In 2005, a patient came to my office with a diagnosis of stage 4 lung cancer – the most serious classification of cancer. With large tumors in both lungs, she was given two to six months to live. Although other doctors told her that the cancer was inoperable, my patient wasn’t ready to give up. She came to see me, even though she knew conventional wisdom said her cancer was incurable.
I talked to the patient about a new, noninvasive way to diagnose and treat lung disorders – called interventional pulmonology – and together we decided to go this route for her treatment. I used an interventional pulmonology technique to open her breathing tubes, which were blocked with cancer and causing her lungs to collapse and suffocate her. As a result, we prolonged her survival by five years.
During the past five years, this patient came to me three times for removal of lung tumors that can be reached without having to perform surgery – and for the insertion of stents in the lungs to ease her breathing.
Lung cancer causes more deaths in the United States than any other cancer and is second only to heart disease in overall mortality. Because pulmonary tumors (a form of lung cancer) are difficult to detect and biopsy, they are often diagnosed late – at stage 3 or 4. At those stages, five-year survival of lung cancer is only approximately 15 percent.
Interventional pulmonology offers a noninvasive way to diagnose and treat lung disorders, including cancer, emphysema and other conditions affecting the lungs. One very effective interventional pulmonology method is called the inReach electromagnetic navigation bronchoscopy system, which allows clinicians to noninvasively biopsy small lesions in the periphery of the lung for the first time.
Using traditional methods, doctors can only direct a typical bronchoscope down two or three airway branches; however, there may be 17 to 25 branches before they get to a small nodule in the periphery of the lung. In the past, pulmonologists would either follow these nodules over time or insert a needle through the chest and into the lung, which can sometimes collapse this delicate organ. The new electromagnetic navigation system allows pulmonologists to remove tissue they wouldn’t have been able to reach otherwise.
The inReach electromagnetic navigation bronchoscopy system offers patients cutting-edge noninvasive procedures for diagnosing and treating lung cancer. There are other minimally invasive procedures for conditions such as asthma, emphysema and other lung diseases.
Interventional pulmonology offers a breakthrough in the diagnosis and treatment of lung disorders, including cancer. In some cases it can offer the greatest gift of all – a way to extend life and quality of life.
Dr. Ganesh Krishna is a pulmonologist at the Palo Alto Medical Foundation’s Mountain View Center. He is one of few physicians in the United States trained in interventional pulmonology.
The Palo Alto Medical Foundation and column editor Arian Dasmalchi provide this monthly column.