Medical director bringing awareness of lung disease

Marcia Shottenkirk

07/29/2001

---

 

It's one of the deadliest, most aggressive diseases, sometimes claiming its victims before treatment can begin.

But not much is heard in the news about lung cancer.

"It's a matter of not having a champion," Dr. James Blalock said. "With breast cancer, the victims and survivors have put a face on women's health issues and helped to spread a message of awareness. That's led to prevention in many cases. But nothing captures the public's attention until it has a champion."

As the medical director of the new Lung Cancer Detection and Treatment Center at St. Anthony Hospital, Blalock wants to see that patients have a chance to be champions of the illness.

Before the center opened this month, it would take between six and eight weeks from the time a patient was diagnosed to the first treatment. But in fighting lung cancer, time is of the essence.

That led the pulmonary disease and critical care doctor to set up a network among himself, a thoracic surgeon, medical oncologist, radiation oncologist and two pathologists at the center. The specialists meet weekly to review patients' charts and X-rays and determine the best treatment methods.

"Part of what we're trying to do is shorten the time between diagnosis and treatment. Weeks - even days - count when you're treating lung cancer.

"Now, we can see a patient, make the diagnosis and recommend treatment within one week," he said.

"Hopefully, we'll be increasing our patients' rate of survival. I know we'll be calming some of their anxiety."

Blalock's concern for his patients resonates in his casual, comfortable demeanor and carefully chosen words. He relates his thoughts to his patients in a language they can understand.

"Science and medicine can be so complicated that doctors can get detached from the human side of it. It's always important to step back and see it from the patient's perspective," he said.

Blalock said the best advice he ever received came from Dr. Solomon Papper at the University of Oklahoma medical school: "It's more important to do right than be right."

In other words, a patient's wishes come before a doctor's desires.

"I always tell the residents here that caring for the patients is the central thing," he said.

During his college years at Yale University, Blalock's deep desire to help people kept him enrolling in prerequisite courses for medical school even though he was majoring in English.

"All through undergraduate school, I didn't know I would go into medicine. I just kept that option open," he said, with a reminiscent smile. "It was something that was always in the back of my mind."

It wasn't until he was nearly through with his training in internal medicine at the OU medical school that he turned to pulmonary disease and critical care as a specialty.

"My older brother, Bob, became a pediatrician, a neonatologist actually. Seeing the critical care angle he went into led me to want to do the same.

"It's practicing basic care but taking it a step further."

Blalock has practiced medicine at St. Anthony since completing his training in 1983.

"I've always enjoyed it here in Oklahoma City and at St. Anthony. It's where I belong."

And, it's where he's needed.

In Oklahoma, there is a higher rate of lung cancer than the national average and an increase in the cancer in nonsmokers and in women, according to the Centers for Disease Control and Prevention.

An estimated 200,000 cases of lung cancer will be diagnosed in the United States this year alone.

California, Florida and Texas lead with an estimated 10,000 cases per state, while Alaska, District of Columbia, Hawaii, Montana, North Dakota, South Dakota, Utah, Vermont and Wyoming will have fewer than 500 cases per state, the American Lung Association has reported.

Oklahoma falls somewhere in the middle with about 2,500 new cases expected.

"We do have more than our share, in part because the number of cigarette smokers is higher here. The image of the Marlboro Man is so strong here," Blalock said.

"But that's not the only thing to blame. Actually, we're seeing the cancer in more and more nonsmokers."

That statistic intrigues him.

"In other fields, you hear doctors say they have periods where they get tired of it. I've never had that problem," he said.

"There's always new information coming out, new problems to figure out."

In terms of lung cancer research, scientists are now focusing on what's called multimodality treatment.

"Instead of doing surgery to remove a tumor or tumors and then having the patient undergo chemotherapy and radiation, we're looking at doing those first and then looking at surgery," he said.

"Researchers are asking, 'What's the optimum way to treat the patient?'"

But sometimes even the best treatment can fail.

"It's right at the top in terms of deaths," Blalock said of lung cancer. "It leads breast and prostate cancer. A much higher percentage of patients die because it's so aggressive."

Unlike other cancers that can be associated with either men or women, young or old, lung cancer has no stereotype.

"The problem with it is that there isn't one. By the time the symptoms appear, a pain or cough, the disease is fairly advanced, and there's not much that can be done to ensure survival.

"That's why awareness and prevention are so important. And that's why we need a champion."