Rockwood Clinic PS, of Spokane, says it plans to launch a multidisciplinary program in July to coordinate thyroid cancer care for patients.

The program will be based at Rockwood's Cancer Treatment Center, in Spokane Valley, which has been open for about a year.

At regular intervals, a number of doctors in different medical specialties who have an interest in the diagnosis and treatment of thyroid cancer will devote time to the program so patients could see on the same day all the specialists they need to see.

"Delivery of cancer care needs to be an integrated model," says Dr. Renu Sinha, a surgeon who is one of the team members. Rockwood Clinic is moving toward a similar care model with other cancer specialties as well, bringing specialists in several disciplines together regularly to discuss cases on the same day patients are seen at the clinic, Sinha says. The approach will reduce the time and travel expense for patients who might live out of town, and seeks to make it easier for patients to get the care they need quickly. It also streamlines and improves patient care when doctors can discuss patients' issues together, rather than rely on notes written at the end of the day and faxed to other providers, she says. Sinha says Rockwood hasn't determined yet how frequently it will offer the program.

Physicians in the thyroid cancer program will include specialists in radiology, endocrinology, and surgery, as well as medical oncology and radiation oncology. The doctors involved in the program include endocrinologists Carol Wysham and Lynn Lagerquist, surgeons Andre LaSalle, and Sinha, head and neck surgeons Mark Bassett and Kevin McVey, and radiologists.

The location of Rockwood's Valley center also is ideal, Sinha says, because Rockwood offers radiology and radiation oncology services in the same building, so imaging studies and other tests and treatments can be done on site as well.

Typically, a patient is referred to an endocrinologist when a doctor detects a suspicious mass or nodule in the thyroid gland, whether through a physical exam or on an imaging study that's done for another reason, Sinha says. The endocrinologist may then order radiology studies or a needle biopsy and a consultation with a surgeon.

Sinha says Rockwood hopes to streamline the process, so patients can have many or most consultations and tests on the same day at the same location.

"The greatest benefit is for the patient," Sinha says.

One of the reasons the clinic is implementing the thyroid cancer program is that thyroid cancer is one of the fastest-growing types of cancer in the U.S., Sinha says. Thyroid cancer patients made about 925 visits to Rockwood Clinic in 2008, and this year the clinic anticipates even more visits from such patients, Sinha says. Though the reasons for the rising numbers of thyroid cancer cases still are being studied, Sinha says that in general, it's believed that people are exposed to more radiation in the environment in their daily lives now than ever before, causing more thyroid cancer cases.

She says Rockwood Clinic hopes that coordinating care across medical disciplines will help improve the long-term prognosis for such patients because although the death rate from thyroid cancer is small—out of the 37,000 new cases diagnosed nationally each year, the survival rate is 98 percent—patients frequently have recurrences years later, Sinha says. Females, people of Asian descent or with a family history of thyroid cancer, or those who have had a goiter, childhood exposure to radiation, or are chronically hoarse all are at higher risk for thyroid cancer, Sinha says.

"With proper follow-up, we can potentially cure" the most common types of thyroid cancers, she says.

Rockwood Clinic is focusing now on letting Spokane-area general practice physicians know that it plans to launch the thyroid cancer program, as those doctors usually provide referrals for cancer treatment. It already has the staff members it needs to operate the program.