Lung Probe Aids Lung Cancer Screening
Dr. Costanzo Di Perna, a thoracic surgeon at Mercy San Juan Medical Center, seeks to dispel the notion that lung cancer means certain death says the Sacramento Bee.
The prevailing attitude among victims of the disease and some doctors, he said, is “nihilistic.”
“They think everybody dies. It’s not true. We have to prove that it’s an untruth, when lung cancer is caught early and taken out early,” he said.
Since January, Di Perna has been making his case – using technology new to the capital area that allows doctors to zero in on tiny lesions that could potentially grow into massive, deadly tumors. The idea is to find the tumors before they grow.
Currently, only one in six cases of lung cancer are caught in the earliest, most curable stage, according to the Lung Cancer Alliance.
The group says the disease kills an average of 437 people a day in the United States – more than breast, colon and prostate cancers combined.
Yet considerably less funding goes into lung cancer research. In 2008, the federal National Cancer Institute spent $248 million on lung cancer research – compared with $285 million for prostate cancer and $573 million for breast cancer.
Unlike mammograms for breast cancer or colonoscopies for intestinal cancers, there are no systematic screening programs for lung cancer. Many early stage lung cancers are discovered by luck.
Today, lung cancer is often diagnosed using a procedure called a bronchoscopy. Doctors visually inspect lung tissue with a camera-tipped probe inserted through a patient’s mouth.
More than 500,000 traditional bronchoscopies are done annually in the United States, but about two-thirds of the procedures fail to find suspicious tissue because it’s in a part of the lung that is too hard to reach.
Patients rarely exhibit symptoms until tumors grow large enough to affect their respiratory systems – or until traditional X-rays can detect them. Small, soft tissue lesions in the lungs are virtually invisible.
While CT scans have the ability to show some of the tiniest lung lesions, they are usually too expensive or aren’t covered by health insurance.
As imaging technology becomes cheaper and safer, however, more lung cancers are being detected at an earlier stage.
The technology Di Perna uses relies on electromagnetic sensors that allow a flexible probe to follow digital “breadcrumbs” to reach suspicious tissue.
The manufacturer, superDimension, likens the technology to a GPS navigation system for the lungs that guides the surgeon through the organ’s intricate network of airways.
Like a traditional bronchoscopy, the scope is inserted through a patient’s mouth and into the lungs. Real-time images from an attached camera lens help the surgeon navigate the lungs’ larger pathways.
As the probe goes deeper into areas inaccessible by the lens, the surgeon uses a computer-generated image of the lungs displayed on a nearby monitor to guide a thinner probe through the organ’s narrower airways. The software produces digital markers, seen on the monitor, that the surgeon follows until the suspected tumor is reached.
The probe then collects a tissue sample for analysis.
A 2007 study published in the Journal of Bronchology concluded that the procedure was “a safe, effective and noninvasive alternative” for diagnosing lesions and tumors in the lungs’ hard-to-reach areas. It further said that the technique “might reduce the necessity for more-invasive, higher-risk diagnostic procedures, or unnecessary surgery.”
Mercy San Juan officials tout the technology as a money saver. The superDimension technology cost the hospital about $180,000 to purchase. The machine is expected to save consumers and their insurers thousands of dollars in hospital stays and unneeded surgery.
Previously, doctors relied on needle biopsies, but the procedure sometimes lacked precision and couldn’t always get to a suspected tumor. They could also do surgery to get a tissue sample, but that’s invasive and puts the patient at risk of severe complications, including infection or worse.
Or doctors could simply wait to see whether a small lesion grew into a cancerous tumor before taking action – an option that could make the tumor more difficult to treat, particularly if it had spread.
Beatrice Conerly, 66, sought advice from her doctor two years ago when she developed what she thought was a cold that wouldn’t go away. An X-ray revealed a quarter-sized lesion in her right lung. A biopsy confirmed a tumor.
Her doctor ordered six weeks of radiation and chemotherapy. But more recently, another doctor found a suspicious new mass in her lungs. A surgical biopsy would be too risky because of her age and her lungs’ delicate condition.
Her doctors recommended the less-invasive bronchoscopy that allowed the camera-tipped scope to navigate her airways – without surgery, to her relief – and help doctors diagnose the lesion.
“They said it was a new thing and said they didn’t have to do any cutting,” Conerly said.
“Well, that sounded good to me – instead of opening me up and doing all that stuff,” she said. “I heard too many stories about people with surgeries and bad experiences.”
Still, surgery may be the inevitable treatment once a tumor is found.
“Surgery is still the best and only proven method to cure lung cancer,” Di Perna said.