HYANNIS – Lung cancer is the leading cancer killer of both men and women in the United States, according to the American Cancer Society. Part of the reason the death toll is so high is that in many cases lung cancer doesn’t present symptoms until it is in the later stages. Early diagnosis saves lives and a new technology is helping physicians to find lung tumors earlier in those most at risk.
The new SPiN Thoracic Navigation System™, also known as Navigational Bronchoscopy, is available now at Cape Cod Hospital and Falmouth Hospital. The system adds a new dimension to traditional bronchoscopy, which guides the physician to the exact location of the nodule in the lung.
“A typical bronchoscopy is like driving a car. A navigational bronchoscopy is like driving a car with a GPS navigation system,” said Cape Cod Hospital pulmonologist Paul Evans, MD.
With the enhanced precision of the Navigation System, the physician can preserve more healthy tissue and, because the procedure is minimally invasive, side effects and recovery time are decreased.
A bronchoscopy is typically done following the discovery of a suspicious nodule on a lung CT screening. Both Cape Cod Hospital and Falmouth Hospital have low-dose CT scans available to screen for cancer.
The Lung Cancer Alliance recommends lung screening for the following people:
- Ages 55 to 80
- Current smoker or former smoker who has quit in the past 15 years
- 30 pack-year history (packs smoked per day) x (years as a smoker)
- Have symptoms like a persistent cough, coughing up blood or unexpected weight loss
“It’s estimated that somewhere in the order of 8 million people in the U.S. are going to have nodules that are found on these CT scans that are suspicious and fall into the high risk category,” said Dr. Evans.
Some nodules found on the CT scans are not worrisome, according to Dr. Evans, who compared them to a having an innocent mole on your body. For the suspicious nodules, there are two further tests that can be done, he said.
The first is a needle biopsy, which is most appropriate for nodules that rest up against the outside of the chest wall. The second procedure is a bronchoscopy.
A Map of Airways
“Bronchoscopy is a procedure that we do every day,” Dr. Evans said. “With the existing bronchoscopy, we can only reach nodules and tumors that are within reach of the scope, meaning we can snake the scope through the tree branches of the lung only so far and then the scope physically wedges and you can’t see further out..”
With the navigational bronchoscopy, sensors are placed over the patient’s chest, then a low-dose CT scan of the patient on both the full inhalation and full exhalation, because the nodules move up and down as people breathe. He or she is then moved to the bronchoscopy suite of the hospital.
The patient is then put under general anesthesia and the scope with a small antenna on it is threaded down through the natural airways.
“We drive around through the airways and the sensors overlying the body are making a virtual map of your airways,” Dr. Evans explained. “The computer draws an actual map. The really interesting part is that then the computer takes that image and the layout of the body you just made and synthesizes it with the CAT scan and creates a virtual 3D map of your lungs.”
The nodules or tumors are also in 3D and the navigation system shows the doctor the best route to get to them. The navigational bronchoscopy also lets doctors go beyond the branches of airways the traditional bronchoscopy allowed.
It’s an outpatient procedure and does not cause pain because lungs don’t have any pain fibers, Dr. Evans said. It typically takes about 30 to 45 minutes.
“It’s just an extension of the technology that we’ve already been doing with a lot lower risk and a lot of extra assurance because you are actually watching the needle go right into the mass,” he said. “This is an exciting new tool to get the answer faster and less invasively.”
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