This article first appeared in the medical column “Ask-the-Doc” in the World Journal
Lung cancer can be effectively treated, even cured if it is caught early stage. Because there are usually no symptoms of the disease in its early stage, detection can present a great challenge. By the time cancer is diagnosed, it is often at an advanced stage. In recent years, however, new methods, technology of detection have been developed that can help diagnose lung cancer in the early stages.
Pulmonary specialist Dr. Lei explains that traditional ways to diagnose lung cancer include sputum cytology (looking for tumor cells at sputum under a microscope) and imaging tests such as x-ray and CT scans. If abnormality is detected, then tissue biopsy may be ordered. However, traditional diagnostic procedures such as fiberoptic bronchoscopy, trans-thoracic needle aspiration and surgical excision have much limitation in early lung cancer diagnosis. For example, the vast bronchioles network is complex and full of turns (small airways in the respiratory tract) can be very narrow, limiting the passage of instruments and access to the tumor.
An exciting new technology, Electromagnetic Navigation Bronchoscopy (ENB), is a minimally invasive GPS-like technology that enables doctors to steer a probe to lesions deep within the lung, where it is nearly impossible for traditional bronchoscopes to reach. Dr. Lei explains that ENB combines advanced imaging techniques with electromagnetic navigation. Patients lie on a low frequency electromagnetic bed (equivalent to a magnetic field) for the procedure. Doctors use a CT scan digital data to reconstruct airway anatomy, create a 3D virtual graphs to locate and confirm the position of the target lesion and diagnostic pathway leading to it, then use a simulated map to steer the bronchoscope/tools to the intended target. Since the simulated map can be updated in real time during procedure, coordinate patients’ breathing cycles, the bronchoscope and diagnostic tools can accurately navigate to the lesion.
ENB can also be used in conjunction with other surgical procedures in addition to diagnosis, treatment of early lung cancer, like taking a biopsy of small tumor or delivering targeted treatments such as radiation therapy maker, dyes, helping surgeon for resection of small tumor. In this way, high dosage radiation can treat the tumor while minimizing collateral damage to surrounding healthy tissue, guide surgeons to the small tumor otherwise difficulty to see.
This minimum invasive technology is becoming increasingly popular and it’s revolutionary in the diagnosis and treatment of early lung cancer. El Camino hospital interventional pulmonary department is one of the country’s leading centers in the diagnosis and treatment of early lung cancer. The widespread use of ENB and bronchoscopy in recent years has pushed many insurance companies to accept and cover this type of procedures.
Dr. Thomas Lei specializes in Pulmonary Disease and Internal Medicine. He received his medical degree from Third Military Medical University and Masters in Immunology from the West China Center of Medical Sciences. He did his post-doctoral research at Tulane University and Louisiana State University and his fellowship in Pulmonary Medicine at Columbia/Cornell Medical School. He also served as the Assistant Professor at the West China Center of Medical Sciences University. Dr. Lei has been practicing in the San Francisco Bay Area since 2002, specializing in lung nodules and in the diagnosis and treatment of early stage lung cancer.
by Richard Lee
This article appeared in the Fall 2018 issue of Chinese Health Initiative Wellness eNewsletter. Learn more about the Chinese Health Initiative.