April Plank, DNP

By April Plank, DNP, The Center for Lung Cancer Screening and Prevention, Stony Brook Medicine

I realized at a young age that I enjoyed working with people.  This rather broad statement could have led me down endless career paths. My decision to choose the nursing path was easily made after realizing that a nursing degree, while single in its title, yields endless opportunities.  During my years of schooling and internships, I came to discover two common factors that crossed all specialties:  Years of experience trumps book knowledge AND kindness matters.

I chose a full-time position in the medical intensive care unit where I gained experience with critically ill patients, including those with cancer. My notion of cancer being a terminal disease where the medical team is often powerless dissipated as I learned the many ways that a healthcare professional can impact a patient’s life.

I recall quite vividly my first patient with lung cancer.  Ms. E (as we will reference her here) was a 37 year-old heavy smoker who went on life support after she become septic during chemotherapy.  She was weak and frail with a beautiful blue head wrap.  During one visit, she asked me if I knew the song “Amazing Grace” which I would later learn was her father’s favorite song.  I told her that I did know the song well, as it was a regular during the Sunday church service I attended.  She explained that her father was coming in from out of town and she hoped that I would sing it for them during his visit. This request was a surprise but it wouldn’t be the last time that I would be asked to do something “outside of the box.” Shortly into her father’s visit, I heard the familiar sound of Ms. E’s call bell rang requesting the song.  I was joined by three ICU colleagues in the most moving and difficult song as Ms. E mouthed the words as we sang.  There was not a dry eye in the room and shortly after Ms. E. fell into her last sleep.  I wept endlessly as we prepared her for her eternal rest.

As I cried, asking “Why?”, I realized that I might never know all the answers.  I also became keenly aware that while we (nurses) might not always be able to cure patients of their disease, we are ALWAYS able to help make the journey easier and the burden lighter.

That evening, singing to Ms. E and her father, I realized that in addition to all the medications and care that people with devastating diagnoses needed, one thing that all of us in the healthcare profession could offer was HOPE.  Time and time again, I have seen the power of that hope in the eyes and lives of my patients dealing with a cancer diagnosis.

I focused on pulmonary diseases including lung cancer from that time on.  I later subspecialized in lung cancer as I recognized that the more focused I could be, the more expert I would become thus positioning myself to make the greatest contribution to those affected by the disease.

I am happy to report that the years that have passed since singing “Amazing Grace” have brought many changes in the lung cancer treatment arena.  New drugs and therapies as well as new treatments have emerged providing evidence that there is every reason to believe that progress is here to stay.  Lung cancer, which was once thought to be a terminal disease leaving us powerless, is becoming one that can be managed and people are living longer after diagnosis. I take great joy in informing lung cancer patients that HOPE prevails. I have watched in awe as many defy the odds and I enjoy sharing those stories with other’s fighting the disease. In addition to treatment options for those diagnosed, lung cancer screening guidelines now provide opportunities for those deemed at high risk for lung cancer to undergo screening for lung cancer with hopes of increasing early detection of this disease.  This coupled with smoking prevention initiatives in schools, smoking cessation education and environmental hazard awareness will also change the tide with a decrease in the burden lung cancer.

Additionally, I am passionate about helping patients through the guilt and shame that tends to accompany lung cancer as the “smoking cancer.”  They deserve the hopeful news that smoking cessation, even at the time of diagnosis, can result in better response to treatment, increased survival time and decreased rates of lung cancer recurrence.  I encourage every patient to channel their grief and regret for smoking to the mission of raising awareness among the millions of youngsters who are vulnerable in getting caught in smoking addiction.

Here are my words of advice to patients:

  • Never lose hope! And as one of my patients once said, “Live life to the fullest”.
  • Be sure to communicate with your healthcare team. It may be helpful to write down your questions and concerns so as not to forget during your office visits.
  • Don’t be shy about seeking a second opinion.
  • If you are, or were, a smoker; don’t dwell on the past but recognize that each day that the sun rises is a fresh start.
  • Read about patients who have defied the odds of this disease. Know your options for treatment and be sure that all of your questions are answered.
  • You are not alone in this journey. Allow your family, friends and healthcare team to support you along the way.  Consider joining a support group where you may meet someone who is many months or years into the diagnosis and can encourage you as you undergo treatment.

Much progress has been made in the lung cancer arena.  I speak on behalf of many who are honored to work in this field in saying we will not stop until we have found a cure.  Keep the faith and be forever HOPEFUL.