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Lourdes Offers Two New Technologies for Diagnosing and Treating Lung Cancer Sooner

Two new technologies at Our Lady of Lourdes Medical Center are enhancing physicians’ ability to diagnose and potentially treat lung cancer at an earlier stage.

Electromagnetic navigational bronchoscopy and endobronchial ultrasound combine advanced imaging techniques and specialized tools to access the smaller airways in the outer part of the lung. A significant proportion of lung cancers, called adenocarincomas, develop in the peripheral areas of the lungs and have a tendency to spread to the lymph nodes and other parts of the body.

“Traditional bronchoscopy cannot reach deep into the lungs, where two-thirds of lung lesions are found,” explained pulmonologist Thomas Nugent, MD, Director of Critical Care at Our Lady of Lourdes Medical Center. “Other tests are available, but they are often more invasive and can increase a patient’s risk of complications. Navigational bronchoscopy and endobronchial ultrasound, whether used together or separately to confirm diagnosis, give us direct, guided access to 90 percent of the lung through a minimally invasive procedure.”

Lung cancer is leading cause of cancer death in the United States. Lung cancers can be found by screening, but most are not discovered until they have advanced and are causing symptoms. Like many cancers, early lung cancer diagnosis is a key to survival.

Here’s how each tool works:   Navigational bronchoscopy uses a CT scan of the patient and GPS-like technology to create a three-dimensional “roadmap” of the thousands of tiny pathways, called bronchi and bronchioles, in the lungs. Once the patient is under anesthesia, a bronchoscope (a lighted, flexible fiber-optic tube) is inserted into the mouth and moved down into the lungs.

“The lung branches like a tree. A standard bronchoscope can only visualize the major airways or branches of the tree. The GPS-like guidance provided by the navigational bronchoscopy allows us access and visualization to a much greater portion of the lung,” said Dr. Nugent. “The navigational bronchoscopy can also allow the placing of markers around or near a suspected cancer to help guide surgery or radiation therapy.”

Endobronchial ultrasound (EBUS) helps physicians diagnose and stage lung cancer by determining if the disease has spread to other parts of the body, such as the lymph nodes.

EBUS is a less-invasive alternative to mediastinoscopy, a surgical procedure performed under general anesthesia where several small incisions are made in the chest wall. A thin scope is inserted and tissue samples from the lymph nodes are taken.

During EBUS, a bronchoscope fitted with an ultrasound device is guided through the patient’s mouth into the lungs. EBUS is performed under local anesthesia and can be done in an outpatient setting.

“The ultrasound probe can see through the bronchial wall to identify lymph nodes or lung masses,” said Dr. Nugent. “If an enlarged lymph node or other suspicious mass is observed, we can feed a needle through the scope and aspirate the nodule. The EBUS can improve our accuracy by providing real-time feedback during a biopsy and confirming the biopsy needle is in the lung tissue or lymph node in question.”

Dr. Nugent noted the two technologies can work together so that the patient only has to have one procedure instead of two.

“These technologies guide me to the exact area of the lung needing biopsy as well as allowing us to sample lymph nodes to help in staging of a possible lung cancer. Therefore, it is now possible to have one procedure to diagnose and stage a possible lung cancer whereas before the patient had to have two separate procedures.”

“These procedures are easier on the patient, who may afterwards only complain of a sore throat,” he added. “The earlier we can diagnose and treat a patient’s lung cancer, the greater their chance for survival and improved quality of life.”

For more information, or to make an appointment with Dr. Nugent, please call 1-888-LOURDES or visit www.lourdesnet.org.

 

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