Lung cancer accounts for more than one-quarter of all cancer deaths in the U.S., according to the American Cancer Society. It’s hard to catch early, as many people don’t experience symptoms until the cancer reaches advanced stages.
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People at high risk, however, may be screened by having a low-dose computer tomography (CT) scan, which creates detailed images of the lungs that can help doctors find potentially cancerous lesions or nodules.
The good news is that CT scans are good at detecting these potentially cancerous spots. The bad news is that even when very small spots are detected, the next steps are usually to watch and wait – a person may get annual CT scans to monitor any progression in shape or size of the lesion, and then take proactive steps such as partial removal of the lung, radiation or chemotherapy if the growth develops into cancer.
Now, an innovative procedure performed by specialists at a handful of medical centers across the country has the potential to change that.
It’s a complex but minimally invasive technique called microcoil localization, where doctors pinpoint and remove tiny nodules or lesions in the lung without damaging additional healthy tissue.
“Rather than cutting out an entire lobe, or potentially even an entire lung, we can just take out a small bit of tissue,” explains Jason Lempel, MD, a thoracic radiologist. “So we’re able to treat patients with early-stage lung cancers quickly and thus decrease the chance of the cancer spreading.”
A two-step procedure
Microcoil localization requires close teamwork between a radiologist and a thoracic surgeon, who specializes in the organs within the chest.
The patient goes to sleep in the operating room, where a radiologist uses at CT scanner to find the lesion or nodule. He inserts a needle that’s pre-loaded with a soft, fiber-coated platinum thread through the chest and into the lung. When the needle touches the nodule, the radiologist releases the thread, which conforms to its natural coil shape, marking the location of the nodule.
The needle is partially removed until it’s touching the outer layer of the lung, where the opposite end of the coil is released.
Then, a thoracic surgeon uses tiny video-assisted scope to locate the coil and carefully cuts out a wedge of tissue surrounding it and the nodule. The team can then instantly examine the tissue, make a diagnosis and perform further surgical treatment if necessary.
Thoracic surgeon Daniel Raymond, MD, is hopeful that the technique may one day vastly reduce the need for lobectomy, a surgical procedure in which a much larger section of the lung tissue is removed.
“Eighty-five percent of lung cancer patients present with stage 4 disease, where the cancer has spread to the bone or brain,” he says. “If we can detect these patients earlier with CT screening and use microcoil techniques to treat patients sooner, we’re going to be able to treat many more patients and save a lot of lives in the process.”