BRISTOL – Patients with potentially cancerous lesions in previously unreachable areas of their lungs have improved chances of diagnosis with new technology at Bristol Regional Medical Center that allows lung specialists to extend farther into the lung to perform biopsies more accurately.
Pulmonologists at Bristol Regional recently began using electromagnetic navigational bronchoscopy, an enhancement to their delivery of compassionate lung care. Providing more range than regular bronchoscopy, this new system lets pulmonologists diagnose some cases of lung cancer earlier and enhance treatment.
It is a minimally invasive, new outpatient procedure that is performed under anesthesia. Bristol Regional is the only medical facility in Northeast Tennessee and Southwest Virginia using this new method to reach these lesions.
Used in conjunction with images from CT scans, guidance from computer programs and special medical probes, electromagnetic navigational bronchoscopy is opening new frontiers in lung care.
"Bristol Regional has long been a leader in the diagnosis and treatment of medical cases involving the lungs, and this new tool is the latest example of how the hospital and its physicians are on the cutting edge of care," said Dr. Roger McSharry, a pulmonologist and the hospital's chief medical officer.
"Electromagnetic navigational bronchoscopy is a major breakthrough for our patients because our experienced pulmonologists will be able to find smaller lesions or lesions that are farther than we could reach before with better results. This is important because early diagnosis of lung cancer is essential in increasing the patient's chance of cure and survival. This new technology enhances those odds by allowing us to extend our reach."
While she would prefer not to have been diagnosed with lung cancer, Dorothy Fulcher of Kingsport said she is grateful electromagnetic navigational bronchoscopy was available at Bristol Regional to alert her. This technology was used to assist her during a procedure in May.
"I wouldn't have known I had lung cancer if this technology weren't available," Fulcher said. "It let me know where I stood by showing that I had cancer. I'm pleased it did. I'd rather know I have cancer than not know. Otherwise, it could get worse."
Thanks to electromagnetic navigational bronchoscopy, Fulcher is now on the road to better health. She will receive treatments from CyberKnife Robotic Radiosurgery System, which delivers radiation to affected lung tissue with sub-millimeter accuracy. CyberKnife is only available in the area at Bristol Regional.
Bronchoscopy involves the insertion of a scope into the breathing passages to evaluate the lungs and collect biopsies, which are small tissue samples, to diagnose lung cancer and other lung disease. These suspicious areas have been spotted through a CT scan.
This form of bronchoscopy is a standard procedure for pulmonologists, but the only difficulty it poses for them is its limited reach.
Bristol Regional has invested in this more advanced system in which the scope continues its normal distance. Then a steerable probe guided by three electromagnetic receptors extends from the scope and maneuvers through the smaller breathing passages to the suspicious lesion in the more distant area of the lung.
Pulmonologists are not finding the lesion alone. Instead, a computer program created from the CT scan creates a three-dimensional image of the breathing passages that guides the physician as he or she maneuvers the probe to the lesion.
"Think of this in the same way as a GPS for your car," Dr. McSharry said. "A physician does not necessarily have to know at all times the exact direction because he is receiving guidance from the computer. The technology has become that refined.
"But like a GPS for a driver, a pulmonologist doesn't have to follow the suggested path to the letter. If we feel it would be appropriate to go another route, the computer program adjusts and guides the pulmonologist to the lesion through this alternate path."
Once the pulmonologist reaches the lesion, he withdraws the probe and then tiny surgical instruments are inserted through the same path to collect the biopsy.
Fulcher said it is comforting to know a hospital so close to home has this technology to go farther into the lung. Otherwise, she might have to travel a long distance to receive this high level of care. Her niece, Faye Owens, who lives in Bristol, has told multiple people about this new method at Bristol Regional for reaching these lesions.
Nancy Preston, a Bristol, Va., resident who underwent this procedure and, fortunately, was not diagnosed with cancer, said electromagnetic navigational bronchoscopy is effective.
"You don't know how many people will get help from what this procedure might reveal," Preston said. "It might help save someone's life. Even though it didn't reveal any cancer for me, I'm all for it because of what it might reveal for others, possibly saving their life."
Dr. McSharry said electromagnetic navigational bronchoscopy is not only beneficial in diagnosing cancer but in its treatment. He said it helps medical professionals develop a plan for the use of CyberKnife.
Dr. John Fincher, medical director of oncology at Bristol Regional, agreed and said electromagnetic navigational bronchoscope is a significant evolutionary step in lung cancer treatment by impacting less lung tissue.
"Often lung tumors are in the periphery of the lung," Dr. Fincher said. "We have been unable previously to place seed markers in there, which allow us to track the lung tumors with movement and with respiration."
He said a lot of these patients have severe chronic obstructive pulmonary disease, which led to an alternative form of treatment to prevent the lung from collapsing. But that option affected more lung tissue.
With electromagnetic navigational bronchoscopy, medical professionals at the J.D. and Lorraine Nicewonder Cancer Center at Bristol Regional can place the seed markers and minimize collateral tissue damage, Dr. Fincher said.
"That will allow us to treat the lung tumors more effectively and spare more lung tissue," he said. "It substantially increases the percentage of patients who are able to get better treatment with CyberKnife."
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