructive pulmonary disease] or emphysema, then I continue treating the patient for that issue throughout their cancer journey.”

When Dr. Vachani is not seeing patients, he, like many pulmonologist, conducts research. Pulmonologists collaborated with radiologists to develop low-dose CT screenings, our current standard for detecting lung cancer in high-risk individuals at earlier stages when it is most treatable. Pulmonologists, including Dr. Vachani, also conduct research to improve the techniques used to biopsy and diagnose lung cancer.

As a member of LUNGevity’s Scientific Advisory Board, Dr. Vachani is able to leverage his research expertise and his experience in the clinic to help direct LUNGevity’s research projects. “I like to contribute to the Board’s discussions about the most exciting and interesting research,” says Dr. Vachani. “LUNGevity is a tremendous organization with a committed leadership team and an impressive mission. Working with LUNGevity is a good use of my professional skill set and is very satisfying to me personally.”

Juhi Kunde, MA, is a science writer for LUNGevity. Juhi Kunde


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