Andria Caton, M.S.N., RN, OCN, CHPN

Educators, nurses and community members can work together to accomplish great things in lung cancer prevention. Ellen Petree, the Barrow County School System and local health care leaders identified a serious health concern for the residents of Barrow County, Georgia, in 2018.

From left: ELLEN PETREE and ANDRIA CATON, M.S.N., RN, OCN, CHPN. PHOTO PROVIDED BY PETREE AND TAKEN BY SHENLEY ROUNTREE.

Based on data revealed in a regional community needs assessment conducted by Truven Health Analytics, public health indicators demonstrated that lung cancer death rates, as well as lung cancer incidence rates, were significant health concerns in Barrow County. Furthermore, the incidence and death rates of lung cancer were occurring at higher rates per 100,000 people than the state and national benchmarks. Knowing that tobacco use typically begins in middle- and high-school-age youth, Ellen, the Barrow County School System and local health care leaders searched and reviewed evidence-based tobacco-use prevention programs to implement in elementary schools.

Tar Wars, the American Academy of Family Physicians’ tobacco-use prevention program, was selected as the intervention. The program was implemented by Ellen Petree, along with community nurses and local health care leaders, to reduce the number of future youth tobacco users in Barrow County. With Ellen’s leadership and guidance, the Barrow County School System, teachers, school nurses and more than 2,000 fourth- and fifth-grade students successfully participated in Tar Wars for each of the past three years, including during the COVID-19 pandemic.

Prior to the pandemic, Ellen coordinated the presentation of the evidence-based initiative program, Tar Wars, by local nurses and school nurses in the fourth- and fifth-grade classrooms of each of the nine Barrow County elementary schools. Pre- and post-tests were administered to assess learning gains and to refine future presentations.

Concerned about losing momentum with the students during the pandemic, Ellen organized a virtual delivery of the Tar Wars program with local oncology nurses and worked to have the pre- and post-tests administered online.

To pique interest, increase motivation and fuel participation of the fourth- and fifth-grade students, Ellen has also coordinated a poster contest each year to showcase the students’ learning after the Tar Wars presentations. Winning posters were selected through a Facebook public vote, and students were awarded cash prizes.

Unfortunately, personal habits that lead to the development of lung cancer start at an early age. To spare a future generation the burden and devastation of lung cancer, consistent and early tobacco-use prevention interventions are needed in our communities. Ellen Petree and the Barrow County School System are inspired to improve the long-term health of the community in which they live and work by focusing on the youth today.

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Ellen Petree worked with local health care leaders and community nurses to help reduce the number of children who went on to use tobacco, lowering their risk for lung cancer.

Lung Cancer Hero Implements ‘Tar Wars’ School Initiative Program

 a person who inspires others to pursue a long-term concept. 

 a person who protects others from danger.

Dr. Rami Arfoosh, a pulmonologist, has been defending people with abnormal lung cancer screening exams for more than four years in northeast Georgia. With high rates of incidence and mortality, lung cancer is a dangerous and often silent killer for the residents of northeast Georgia. For Dr. Arfoosh, lung cancer screening, quick referrals and prompt treatment for people with newly diagnosed lung cancer are at the forefront of his daily work.

Under his leadership of chest board, an interdisciplinary team that reviews abnormal lung cancer screening exams, he has directed the evaluations of over 200 abnormal lung scans, assisted with the identification of over 50 early-stage lung cancers, gradually improved the time to treatment for those with newly diagnosed lung cancer and facilitated prompt referrals for people during the COVID-19 pandemic. By the end of 2020, Dr. Arfoosh and the chest board completed 

more lung cancer screening exam evaluations than the previous year and cut the time to treatment almost in half. Dr. Arfoosh’s achievements in early detection and prompt treatment of lung cancer are most certainly rooted in his ability to collaborate with the interdisciplinary team to identify the best evidence-based approaches to care.

Dr. Arfoosh relentlessly strives to improve overall lung cancer care in northeast Georgia. Recently, his visionary concept of implementing a lung nodule clinic to detect earlier-stage lung cancers for people in Northeast Georgia that do not fit into the traditional lung screening guidelines is in the early phases of development.

From left: Dr. Rami Arfoosh and Andria Caton, M.S.N., RN, OCN, CHPN.

Dr. Arfoosh cares about people after they receive a lung cancer diagnosis. Dr. Arfoosh lends his assistance and backing to the monthly community lung cancer support group, and he frequently speaks to the group (who are often patients in his practice) on survivorship issues and long-term side effects of lung cancer treatment.

In addition to his passion for early detection and prompt treatment of lung cancer, Dr. Arfoosh is a lifelong learner and teacher. He takes time to mentor physician residents, physician assistant students and medical students in his daily pulmonary practice. During chest board discussions, he can be heard taking additional time to explain radiographic findings, review clinical data and reinforce evidence-based guidelines with the students. Dr. Arfoosh ensures the success of lung cancer care in the future by investing his time with residents and students today.

The people of Northeast Georgia are fortunate to have Dr. Rami Arfoosh, a dedicated visionary defender in the fight against lung cancer.

Lung cancer is a dangerous and often silent killer for the residents of northeast Georgia. For Dr. Arfoosh, lung cancer screening, quick referrals and prompt treatment for people with newly diagnosed lung cancer are at the forefront of his daily work.

Andria Caton, M.S.N., RN, OCN, CHPN

Lung Cancer Hero Implements ‘Tar Wars’ School Initiative Program

Meet the Visionary Defender of Early Detection and Prompt Treatment

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