This year in the US, more than 234,000 new cases of lung cancer will be diagnosed, including nearly 6,500 in Tennessee alone. The good news is that many of those cases are now being diagnosed earlier.
Lung cancer remains the leading cause of cancer death, both in the United States and across the world. But mortality rates from the disease have been steadily decreasing over the past few decades—decreasing by 59% in men since 1990 and 36% in women since 2002.
What’s driving that decrease? First, fewer people are smoking, lessening the risk of developing lung cancer in the first place. Second, and more significant is: Earlier detection of lung cancer, allowing for earlier treatment and better outcomes.
Lung cancer detected in an early stage before spreading, the more easily and effectively it is treated.
The Facts About Lung Cancer Detection
Previously, most cases of lung cancer were detected in an advanced stage, after the disease begins causing symptoms. Symptoms of lung cancer such as shortness of breath, a persistent cough, and recurrent lung infections like bronchitis, typically don’t develop until it has spread.
Because there are usually no outward signs of lung cancer in those early stages, people who develop the disease don’t know to seek medical attention. That delay in seeking care, getting a diagnosis, and beginning treatment significantly impacts outcomes.
These days, however, more patients are receiving earlier diagnoses. That’s thanks, in part, to increased screening for lung cancer. Since 2013, the U.S. Preventive Services Task Force (USPSTF) is recommending annual lung cancer screening for some people with a smoking history.
Lung cancer screenings consist of a low-dose computed tomography (CT) scan of the lungs. The USPSTF now recommends annual screening for those who:
- Are between the ages of 50 and 80 and
- Have a 20 pack-year or more smoking history and
- Smoke now or have smoked within the past 15 years
A “pack-year” is defined as smoking an average of one pack of cigarettes per day for one year. You can have a 20 pack-year history if you smoked one pack a day for 20 years or if you smoked two packs a day for 10 years, for example.
This simple test can help your medical providers spot any suspicious lung nodules and track them over time.
When a Lung Nodule Might Be Cancer
If a lung nodule changes in some way between screenings, the next step is to determine whether the nodule is cancerous. The majority of lung nodules—up to 95 percent—are not cancerous.
To determine whether a suspicious nodule is cancerous, your provider may recommend you first undergo another type of screening test known as a positive emission tomography (PET) scan. This test uses an injection of a radioactive sugar isotype to determine whether cancer is present in the body.
If cancer is suspected after a PET scan, a biopsy of the lung tissue is used to confirm a lung cancer diagnosis and help determine next steps.
A biopsy is the only definitive way of diagnosing lung cancer.
A Better Way of Biopsying
Biopsies are used in diagnosing many different medical conditions, including other types of cancer. But lung cancer biopsies can be challenging, both for patients and their medical providers.
There are many different methods for obtaining the lung sample needed for a biopsy, including:
- During a bronchoscopy, a flexible tube called a bronchoscope is passed through the mouth or nose and into the airways of the lungs to take tissue samples.
- In some cases, endobronchial ultrasound-guided transbronchial needle aspiration may be used along with bronchoscopy. During this procedure, a needle is passed through the bronchoscope and guided into place in the lung using ultrasound. Once in place, the needle samples the tissue.
- Less commonly, endoscopic ultrasound may be used along with bronchoscopy. This procedure is similar to endobronchial ultrasound, but an endoscope fitted with an ultrasound device is passed down the throat and used to guide the process of obtaining a tissue sample.
- A thoracoscopy or video-assisted thoracoscopic surgery is another common form of biopsy. During this procedure, a thin tube with a video camera is inserted into the body through a small incision in the chest. Small tissue samples are then removed to be examined.
- In cases where a potential cancerous nodule is located in a difficult-to-access spot in the lung, fine needle aspiration may be used to remove a sample of cells.
- If other methods of obtaining the tissue sample needed for a biopsy aren’t an option, an open biopsy may be used. During this procedure, an incision is made between the ribs to allow access to the lung tissue.
Take-Away
If you’re confused after reading all that, that’s totally understandable! For years, the process of obtaining a biopsy has been complex and highly dependent on the location of a suspicious lung nodule. Many nodules are located in the peripheral lung, making them difficult to access using traditional techniques.
In the past, those nodules would typically have required a more invasive procedure such as a fine needle aspiration or VATS procedure, but advancements in technology are changing that. At West Tennessee Healthcare, we are now offering Ion robotic bronchoscopy, a new technology that allows our specialists to more easily obtain tissue samples from all 18 segments of the lung.
Prior to an Ion-aided biopsy, a medical provider can plan out how the procedure will be performed, including the path to access the suspicious lung nodule. During the procedure, integrated, real-time 3D imaging helps the provider guide the catheter to the nodule, where it can be held in place while a needle grabs the necessary tissue samples.
West Tennessee Healthcare recently treated our 100th patient using this new technology. We’re proud to offer our community an advanced method of diagnosing lung nodules more easily and more quickly, with fewer complications than with other forms of lung biopsy.
When the lungs are involved, you deserve the innovative care provided by West Tennessee Medical Group’s team of board-certified pulmonologists. We offer comprehensive services for the diagnosis and treatment of lung-related disease, including lung cancer.
