When a patient gets a lung nodule, the biggest concern is that "Is the nodule
cancerous?" Many of these long nodules turn out to be nothing, but you can't
ignore them. You can't sit on them. You can't wait. For those that have lung
nodules that end up being a cancer, we need to move fairly quickly.
Fox Chase Cancer Center has a comprehensive lung nodule program, where results can be
fast-tracked to meet specialists who diagnose and specialists who treat lung
nodules. When a patient comes in with a lung nodule, they can be seen by a number of
different people. They could be seen first by a thoracic surgeon, they could
be seen by a pulmonologist, or they could be seen by one of our nurse
practitioners. They could have a repeat CAT scan in a short order, to see if the
nodule is changing in size or shape. They could have a PET scan to see if
it's metabolically active, or if it's suspicious enough, we'll proceed straight
to a biopsy so that we don't delay their diagnosis. You have a couple of options
in terms of how you would approach them to do a biopsy. One way is to do a
bronchoscopy, which involves going down your airways with a small flexible scope
and trying to biopsy a nodule from within. The other option is for a
radiologist to do a needle biopsy from outside the lung. These traditional
methods, though, may not be able to reach nodules if they're further out in the
branches of the lung. That's why our pulmonologists have this advanced
technology to get to these hard-to-reach nodules. So here at Fox Chase, we're one of
the first centers in the nation to have the Monarch Robotic Bronchoscopy
Platform. This allows us to get out into the periphery of the lung with increased
dexterity and increased visualization to get a more targeted biopsy specimen. What it
means to me is the next evolution in how we approach these lung nodules. You're
taking a very small, very sophisticated robotic arm and you're navigating
through the airways with direct visualization. We've done hundreds of
these cases over the past couple of years and we're doing it in a high-volume
center with a team that has been drilled on these procedures. That's where that
consistency comes from and that's where we get great success. Instead of you
having to hold the scope with your hand, you're now using a remote controller to
drive a scope down a patient's airways. The first part of
how the system works, starts with a very simple CAT scan. We can take those images
and we can sync them to the robotic platform, so now we've got a road map. Now
we've got basically a turn-by-turn GPS for the lung, so just with one procedure
you're much more likely to get an accurate answer the first time. We can
reach nodules that we have not been able to reach before far more deep out in the
lung, close to the edge of the lung, now. In order to decide the best course
of treatment, the team needs a tissue sample large enough to determine the
cancer's genetic makeup. Being able to directly see the nodule
gives our physicians the assurance that they're collecting a large enough
targeted sample for testing. We'll be able to make these cases shorter and
make them faster with less anesthesia time for the patient, and less recovery time. We
find the nodule. We biopsy it. We look at all of the lymph nodes throughout both
lungs, so the person has a diagnosis and a stage for their cancer, and then they
can meet quickly thereafter to decide what to do next. Having this technology
is so important for these lung patients, but it's the strong Fox Chase
Interventional Pulmonology team, as well, that makes all the difference.
It's our nurses, our respiratory techs, and our bronch techs who are helping with all
these instruments and all that team effort is why we have great success. At
Fox Chase, the landscape of Interventional Pulmonology is changing every day and
these technologies - they build on previous generations so that we're able
to offer our patients cutting-edge modalities. When I think about Fox Chase,
I think about the years of experience in the departments around me. I think about
the reproducibility of our biopsy procedures; the level of training of our
cytologists, respiratory therapists, endoscopy nurses, and that gives us great
insight. We use the experience of all of our peers to provide the best
recommendation and the best treatment plan for patients.