RESUMO
Oligometastatic non-small cell lung cancer (NSCLC) has a poor prognosis for rural patients with traditional therapies. Implementation of multi-modality systemic therapy in conjunction with surgical resection can dramatically improve overall survival, leading to clinical complete remission. The currently accepted indications for resection in oligometastatic NSCLC include brain and adrenal metastases. Rural populations are known to have disparities in care of complex malignancies and the use of telehealth has been shown to improve outcomes. We present a case of a rural patient with stage IV NSCLC, who was able to participate in two clinical trials, undergo trimodality therapy, and remain disease-free for 18 months, whose care was facilitated via telehealth video conferencing with a tertiary care center.
RESUMO
Small rural hospitals in the United States have had challenging issues developing sustainable oncology programs. This is a report on the development of a successful rural oncology program. In 2006, the Tahoe Forest Health System in Truckee, CA, a remote mountain resort town, started a cancer program that was focused on addressing patient and family fears that are common to all cancer patients but more frightening in the rural setting. Four years later, it is a thriving program with significant community support, a creative academic affiliation, and a central focus of the future of the hospital. The Tahoe Forest Cancer Center developed a sustainable model for high quality cancer care that overcomes geographic, cultural and financial barriers. This structure may serve as a model for national rural health care.
