Long-time heavy smokers may benefit from a new robotic procedure at St. Luke’s, which has the potential to diagnose lung cancer in its early, less-lethal stages. St. Luke’s doctors have added this new tool, the Monarch robotic bronchoscope, to their tool kit in hopes of reducing deaths from lung cancer.
This physician-controlled device includes a long, flexible camera affixed to an extending arm, which is inserted into a patient’s lung to reach the suspicious mass for sampling. Working at a remote console near the patient in the operating room, the physician operates the bronchoscope by manipulating a joy-stick-like controller. At the tip is a camera, light and working channel to pass through tiny instruments that can remove a small sample of tissue even in the deepest areas of the lung.
The physician is guided to a suspicious nodule by the Monarch robotic bronchoscope using a GPS-like map created by a computer and facial recognition-like software into which a CT scan of the lung has been uploaded.
“Using this safe, precise, non-invasive device, we can get to the mass, no matter how deep in the lung, take a sample and have a diagnosis sooner, all during the same session in the OR,” says Dustin Manchester, MD, St. Luke’s Thoracic Surgeon. He is leading the use of this robot at the network with his colleague, Pulmonologist Deborah Stahlnecker, DO.
Lung cancer kills more than 130,000 Americans yearly. But early detection of the disease, like that provided by mammograms and colonoscopies, often allows for sooner and better treatment results. Cancerous tumors hidden deep within the remote areas of the lung can be missed or must be biopsied using invasive means without this kind of innovative device.
Once a tissue sample is retrieved, a pathologist in the room then examines it under a microscope to provide a preliminary diagnosis. During the same procedure, another advanced instrument, the endobronchial ultrasound (EBUS) is used to determine if the cancer has spread to the lymph nodes in the chest, providing staging information. This information is then reviewed at St. Luke’s Multidisciplinary Chest Tumor Conference to plan the best treatment option for patients found to have lung cancer. The team at St. Luke’s takes pride in creating an individualized treatment plan to best care for each patient, whether it be with minimally invasive surgery, chemotherapy, radiation or a combination of these three.
“This is a collaborative effort involving physicians from thoracic surgery, pulmonology and pathology to provide the quickest, most accurate diagnosis using the Monarch robotic bronchoscope, which can lead to earlier treatment and hopefully better patient survival,” says Dr. Stahlnecker.
“Unfortunately, many lung cancers are silent, or without symptoms, until they’re in advanced stages when they’re most deadly. Smokers who have lung scans and nodule sampling when asymptomatic may have the chance of finding an early-stage nodule that responds to sooner treatment.”
The U.S. Preventive Services Task Force recommends that smokers, aged 50 - 80, who have smoked at least a pack of cigarettes per day for 20 years and who still smoke, or have quit smoking in the past 15 years, should undergo a lung CT scan yearly to promote early detection of cancer. These scans have been shown to reduce deaths related to lung cancer. Primary care physicians often send smokers for these tests as part of yearly health assessments. Patients interested in lung cancer screening should discuss this test with their primary doctor to see if it’s right for them.