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Allegheny Health Network Using New Robotic Tool To Diagnose Lung Cancer

As technology advances in the fight against cancer, Allegheny Health Network is using a new robotic tool to diagnose lung cancer.

For many people doctor's visits bring anxiety, but the word cancer brings a whole new level of stress.

Doctors told Jacqueline Rysz she might have lung cancer after they found one mass in her left lung and another mass in her right lung.

"By this time, my heart is beating so fast, I'm thinking, 'Oh my God, I have cancer," Rysz said. "Everybody thought it was cancer."

After seeing more doctors and having more scans done, she came to Allegheny Health Network Forbes Hospital for a second opinion. AHN Forbes Hospital Pulmonologist Dr. Giath Shari used new robot-assisted equipment to enter Rysz's lungs this time.

With the tube in the main airway, doctors dropped an ultra-thin, extra-maneuverable catheter down to her lungs with a camera to see the lungs in real time. While inside the lungs, Dr. Shari drained one abscess and performed a biopsy on the other mass, and Rysz learned she was cancer-free.

"I was like, 'Oh, my God.' I started crying because I was just really, really happy," Rysz said.

With this Ion Endoluminal System, doctors said they could collect lung tissue samples for biopsy in a simpler way and get results quicker.

"They don't have to wait until they recover from a surgical biopsy to start treatment for cancer," Doctor Shari said.

It reaches small lesions in all 18 segments of the lung.

"With a traditional scope, we could never go that far," said Dr. Hiran Fernando, the Director of Thoracic Surgery for AHN Forbes.

Doctors said it's more precise and stable with fewer procedures. It can reduce risks for patients.

"If we find lung cancers early, we have a much better chance of curing them," said Dr. Fernando.

Rysz said she's relieved this procedure was a "one and done" situation.

"With me, I have a lot of anxiety about this, to begin with, and I thought, 'Well if I have to go through this five or six times, it would be horrible.'"

For Rysz, this medical experience is a wake-up call to be vigilant about her health. It's also a reminder for her that not being one of thousands of new cases of lung cancer comes down to the science and skill of doctors and technology.

"If you have any signs of lung cancer, get this bronchoscopy, because it is simple, easy and it saves you a lot of trouble from having a lot of other tests done," said Rysz.

"It was a miracle for me, a miracle."

Veterans Clinic Can Spot Early Signs Of Lung Cancer

The Birmingham VA Health Care System showed off its robotic-assisted tools available to veterans for early lung cancer detection and treatment at a live demonstration at the Huntsville VA Clinic.

Provided by Intuitive, the parent company of the Ion and Da Vinci robotic platforms, the 1,000-square-foot interactive display, housed in a tractor-trailer, showcases the Ion Robotic Bronchoscope, Cone Beam CT and Da Vinci Surgical System. Birmingham VA pulmonary specialists and thoracic surgeons use these tools to detect and treat lung nodules with precision and efficiency, improving outcomes through early intervention.

Of all cancers, "lung cancer has the highest mortality rate," Dr. Joseph Thachuthara-George, the Birmingham VA's director of bronchoscopy, said as he demonstrated the Ion Robotic Bronchoscope on Friday morning. Even though screening for lung cancer can save thousands of lives, less than 5% of Americans considered high risk are screened, according to the American Lung Association.

The exhibit, called the Intuitive Thoracic Oncology Mobile Experience, was open to veterans, health care professionals and the public. The event was held as the Birmingham VA prepares to launch a new tele-clinic at the Huntsville VA Clinic.

"A low-dose CT scan that a primary care provider might order can pick up lung cancer at an early stage," Thachuthara-George said. "If a primary care provider sees a nodule or a spot on the lung, they will place a referral to us." Then patients are given the option of either an in-person appointment at the Birmingham VA or a tele-clinic appointment at the Huntsville VA Clinic.

