In the past, diagnosing and treating lung cancer was a somewhat painful process on many different levels.
“We would get CAT scans of the chest to provide detailed pictures of the lungs and we would see these spots on the lungs, but not be able to tell what, exactly, they were,” says pulmonologist Dr. Eustace Fernandes. “Obviously, this creates a source of stress and anxiety for the patient, knowing there’s something on their lungs, but we can’t really identify it. Some of the spots on the lungs, often referred to as pulmonary nodules, are very small or in areas that were very difficult to access with a traditional bronchoscopy.”
Dr. Fernandes and his colleague, cardiothoracic surgeon Dr. Robert Roether, are the only two physicians at Lutheran Hospital specifically trained to offer a minimally invasive procedure to identify and provide early treatment options for these pulmonary nodules.
“We are entering an exciting new era with cancers being screened and identified at earlier stages and smaller sizes,” says Dr. Roether. “The robotic platforms now at Lutheran Hospital allow for a more targeted diagnosis and minimally invasive surgical therapies for our patients, resulting in faster healing, improved survival and more hope.”
Since it was first introduced last May, Dr. Fernandes says the results of the robotic lung surgery have been exceptionally promising.
“This is really more of a procedure than a surgery because it’s so non-invasive and does not require an incision,” he says. “There’s also a very low risk of complication.”
Dr. Fernandes points out that lung cancer is the leading cause of cancer death among adults in the United States. He says the robotic lung surgery can help to diagnose lung cancer at an earlier stage, giving the patient an opportunity for a cure.
“The general trend in medicine is to try to achieve a diagnosis for a patient with as little invasion of the body as possible and this platform does just that,” he says.
The robotic bronchoscopy system has a thin, maneuverable catheter that can reach suspicious-looking nodules deep within the lung that would otherwise be nearly impossible to reach using a traditional bronchoscopy.
“The beauty of this platform is that we can do our biopsy from the inside, making it very non-invasive,” says Dr. Fernandes. “My colleague, Dr. Roether, used the robotic platform to do the biopsy of a tumor and then immediately took the patient into the operating room for a curative surgery. This is a special occurrence because it allows the patient to, in a way, have a one-and-done experience with the diagnostic procedure, and then proceeding immediately to a curative surgery without having to wait and without having to go through anesthesia twice.”
Dr. Roether is the first physician in northern Indiana to complete a single anesthesia robotic bronchoscopy and tumor removal from a patient’s lung using the new system.
Right now, the robotic lung surgery is performed exclusively at Lutheran Hospital, but Dr. Fernandes expects to see tremendous growth in this area of medicine.
“A lot of health care systems are encouraging lung cancer screenings much the same way as we encourage a mammogram for early detection of breast cancer or a colonoscopy for early detection of colon cancer. So, the patient who meets certain criteria, such as a former smoker or being of a certain age, may qualify for a low dose radiation CAT scan of the chest. With increased screening, you’re going to see an increased demand for evaluation of the spots on the lung. If we were to wait until the patient showed symptoms of lung cancer to do a screening, we dramatically lower the chances of a positive outcome.”
Dr. Fernandes cautions that lung cancer can also affect non-smokers. While smoking tremendously increases the chances of getting lung cancer, he says there are plenty of non-smokers who end up with the disease.
“There are certain genetic conditions that predispose people to getting lung cancer and there can be environmental factors as well. It’s critical that patients pay attention to the signs and symptoms that they have in order to facilitate early detection. I encourage everyone to keep in mind that robotic bronchoscopy is not at all experimental, but is an approved technology that is proving to be lifesaving through early detection and treatment.”
Robotic bronchoscopy is one offering from Lutheran Health Network’s comprehensive lung cancer treatment program. The Network recently launched a dedicated Lung Nodule Clinic, which will facilitate a multidisciplinary approach to screening, diagnosis and early treatment of lung cancer.
“The clinic, along with our multidisciplinary tumor board meetings, complement our diagnostic and curative procedures to create a sophisticated and comprehensive lung cancer program,” says Roether.