Lung Cancer

To diagnose, evaluate and stage lung cancer, pulmonologists order and perform a number of procedures, including bronchoscopy, needle biopsy, computerized axial tomography (CAT) and positron emission tomography (PET) scans or a combination of these tests. The results of these diagnostic tests enable the physicians to determine the disease involvement and staging, and work in collaboration with the patient’s surgeon and oncologist to make an appropriate recommendation for surgery, chemotherapy, radiation or a combination of these three treatments.

SuperDimension® inReach for the Lungs
News that a spot has been found deep in your lung and that invasive surgery for a lung biopsy needs to be performed raises many concerns and emotions. It is important to know that Saint Vincent offers a minimally invasive outpatient procedure for lung biopsy and certain other lung procedures, utilizing superDimension inReach technology. This system utilizes electromagnetic navigation technology—similar to a GPS system—to help surgeons navigate a unique set of catheters through the complex airways of the lung, far beyond the reach of a traditional bronchoscope. It also provides the ability to detect lung disease and lung cancer earlier, even before symptoms are evident, enhancing treatment options and survival rates for patients. Saint Vincent is the only facility within 100 miles to offer this state-of-the-art technology. For patients, this means no scarring, minimal pain and discomfort, less chance of infection and a quick recovery. Want to learn more or find out if you are a candidate for this procedure? Contact Chest Diseases of Northwestern Pennsylvania at 814-864-4755.

Bronchoscopy
Bronchoscopy is a diagnostic or therapeutic procedure, in which a tube with a tiny camera on the end is inserted through the nose or mouth
into the lungs. The procedure provides a view of the airways of the lung and allows doctors to collect lung secretions or tissue specimens for biopsy. Bronchoscopy may also be performed to determine the extent of lung cancer or destroy growths in the airway, in conjunction with the radiation oncologist, in a procedure known as brachytherapy.

Physicians utilize two types of bronchoscopes:

• flexible bronchoscope is a long, thin tube that contains many small, clear fibers or a small camera that can transmit light images as it bends. The flexible bronchoscope is used more often than the rigid bronchoscope because it is usually safer, does not require general anesthesia, is more comfortable for the patient, and offers a better view of the small airways. Small samples of tissue can also be removed using a flexible bronchoscope. It can also be used to widen the airway or destroy a growth using a laser.
• A rigid bronchoscope is a straight, hollow metal tube that can be used for better visibility when there is major bleeding in the airway, when a larger tissue sample is required, or when it is necessary to widen the airway or destroy a growth using a laser.

Pulmonologists (lung specialists) complete comprehensive evaluations, direct diagnostic studies and coordinate multidisciplinary team care. For lung cancer patients the care team may include a pulmonologist, a radiologist, a surgeon, a medical oncologist and a radiation oncologist.

Practice Profile
Chest Diseases of Northwestern Pennsylvania
3580 Peach Street
Erie, PA 16508
814/864-4755
This practice consists of four pulmonologists, who are all certified in internal medicine, pulmonary disease and critical care medicine.

For More Information
Physicians: To refer a patient, contact Chest Diseases of Northwestern Pennsylvania directly at 814/868-4755.
Patients: To learn more, talk to your family physician or call Saint Vincent Ask-A-Nurse at 814/452-5500 or 800/326-8080.

Mediastinoscopy Diagnosis

Mediastinoscopy is a procedure in which the surgeon inserts a camera through a small incision in the neck in order to diagnose lung cancer, infections and lymphoma.

Surgical Options
Surgical management of lung cancer is typically performed by one of two methods: video-assisted thorascopic surgery (VATS) or open thoracotomy.

Video-Assisted Thorascopic Surgery (VATS) can be performed on tumors that are clinical stage I. This minimally invasive procedure makes use of a telescopic lens and video camera to view the surgical target and guide the surgeon through the procedure. Three to four small (one-to two-inch) incisions may be used in a VATS as compared to one seven-inch incision in a thoracotomy. With a VATS procedure the chest wall musculature is not disrupted. This results in less post-operative pain which allows the patient to breathe deeper, minimizing lung collapse, and usually results in a shorter length of stay. The types of complications are similar in both VATS and thoracotomy procedures. Saint Vincent Health Center cardiothoracic surgeons perform both of these procedures for lung cancer with the latest in videoassisted technology.

VATS Patient Benefits

• Smaller scars
• Less post-operative pain
• Reduced post-operative pain allows the patient to cough and take deep breaths
• Decreased need for pain medications post-operatively
• Shorter length of stay
• Less risk of infection

Thoracotomy
The traditional approach to lung resection is a thoracotomy. During a thoracotomy an incision is made on the side of the chest between the ribs. This allows for excellent exposure and enhanced options for resection.

Thoracoscopy

A thoracoscopy, or pleuroscopy, is a procedure used to assess lung cancer. During the procedure a surgeon inserts an endoscope through two or three small incisions in the chest wall to view the chest cavity and the lungs. The procedure allows the surgeon to view any suspicious tissue and take samples. The procedure takes between two and four hours. Performing a thoracoscopy instead of an invasive surgical lung biopsy reduces complications, pain, hospital stay, and recovery time.

For More Information

Physicians: To refer a patient, contact Saint Vincent Cardiovascular Surgery directly at 814/456-9197.
Patients: To learn more, talk to your family physician or call Saint Vincent Ask-A-Nurse at 814/452-5500 or 800/326-8080.