By Rose de la Cruz | Published: November 25, 2020
In the medical profession, doctors must keep upgrading their knowledge and skills through further studies and specializations to enhance their practice and at least get recognized in the medical profession through newsletters or journals.
Dr. Arthur Romero, critical care pulmonologist, had been upgrading his skills through further and continuous studies while constantly searching for ways to reduce deaths from lung cancer and other pulmonary afflictions. These advancements are also to manage the pain for patients through improved treatment protocols with the least use of the operating room.
Sidetracked By COVID-19
In the era of COVID-19, Dr. Romero’s dedication to lung cancer treatment and pain management, had to be sidetracked by the more contagious coronavirus —with still no known vaccine to address it and which has caused 257,000 deaths in the United States as of November 22.
Romero was described in the recent newsletter of the University of Nevada in Las Vegas as the one “frequently called upon during this pandemic, to help patients critically ill with COVID-19.”
Most Deadly Of All
The UNLV newsletter said that 1 in 4 cancer deaths are from lung cancer. This makes it the leading cause of cancer deaths among both men and women.
“More people die each year of lung cancer than of colon, breast and prostate cancers combined. In 2020, the American Cancer Society estimated there will be about 135,720 deaths from lung cancer.”
Dr. Romero has been working at better treatment of patients with lung cancer, with 3 years of post- graduate Pulmonary Critical Care fellowship in 2007 to 2010 at the University of California San Francisco, Fresno, focused on diagnosing and treating disorders of the respiratory system, the UNLV said.
He recently described his role as “helping patients breathe better and give them the best quality of life possible in the time they have left.”
In 2015, he formed a team of doctors and nurses all involved in cancer care and initiated the SPOTS or Screening for Pulmonary Oncologic Tumor Services Program at UMC, which started as a screening program for lung cancer. But this later evolved into a multi-specialty group including a thoracic surgeons, medical and radiation oncologists, pathologists, an oncology nurse navigator, and himself.
“We saw the patients in our respective offices but met every two weeks in a Thoracic Tumor Board to discuss and coordinate the care of patients,” he said.
“It was as if the patient was seeing all the specialists at once and we would send the patient, after formulating a consensus treatment, to whomever is next in the management plan. We made sure there was no lag in their care,” Dr. Romero further explained.
He acquired skills in bronchoscopy for biopsy previously unreachable lung nodules but as the cases became more complex, he found that he wanted to do more.
Dr. Romero underwent a year-long advanced fellowship in interventional pulmonology at UCSF in July 2019. This focuses on minimizing the invasive procedures to help patients with lung cancer.
From this, he learned novel therapies to offer patients with severe chronic obstructive pulmonary disease or COPD, refractory pleural effusions, and interstitial lung diseases. His goal was to set up this program in UNLV, the first and only such program in Nevada.
But COVID struck last March and he had to return from his training to help in the ICU frontlines.
Dr. Romero said, “I want to do all I can to help people overcome COVID-19 infection and with vaccination still on the horizon, physicians must do what they can to support and help patients recover usually with a regimen of convalescent plasma, the drug Remdesivir and a course of high dose steroids.
“We also put patients on specialized nasal breathing devices or pressurized face masks as long as they can tolerate these. We like to keep them breathing on their own as long as possible.”
Frustrating … Sometimes
Dr. Romero admits that sometimes it gets to be frustrating, still “I have to give credit to our nurses, respiratory therapists and other staff and trainees, the UNLV residents and fellows who are with us every single moment caring for these patients.
“We couldn’t do without them,” he said citing the difficulty of ensuring that patients on ventilators, esp. the most sick, are positioned alternately between lying on their backs and stomachs which would need 3 to 4 medical professionals to do this each time.
“This would help open up the lungs that may have been compressed in one position and decrease their oxygen requirements.”
Dr. Romero expressed confidence that the day will come when “we will get past COVID and lung cancer will still be there. In fact, it is here now and will not go away.”
He is now able to intubate a COVID patient without using the OR and keep these available for other procedures.
Dr. Romero graduated from the UP College of Medicine and did his post graduate work and earned his Master’s in Medical Information at Erasmus University in Rotterdam (the Netherlands) before going to UCSF Fresno for postgraduate medical training.
Love, Support Needed
The “no visitor policy” of hospitals, he said, makes it more difficult for both families and medical practitioners alike.
“In the pre-COVID era, we always had families involved in the care of ICU patients. They were always there at bedside spending time with their loved ones and helping them recover more quickly. This allowed for a constant flow of communication and for us to take care of the family, too.
“Given the current high risk of transmission, no visitors are allowed except during the end-of-life scenarios. So this has clearly been very difficult for family members and adds to the complexity of caring for the COVID patients. It has become part of our routine to call and update family members daily,” Romero concluded.