Jacki’s Story: ‘Very Grateful’ for Multidisciplinary Cancer Care

Jacki Hagelberg received unexpected news after getting a calcium score test to assess her heart disease risk: In the images of her heart, doctors saw a large mass that looked like cancer on the left upper lobe of her lung. “I was knocked sideways,” Hagelberg said. “I had no coughing or shortness of breath. I go to the gym. I do yard work. I only smoked briefly in college, 50 years ago. I didn’t expect that.”

Hagelberg’s primary-care physician recommended that she see Charles Mulligan, M.D., a thoracic surgeon at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute. In July 2023, shortly after the finding, Mulligan examined Hagelberg and reviewed her CT scan. He then ordered a PET scan, a brain MRI and pulmonary function tests. He recommended surgery to remove the tumor. Hagelberg sought a second opinion at Penn Medicine. The surgeon offered the same treatment, so she returned to ChristianaCare.

“I came back because I like Dr. Mulligan, and he was confident that he could remove it, then do chemotherapy, and I’d be good,” Hagelberg said. “Also, it’s 20 minutes from home. When you’re coming home from surgery or chemotherapy, not feeling 100%, I wouldn’t want to sit in the car for an hour. It’s been a very good experience.” After surgery, Hagelberg learned she had stage IIIa adenocarcinoma. She then met with her multidisciplinary cancer center team, which included Mulligan, medical oncologist Gregory Masters, M.D., and Karen Karchner, BSN, RN, OCN, a nurse navigator, as well as a nutritionist, social worker and psychologist.

“The multidisciplinary cancer center model (MDC) allows multiple treating specialties to see and evaluate the patient,” Mulligan said. “It allows for multiple viewpoints, which broadens the view of the patient.” With the patient present, providers discuss their opinions and create a unified plan of care.

“People find it very reassuring to hear the different opinions, and that it’s okay to have some difference of opinion and still come up with a unifying plan,” Masters said. Hagelberg’s multidisciplinary team recommended four rounds of chemotherapy starting in October 2023, followed by three years of targeted therapy (a daily pill). She qualified for targeted therapy because molecular testing identified a tumor mutation that responds to treatment. “It’s a breakthrough, almost doubling the chance that she’ll stay cancer-free,” Masters said. “Being part of the multidisciplinary clinic allows us to get molecular testing done more quickly, offering her the most up-to-date therapy for the best prognosis.” Patients treated in multidisciplinary cancer centers tend to have positive experiences and outcomes. They may have better survival rates, less cancer recurrence, and higher quality of life than patients in other settings, according to research.

“I’m really pleased with my care at ChristianaCare,” Hagelberg said. “Going to a place where multiple services are available and everybody uses the same treatment plan and communicates with each other makes it a smooth experience. I’m very grateful.” One of Hagelberg’s favorite aspects of the multidisciplinary team is Karchner, the nurse navigator. “I can’t say enough about her,” she said. “She ties all the pieces together, making sure Dr. Mulligan and Dr. Masters have everything they need. She’s my point person, if I have questions.” Hagelberg has completed one-third of her targeted therapy treatments. Her cancer is in remission, her doctors monitor her health regularly and her prognosis looks good. “Our patients get top-quality, multidisciplinary, collaborative care under one roof, with access to everything you’d have at bigger cancer centers or universities,” Masters said. “Mrs. Hagelberg went to Penn and came back to ChristianaCare for treatment. She’s very well-educated, and she figured out for herself that this was the place to be."