Skip to main content
Log in

Onco-Pulmonology: Exploring a New Frontier in Pulmonary Medicine

  • REVIEW
  • Published:
Current Pulmonology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To detail the proposed skills and roles of an onco-pulmonologist.

Recent Findings

Lung cancer remains the leading cause of cancer-related death in the USA, and it requires a comprehensive multidisciplinary approach to care, which can be affected in some cases by an imbalance of patients and available providers. While pulmonologists traditionally have played an important role in screening, prevention, diagnosis, and palliation of symptoms, training in onco-pulmonology has been proposed to help bridge the gaps in lung cancer care.

Summary

The onco-pulmonologist should be well versed in advanced diagnostic bronchoscopy and pleural procedures. Additionally, the onco-pulmonologist should have an in-depth knowledge of primary cancer therapies for thoracic malignancies and should be able to recognize and treat all common treatment-related toxicities. Ultimately, the onco-pulmonologist may serve in leadership roles at cancer centers including dedicated lung cancer screening programs and lung nodule surveillance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Data Availability

The authors confirm that the data supporting the findings of this study are available within the article text and/or within the respective referenced articles. Please refer to the full reference list below for information on how to access this data, including DOI for each manuscript referenced.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48. https://doi.org/10.3322/caac.21763.

    Article  PubMed  Google Scholar 

  2. Zhao X, Wen X, Wei W, Chen Y, Zhu J, Wang C. Clinical characteristics and prognoses of patients treated surgically for metastatic lung tumors. Oncotarget. 2017;8(28):46491–7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. American Medical Association. AMA Physician Masterfile (Website: https://www.aamc.org/data-reports Dec. 31, 2021).

  4. Gaga M, Powell CA, Schraufnagel DE, Schönfeld N, Rabe K, Hill NS, Sculier JP. ATS/ERS task force on the role of the pulmonologist in the management of lung cancer. An official American Thoracic Society/European Respiratory Society statement: the role of the pulmonologist in the diagnosis and management of lung cancer. Am J Respir Crit Care Med. 2013;188(4):503–7. https://doi.org/10.1164/rccm.201307-1269ST.

  5. • Tandon S, Biraris P, Bhaskar M. ‘Pulmonary oncologist—an idea whose time has come?’, Indian J Med Paediatr Oncol. 2022;43(01):095–096. https://doi.org/10.1055/s-0042-1742638Authors in this study highlight the need for a multidisciplinary approach to lung cancer care, especially in settings with significant shortage of medical oncologists. Training in pulmonary oncology is proposed to increase patient outreach and help close the gaps in care.

  6. •• Tandon S, Biraris P, Bhaskar M. Pulmonary oncology-scope of the pulmonologist. Indian J Med Paediatr Oncol. 2022;43:29–33. https://doi.org/10.1055/s-0042-1742653Authors in this study propose a set of skills that help define the role of a pulmonary oncologist. These remarks are based on the authors’ experience from a first of its kind 2-year training program in pulmonary oncology at their institution.

  7. Dülger S, Doğan C, Dikiş ÖŞ, Yıldırım E, Tapan U, Özmen İ, Satılmış BŞ, İntepe YS, Ocaklı B, Kaçan CY, Budak E, Yıldız T. Analysis of the role of physicians in the cessation of cigarette smoking based on medical specialization. Clinics (Sao Paulo). 2018;73: e347. https://doi.org/10.6061/clinics/2018/e347.

    Article  PubMed  Google Scholar 

  8. Lim G, Park I, Park S, Song S, Kim H, Kim S. Effectiveness of smoking cessation using motivational interviewing in patients consulting a pulmonologist. Tuberc Respir Dis (Seoul). 2014;76(6):276–83. https://doi.org/10.4046/trd.2014.76.6.276.

    Article  PubMed  Google Scholar 

  9. National Lung Screening Trial Research Team; Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395–409. https://doi.org/10.1056/NEJMoa1102873.

  10. Criss SD, Cao P, Bastani M, Ten Haaf K, Chen Y, Sheehan DF, Blom EF, Toumazis I, Jeon J, de Koning HJ, Plevritis SK, Meza R, Kong CY. Cost-effectiveness analysis of lung cancer screening in the United States: a comparative modeling study. Ann Intern Med. 2019;171(11):796–804. https://doi.org/10.7326/M19-0322.

