Swedish Cancer Institute’s health education intern, Emily Beers spent time getting to know Dr. Jed Gorden to gain meaningful insights on the thoracic surgery and interventional pulmonology department, challenges with COVID-19, and lung cancer screening guidelines and recommendations. Dr. Gorden is the director of interventional pulmonology and the medical director for the Center of Lung research.
Emily Beers (EB): What inspired you to enter your field of medicine?
Jed Gorden (JG): It's been an evolutionary process, initially I was interested in infectious disease. I did research on malaria and drug resistance before coming to medical school. As I went through medical school and residency I became more interested in pulmonary and critical care. Later, through fellowship, I became more interested in thoracic oncology and built a niche for myself by doing another fellowship. From that experience I gained a skill set which was more weighted in thoracic oncology. This allowed me to fit into the thoracic surgery division and help grow into my own niche field. It wasn't a static decision years ago, but more of a journey to get where I am today.
Emily Beers (EB): How has your approach to care changed or been affected since the COVID-19 pandemic?
Jed Gorden (JG): We have all been affected by COVID-19 both individually and professionally. Early on we were all about distance, safety and pumping the brakes with an eye on utilizing our resources. For a short period of time, cancer staging, and diagnosis were put on the back burner. We have continued to see people with advanced cancer and pleural disease. I know my patient population very well; I deal with their needs and comfort. We are able to build a relationship, which had to be put on a brief pause during the pandemic, but I think that’s coming back. I hope that we are supporting each other, in some ways it's brought us closer together and in other ways further apart. I have to give a big shout out to the front-line workers covering the ICU, day in and day out.
EB: If you had the ability to conjure up large funds for cancer care, or within your field what would be your focus?
JG: I can answer that from experience, we have been very fortunate to receive a philanthropic grant which we used for an infrastructure grant in research. We built a foundation for the next generation who are interested in health sciences to come work with us doing clinical research. This research program will hopefully improve care and our understanding on how to improve access to lung cancer screening for Native Americans, communities of color, and individuals who are in rural areas. This will also improve evaluations for people with advanced cancer and continue to push the needle of mentoring young people to get them excited for healthcare careers.
EB: Can you tell us some examples of the outreach efforts being made by the pulmonary department?
JG: We were awarded a lung cancer grant to do background work on better understanding barriers to access for Native American communities in Washington State. Our active research program is working to create maps of access for individuals which includes data such as where they reside, where their health care is provided, and where their lung cancer screening centers are. This is used to better understand barriers that clinical providers may have towards offering care and which individuals are high-risk due to lack of access. We have a very robust lung cancer screening program which is run by a great group of nurse practitioners. We’re continuing to work and grow in order for these services to be more available to marginalized communities and communities of color.
EB: When should someone see a lung doctor? What are the recommendations or suggestions for lung cancer screening?
JG: The current guidelines, which are up for re-evaluation, are that individuals who are between the ages of 55 and 77 who are actively smoking or quit within the last 15 years and have a 30 pack year history of smoking (a pack a day for 30 years or two packs a day for 15 years) should be screened for lung cancer.
EB: How do you think those recommendations will change in the future since they are up for evaluation?
JG: Currently the guidelines are being relaxed to decrease the pack years and to decrease the age. This is to get a broader testing pool of the impact of vaping and tobacco delivery devices as we transition from traditional stick type tobacco. These products are fairly young, and it took decades to get lung cancer screening proven to be beneficial. We have electronic versions which could be equally as challenging and right now those aren’t in the guidelines. We need to be cognizant of understanding the risks of these products and continue to send the message about how starting tobacco products early leads to longer-term use', the effects of delaying tobacco use, and ways to avoid the tobacco use all together.
EB: Are there any certain opportunities or certain trends in the field you think people should know about?
JG: It’s important for people to be aware of the harmful effects of tobacco. It’s a major contributor of Lung Cancer and we need to continue our mantra in education and challenge new forms of tobacco delivery products. We cannot be complacent and allow new products such as vape to rise in the market without being tested and challenged by the clinical world. Another thing people really need to know in the thoracic world is that treatments have improved considerably. People have a negative connotation of radiation and chemotherapy based on historical events, but the reality is that treatments have improved significantly. Our treatments are less toxic, less invasive and have less negative side effects. We can’t give up on individuals with lung cancer, we need to bring them to specialists and continue to educate everyone who may come in contact with lung cancer patients about the different options.