News and Events

A Call for Compassion in Lung Cancer Care

Wednesday, October 1, 2025

Lung cancer is a highly stigmatized form of cancer. It is the leading cause of cancer death, however, “quantum leaps” in screening, diagnosis, and treatment mean lung cancer is no longer a death sentence.

M. Patricia Rivera, MD, chief of Pulmonary and Critical Care Medicine, is a member of the American Cancer Society National Lung Cancer Roundtable and co-chair of the roundtable’s Health Equity Task Force. She and fellow roundtable members recently issued a call for greater hope and compassion in lung cancer care.

Below, Rivera offers advice for physicians to better engage with patients who have lung cancer or who are at risk of developing it.

Abolish Blame

Individuals with lung cancer, particularly those who have smoked, are often blamed by society for bringing on cancer. It’s easy to forget that nicotine is a very potent, addictive, and legal drug—one that is marketed to teenagers and readily available in all communities, especially underserved communities. People smoke because they are addicted, not because they don't care about their health. As physicians, we must be mindful in every patient interaction to avoid insinuating blame.

Stop Using the Term “Smoker” and Other Stigmatizing Language

For years, the National Lung Cancer Roundtable Stigma and Nihilism Task Force has called for healthcare workers, including physicians, to stop using the term smoker and to use person-first language like “person who smokes” instead. But I still see “smoker” and “lung cancer patient”—terms that are stigmatizing and reduce a person to a particular behavior or condition—in most manuscripts I review for major journals. Switching to person-first language is a simple thing you can do immediately to better engage with patients who have lung cancer.

Lead with Empathy

As a pulmonologist, I’ve had many conversations with patients who have just found out they may have or do have lung cancer. These are invariably difficult and delicate conversations, delivering what is likely the worst news these patients have ever received. Once, a fellow in training initiated one of these conversations by first asking the patient, “How much do you smoke?” Smoking history is important to capture, but if that’s your introductory question, you have already stigmatized the patient. It was a teachable moment for the fellow and an example I still use to highlight the importance of leading with empathy. Your first priority should be to understand the patient’s experience. What are their symptoms? Do they have any pain? Saving questions about smoking history for later in the conversation reduces the chance that they will be perceived as accusatory.

Screen, Screen, Screen!

In the last 20 years, the survival rates for lung cancer have improved annually because we're detecting it earlier and treating it more effectively. However, as of 2022, only about 20 percent of eligible individuals are being screened. Under current guidelines, individuals between the ages of 50 and 80 who have a 20-pack-year history of smoking (i.e., one pack of cigarettes per day for 20 years, or two packs a day for 10 years, etc.), and if quit smoking, have quit within 15 years, should be screened. For clinicians, the challenge is confirming the smoking history. Patients’ smoking habits often change over time, and patients who have quit can fall through the cracks. Physicians and advanced practice providers must thoughtfully dissect each patient’s smoking history to get an accurate pack-year estimate and to ensure that all eligible patients are offered and educated about lung cancer screening.

Help Patients Quit Smoking

Quitting smoking is by far the most important intervention to prevent patients from developing and dying from lung cancer, but many patients lack access to smoking cessation support and treatment. Only 22 states provided comprehensive coverage of tobacco cessation treatment through Medicaid. As physicians, we must advocate for better access to tobacco cessation support and pharmacotherapy, and offer empathetic and supportive counseling for all patients who smoke. Here are several regional and state resources physicians and advanced practice providers can use to help patients quit smoking:

• Wilmot Cancer Institute Tobacco Cessation Program
• Center for Community Health & Prevention Nicotine Dependence Treatment
• The Center for a Tobacco-Free Finger Lakes helps health care systems design and implement nicotine addiction treatment policies and guidelines
•  New York State Quitline and Quitsite

URMC Joins National Network for Bronchiectasis and NTM Care

Friday, March 14, 2025

Alexandra Adams, MDSonal Munsiff, MDThe Medical Center is among 33 centers across the country selected for the Bronchiectasis and NTM Care Center Network.  URMC was named a Clinical Associate Center, the only site in Upstate New York, supporting specialized care for bronchiectasis and nontuberculous mycobacterial (NTM).

Sonal S. Munsiff, MD, of Infectious Diseases, and Alexandra Adams, MD, of Pulmonary Diseases and Critical Care, are co-directors of the center.

“We are proud to be part of the first national network for the treatment of these highly complex lung infections,” said Munsiff. “This national designation is a testament to our leadership in providing outstanding patient care and in conducting cutting-edge research in lung diseases.”

The network aims to develop standards of care that can be implemented across different centers, reduce the diagnosis time and support high-quality care.

“This designation will provide us greater access to clinical research trials to treat these conditions and help improve the standards of care for bronchiectasis and NTM patients across Central and Western New York,” Adams said.

More than 300,000 people in the United States are treated for bronchiectasis each year.  It is characterized by enlarged airways that are thickened or scarred, making it difficult to clear mucus buildup. NTM is a chronic condition caused by mycobacteria and impacts people with compromised immune systems or other lung conditions, like bronchiectasis or COPD.

Network centers will create a national registry of patients, which will help management of the diseases and improve patient outcomes. The teams are working to establish a registry in the EMR to track bronchiectasis and NTM patients and support research.