Lung cancer patients are evaluated by a multidisciplinary team of physicians who specialize in the treatment of lung cancer through the Comprehensive Lung Cancer Program. This team of physicians meets on a weekly basis to discuss all current lung cancer patients. The dedicated team of specialists includes thoracic surgeons, pulmonologists, medical oncologists, radiation oncologists, chest radiologists, pathologists and interventional radiologists. In addition to this group of multi-specialty physicians is an extensive and committed support staff that includes physician assistants, nurse practitioners, nurses and tumor registry staff. The combined effort of all of these dedicated individuals generates a dynamic environment for the efficient management of lung cancer patients.
Flexible bronchoscopy involves the placement of a video scope into your airways. This allows us to inspect the airway looking for any area of tumor involvement and potential blockage of the air passages. This procedure can be performed for either diagnostic purposes or therapeutic purposes. Bronchoscopy can be performed as a separate procedure or at the time of surgical resection of a lung tumor.
Endobronchial Ultrasound (EBUS)
This is a specialized type of bronchoscopy that examines the airway with ultrasound technology to help visualize tumors or lymph nodes outside of the airway. This procedure can be performed for the staging of lung cancers looking for spread of tumor cells to the surrounding lymph nodes. This procedure may help avoid an open approach (see mediastinoscopy below) to biopsying these lymph nodes. St. Luke's thoracic surgeons recently were the first to perform this innovative technique in the Lehigh Valley.
This procedure is performed in the operating room under general anesthesia. A scope is placed through an incision in the lower portion of the neck allowing the visualization and biopsy of lymph nodes along the windpipe called mediastinal lymph nodes. This helps your surgeon determine your lung cancer staging and plan the next step in treating your lung cancer.
Video-Assisted Thoracoscopic Surgery (VATS) with Biopsy
This is a minimally invasive approach for biopsying a suspicious lung nodule or lymph node, which sometimes is required before a formal lung cancer operation. This involves making two small incisions (1 to 2 cm) on the side of your chest and then placing a video scope into the chest space. This allows us to visualize the lung nodule and then remove it with specialized long instruments. If a cancer is found, we generally can perform a formal lung cancer operation through these same incisions. (See Thoracoscopic Lung Resection below.)
Thoracoscopic (VATS) Lobectomy
This is a minimally invasive approach to lung cancer surgery. The standard treatment for a lung cancer requires removing the lobe in which the tumor resides. We can perform this operation with two small incisions with no rib spreading. A thoracoscopic lobectomy generally provides the patient with less post-operative pain, a shorter hospital stay, fewer complications and earlier return to prior activities. Currently, we perform more than 85 percent of our lobectomies thoracoscopically. At the time of your consultation, the option for a thoracoscopic approach will be discussed. If you are not a candidate for a minimally invasive approach, other options will be offered. (See Complex Lung Resections below.)
Complex Lung Resections
Occasionally, lung cancers are found in difficult locations that do not make them amenable to a thoracoscopic resection. These types of tumors may require a larger incision to be removed (thoracotomy incision). This requires going between the ribs to adequately and safely remove your lung tumor. In these instances, we would offer an epidural catheter for post-operative pain management to help in your recovery. The thoracic surgeons at St. Luke's have extensive experience with complex lung resections which may involve intricate airway reconstruction such as a sleeve lobectomy.
The thoracic surgeons at St. Luke's are members of the American College of Surgery Oncology Group (ACOSOG) and the Eastern Cooperative Oncology Group (ECOG) and have many active protocols for the treatment of lung cancer. At the time of your consultation, the thoracic surgeons will determine your eligibility for any ongoing national clinical trials.