"I'll talk to them about what we see and what are the next steps," said Thachuthara-George, who is an associate professor at the University of Alabama at Birmingham School of Medicine-Pulmonary, Allergy & Critical Care Medicine. A patient would need to come to the Birmingham VA for a procedure like a biopsy.

The American Lung Association notes that people who meet the following criteria are considered to be at high risk for developing lung cancer and screening is recommended: 50-80 years of age, have a 20 pack-year history of smoking (this means one pack a day for 20 years, two packs a day for 10 years, etc.) and currently smoke or have quit within the last 15 years.

Incidental Lung Nodule Detection May Help Save Lives, Study Finds

The study authors say their findings argue for careful reading of CT scans done for other reasons that may reveal the presence of lung nodules.

Imagine you're getting a chest scan for a potential heart problem, and instead of a heart issue, it reveals a small spot on your lungs. A recent study published in the Journal of Thoracic Oncology suggests that these unexpected findings could be a lifesaver, offering a rare opportunity to catch lung cancer early—when it's much easier to treat.

Lung cancer remains the leading cause of cancer-related deaths in the United States, with most cases diagnosed at later, less treatable stages. Although low-dose computed tomography (CT) screening has proven effective in reducing mortality by detecting early-stage lung cancer, fewer than 5% of eligible individuals currently participate in screening programs. As a result, researchers are now examining alternative ways to detect lung cancer early, including through incidental findings during imaging done for other health concerns.

A team of researchers, including Emanuela Taioli, M.D., Ph.D., director of the Institute for Translational Epidemiology at the Icahn School of Medicine at Mount Sinai in New York, explored the effect of incidental findings of pulmonary nodules on non-small cell lung cancer (NSCLC) mortality.

The researchers analyzed data from over 1,000 patients diagnosed with NSCLC using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. They focused on chest imaging performed up to a year before cancer diagnosis for reasons unrelated to cancer screening, such as evaluating heart issues.

At the time of diagnosis, the median tumor size was 25 millimeters (mm). The predicted tumor sizes at the time of prior imaging were 12.16 mm for fast-growing tumors, 17.3 mm for medium-growing tumors, and 20.42 mm for slow-growing tumors.

The study found that if the nodules had been detected earlier, it could have lowered the risk of death by 7.79% for fast-growing tumors, 4.5% for medium-growing tumors, and 2.45% for slow-growing tumors.

Emanuela Taioli, M.D., Ph.D.

"Our findings support the concept that CT scans performed for other clinical reasons, for example, a heart condition or other issues, should be read in their entirety and interpreted carefully because they may reveal the presence of lung nodules that may need clinical attention," Taioli, the study's corresponding author, told MHE in an interview. "This is particularly true for [patients] who do not meet the eligibility criteria for lung cancer screening."

The study also revealed that approximately 10.5% of patients diagnosed with NSCLC had undergone chest imaging for reasons other than cancer screening in the year prior to their diagnosis. The study's findings suggest that identifying tumors earlier, when they are smaller (less than 10 mm), could significantly improve survival rates. For fast-growing tumors, early detection could have decreased mortality by up to 8%.

However, the study had some limitations.The authors were unable to account for various factors, such as tumor density, which could affect tumor growth rates. Additionally, the study only included NSCLC patients, and it's expected that patients with more aggressive cancer types, such as small cell lung cancer (SCLC), could benefit even more from incidental detection. The study also had to rely on estimated tumor size due to limitations in the SEER database, which only reports tumor diameter.

Despite these limitations, the findings support the need for greater attention to chest imaging done for non-cancer reasons. In the discussion section of their paper, the researchers highlighted the importance of implementing programs to address incidental pulmonary nodules. Machine learning and artificial intelligence-driven tools, already approved for use in detecting lung nodules, could also play a significant role in identifying tumors early.

In many cases, "the incidental finding of a nodule in a CT scan performed for other reasons may be the only opportunity for early detection of lung cancer nodules," Taoli said. "Early detection of lung cancer has revolutionized lung cancer prognosis, from a deadly disease to a highly curable one."

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