    Article  PubMed  Google Scholar 

  11. • Smith HB, Ward R, Frazier C, Angotti J, Tanner NT. Guideline-recommended lung cancer screening adherence is superior with a centralized approach. Chest. 2022;161(3):818–825. https://doi.org/10.1016/j.chest.2021.09.002. Findings from this study highlight the improved screening ability and increased adherence to lung cancer screening programs with a centralized approach.

  12. Nadig TR, Thomas N, Nietert PJ, Lozier J, Tanner NT, Wang Memoli JS, Pastis NJ, Silvestri GA. Guided bronchoscopy for the evaluation of pulmonary lesions: an updated meta-analysis. Chest. 2023;163(6):1589–98. https://doi.org/10.1016/j.chest.2022.12.044.

    Article  PubMed  Google Scholar 

  13. Vu LH, Yu Lee-Mateus A, Edell ES, Hartley C, Vierkant RA, Fernandez-Bussy S, Reisenauer J. Accuracy of preliminary pathology for robotic bronchoscopic biopsy. Ann Thorac Surg. 2022;S0003–4975(22):01501–6. https://doi.org/10.1016/j.athoracsur.2022.11.022.

    Article  Google Scholar 

  14. Duke JD, Reisenauer J. Robotic bronchoscopy: potential in diagnosing and treating lung cancer. Expert Rev Respir Med. 2023;17(3):213–21. https://doi.org/10.1080/17476348.2023.2192929.

    Article  CAS  PubMed  Google Scholar 

  15. Wagh A, Ho E, Murgu S, Hogarth DK. Improving diagnostic yield of navigational bronchoscopy for peripheral pulmonary lesions: a review of advancing technology. J Thorac Dis. 2020;12(12):7683–7690. https://doi.org/10.21037/jtd-2020-abpd-003.

  16. Bibby AC, Dorn P, Psallidas I, Porcel JM, Janssen J, Froudarakis M, Subotic D, Astoul P, Licht P, Schmid R, Scherpereel A, Rahman NM, Cardillo G, Maskell NA. ERS/EACTS statement on the management of malignant pleural effusions. Eur Respir J. 2018;52(1):1800349. https://doi.org/10.1183/13993003.00349-2018.

    Article  PubMed  Google Scholar 

  17. American Association for Bronchology and Interventional Pulmonology. Proposal for ACGME Recognition of a New Sub-subspecialty in Interventional Pulmonary Medicine (Website: https://www.acgme.org/globalassets/pfassets/proposalreviewandcomment/interventional-pulm---new-sub-proposal.pdf).

  18. Gaga M, Sculier JP, Rabe KF. Pulmonologists and lung cancer: pivotal role in multidisciplinary approach. Eur Respir J. 2013;42(5):1183–5. https://doi.org/10.1183/09031936.00145813.

    Article  PubMed  Google Scholar 

  19. Shankar B, Zhang J, Naqash AR, Forde PM, Feliciano JL, Marrone KA, Ettinger DS, Hann CL, Brahmer JR, Ricciuti B, Owen D, Toi Y, Walker P, Otterson GA, Patel SH, Sugawara S, Naidoo J. Multisystem immune-related adverse events associated with immune checkpoint inhibitors for treatment of non-small cell lung cancer. JAMA Oncol. 2020;6(12):1952–6. https://doi.org/10.1001/jamaoncol.2020.5012.

    Article  PubMed  Google Scholar 

  20. Zhang X, Lin D, Pforsich H, Lin VW. Physician workforce in the United States of America: forecasting nationwide shortages. Hum Resour Health. 2020;18(1):8. https://doi.org/10.1186/s12960-020-0448-3.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rahib L, Wehner MR, Matrisian LM, Nead KT. Estimated projection of US cancer incidence and death to 2040. JAMA Netw Open. 2021;4(4): e214708. https://doi.org/10.1001/jamanetworkopen.2021.4708.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

All authors participated in the outline of this manuscript. I.L. wrote the first draft of this manuscript as well as drafted Table 1 and Fig. 1. A.L. modified the manuscript text, as well as Fig. 1 and Table 1. D.S. reviewed this manuscript and provided final recommendations before submission.

Corresponding author

Correspondence to Daniel H. Sterman.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Laniado, I., Velez, A. & Sterman, D.H. Onco-Pulmonology: Exploring a New Frontier in Pulmonary Medicine. Curr Pulmonol Rep 13, 209–213 (2024). https://doi.org/10.1007/s13665-024-00342-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13665-024-00342-3

Keywords

Navigation