Building a better path to early cancer diagnosis

The James Cancer Diagnostic Center: a new ‘front door’ to cancer care

The Cancer Diagnostic Center helps patients get a confirmed cancer diagnosis and start treatment as quickly and easily as possible.

“We have a commitment to our community to take care of our people. It was a relief to do the right thing and address a gap in our access to care,” says Erin Heuser, MBOE, RT, who was part of the Cancer Diagnostic Center’s opening team.

Since opening, the Cancer Diagnostic Center has served 2,400 patients, supporting 60-80 new patients each month. The goal is to get everyone an appointment within a few days; many get same-day appointments. About half of the patients are diagnosed with cancer. The rest are referred to primary care providers or other specialists.

What they share is the comfort of getting an answer quickly and having a plan for the next steps. Mindy Steinbrunner, who was diagnosed with Hodgkin’s lymphoma after finding a lump above her collarbone, says, “I can't imagine a better setup to help you step through that initial uncertain diagnosis process.”

Early detection gives cancer patients the best chance for positive outcomes

“Patients may have a better care experience, experience less treatment toxicity and have a better quality of life if we can catch the disease early,” says Raquel Reinbolt, MD, medical director of the center.

Patients at the center also experience more personalized care. A nurse supports patients from the moment they reach out. Appointments are longer than typical medical appointments and staff stay in close touch through a warm handoff to the next stage of care. “The magic happens when the patient comes to the clinic because the team is outstanding. We walk patients through this hand-in-hand,” Dr. Reinbolt says.

Breaking barriers to cancer diagnosis, one patient at a time

During the pandemic, when patients were delaying diagnostic testing, the Cancer Diagnostic Center was expedited to help correct that gap. Today, the team continues to break barriers and sometimes even bang on doors to help patients. “This is a terrifying time, and we’re not afraid to push if we have to get an answer faster,” says Rupa Ghosh-Berkbile, DNP, APRN-CNP, an oncology nurse practitioner.

How the diagnostic center works

• A patient came in with a CT scan of his neck that showed abnormalities. That same day, he was able to get more imaging, a lymph node biopsy and a same-day appointment with a head and neck cancer specialist. Later that week, his biopsy results confirmed an aggressive B-cell lymphoma. Within two weeks, he started treatment.
• A central Ohio woman was visiting Florida for Thanksgiving when she felt pain on her right side. Emergency department testing showed concerning liver lesions. She returned home and self-referred to the Cancer Diagnostic Center. She was seen within a couple of days and received several diagnostic tests. When she did have a positive cancer diagnosis, she was able to start outpatient chemotherapy the next day.

Before the center opened, patients who requested an appointment without a confirmed cancer diagnosis were often told to visit a primary care provider first. There was no centralized means to expedite that process or track what happened next. Those patients without connections to primary care were on their own to try to navigate the health system.

Victoria Krogg, DNP, APRN-CNP, an oncology nurse practitioner, says health care systems can be complicated, and people get lost in the cycle of identifying providers and scheduling. “We take the reins, control their diagnostic workup and stay on it. We know the system and we’re not the ones worried about treatment, so we can give time and attention to find answers.”

What patients who suspect they have cancer can do

Patients can make an appointment themselves or be referred to the Cancer Diagnostic Center — sometimes that day or the next day. “That’s the expectation, and you don’t hear very often in health care the ability to have almost immediate access outside of emergency care, but we believe in shortening that timeline to diagnosis to provide an earlier diagnosis and improve survival,” Dr. Cohn says.

Dr. Reinbolt works with a skilled team of advanced practice providers at the clinic, such as nurse practitioners and physician associates, who have specialty certification in cancer care.

Appointments are typically at least an hour, giving patients time to discuss their concerns and ask questions. Whenever possible, patients even begin cancer diagnostics that same day. From the moment patients call until they receive a diagnosis, staff at the Cancer Diagnostic Center walk them through every step of the process.

By the time a newly diagnosed cancer patient sees a specialist, they have a full diagnostic workup and can focus solely on treatment.

While it’s never easy to tell a person they have cancer, our staff consider it a privilege to make this difficult time a little easier. “I think of all the times I’ve been helped through situations where I didn’t know which direction to head and am so grateful for advice along the way. To be able to use my training and collaborate with a wonderful group of individuals to do the same for others is really important,” Dr. Reinbolt says.

Physicians at The James also benefit from the Diagnostic Center, which allows them to focus solely on patient treatment and research. “At a large academic cancer center like Ohio State, we need those oncologists and hematologists to have as much bandwidth as possible,” says Scott Rowley, APRN-CNP, advanced practice provider manager.

Today, leaders at the Cancer Diagnostic Center present what they’ve built and lessons learned to other cancer hospitals nationwide.

“There’s so much anxiety between the moment you think something is wrong and the moment you have a plan. Filling that gap holistically puts our patients at the center and provides empathetic care. This makes it a really special clinic,” Dr. Cohn says.