Emily Stone1, Kathryn Yan2
1Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, University of New South Wales, Sydney, NSW, Australia; 2TLCR Editorial Office, AME Publishing Company.
Correspondence to: Kathryn Yan. TLCR Editorial Office, AME Publishing Company. Email: editors@TLCR.org
Editor’s note
Translational Lung Cancer Research (TLCR) has published a number of special series in recent years, receiving overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. This year TLCR launched a new column, “Interviews with Guest Editors”, to better present our guest editors and to further promote the special series. We also hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.
The special series “Lung Cancer Multidisciplinary Care”(1) led by Dr. Emily Stone (Figure 1) from the St Vincent’s Hospital Sydney and the University of NSW has attracted many readers since its publication. The papers in this series explore important aspects of MDT care including the early introduction of palliative care, the impact on advanced disease, optimal staging in the context of the MDT, gaps in our understanding of how to best implement and test the effects of MDTs, patient outcomes associated with MDT care, lung cancer surgery in the MDT setting and optimized approaches to data systems for the MDT. At this moment, we are honored to have an interview with Dr. Stone to share her scientific career experience and insights on this special series.
Figure 1 Dr. Emily Stone
Expert Introduction
Associate Professor Emily Stone is a respiratory physician and clinician-researcher at St Vincent’s Hospital Sydney and the University of NSW. Her research interests include lung cancer screening, tobacco control and the impact of multidisciplinary team care. She has served as past Chair of the IASLC Tobacco Control Committee and TSANZ Tobacco Control SIG. She is the current Deputy Chair of the Thoracic Oncology Group of Australasia and the recently appointed Editor-in-Chief of the Journal of Thoracic Oncology Clinical and Research Reports. She is committed to equity of access in lung cancer screening, integration of smoking cessation into lung cancer screening programs and to universally available, high-quality multidisciplinary lung cancer care.
Interview
TLCR: What inspired you to become an expert of thoracic malignancies and a respiratory physician?
Dr. Stone: It was the people. I first encountered multidisciplinary work during my training years and the collaborative nature of the work really appealed to me. I also love respiratory medicine as a very core discipline that overlaps with many specialities – I could work in acute care and the ICU as well as community medicine and preventative health.
TLCR: In the Editorial of the special series, you mentioned that “the key areas for future work include the implementation of smoking cessation programs in the multidisciplinary setting, expansion of psycho-oncological support, exploration of patient-related outcomes and the impact of allied health services, including pulmonary rehabilitation in the perioperative period”, etc. Could you elaborate on any of these aspects?
Dr. Stone: They are all important and would need plenty of discussion to address them adequately. But if I just focus on the implications of lung cancer screening, which is starting in the next few years in my country, every one of those areas will need to change. We have to prioritise smoking cessation as part of successful screening, we will have a different set of patient-related outcomes to deal with as more patients become eligible for surgery, we will need specialist nurses to help patients navigate the pathways from screening to therapy and we may need to anticipate different psychological requirements.
TLCR: How do you perceive the role of multidisciplinary care in lung cancer?
Dr. Stone: Crucial. Lung cancer is a complicated area and rapidly changing now in terms of diagnostics and treatment. We know from the literature that high quality multidisciplinary care improves outcomes and this translates to better care in daily clinical practice.
TLCR: How do you see the future of multidisciplinary care in lung cancer?
Dr. Stone: It will continue to evolve. Newer treatment strategies, such neoadjuvant immunotherapy in resectable disease, emphasize the need for high quality multidisciplinary care. Oncologists, pulmonologists and surgeons all need to work together, with pathologists, radiologists and specialist nurses to optimize treatment for these complicated cases. Lung cancer has developed into a highly complex field, which gives us many new opportunities to improve things for patients.
TLCR: Have you conducted multidisciplinary care in the clinic treatment of lung cancer recently?
Dr. Stone: Yes, this is a daily practice. I regularly evaluate the detailed decisions each case requires with my colleagues in the formal setting of weekly multidisciplinary meetings as well as regular informal but highly valuable discussions.
TLCR: If given an opportunity to update this special series, what would you like to moderate, add or emphasize to provide a more informative series?
Dr. Stone: Perhaps I would adapt the series to meet the needs of changing practice – screening, the identification of a range of risk factors, differences that are emerging in lung cancer in women compared with men, the need for nodule MDTs and, as survival improves, changing roles for supportive and palliative care and allied health support. Equity of access to care is essential – screening will make this even more important. The role of consumers is changing too – as advocates, investigators and drivers of change.
Reference:
- Lung Cancer Multidisciplinary Care. Available online: https://tlcr.amegroups.org/post/view/lung-cancer-multidisciplinary-care