Advances in Lung Cancer Treatment

What if there was technology to find and remove lung lesions when they’re smaller, promoting better outcomes? It is available at Inova Schar Cancer Institute. Read on to learn more

Two biopsies on one woman’s lung lesion said it wasn’t cancer. Both biopsies were wrong.

By the time this patient came to Inova Schar Cancer Institute for a follow-up test — after her lesion continued growing — she was able to benefit from cutting-edge technology acquired only months ago showing her lung nodule was indeed cancerous. Now, following surgery to remove the tumor while it was still small, she is cancer-free.

Without this advanced procedure, known as fluoroscopic navigation, “What would have ended up happening is that the cancer would have a chance to spread and no longer be operable,” explains Amit “Bobby” Mahajan, MD, Medical Director of Interventional Pulmonology and a member of the lung cancer treatment team at Inova Schar.

“But we have the technology as a gatekeeper to biopsy lesions like these,” adds Dr. Mahajan, who treated the woman. “If we can diagnose lung cancers earlier, we can surgically remove them and cure them.”

A Larger System Effort

Fluoroscopic navigation equipment, which uses GPS to help find and biopsy tiny lung nodules, is one of three new technologies at Inova and part of a larger system effort to shift lung cancer diagnosis from late-stage to early. Combined with a unique collaboration between specialists in interventional pulmonology and lung cancer experts — a partnership few centers can boast — Inova Schar is already changing the complexion of lung cancer detection and care for patients.

Lung cancer is the leading cause of cancer deaths among men and women in the United States, with more than 230,000 Americans receiving a new diagnosis each year, according to the American Cancer Society. Historically, lung cancer is detected after it becomes advanced and patients begin suffering symptoms such as coughing and shortness of breath. The disease is often incurable once it spreads to distant parts of the body. Also notable is the fact that about 18 percent of those who get lung cancer have never smoked.

While newer targeted treatments and immunotherapy have boosted long-term cancer-free survival among some lung cancer patients, five-year survival rates still hover at only 15 percent for stage 3 patients and less than 5 percent for stage 4, according to Dr. Mahajan. Compared to other cancers, such as breast, cervical and prostate cancer, wide-scale lung cancer screening has only recently emerged, and individuals typically don’t get screened unless they have strong family history or risk factors for the disease.

Elite Group

But technology acquired in only the last year places Inova Schar in elite company, empowering specialists like Dr. Mahajan to find and biopsy tiny nodules at the lung’s farthest edges and more rapidly treat cases involving genetic mutations. The approaches include:

• Fluoroscopic navigation: Software that recreates a patient’s airway and lungs in virtual 3D allows doctors to navigate a catheter directly to lung nodules, with enhanced fluoroscopy (continuous X-ray imaging) highlighting even tiny lesions. “Before, if a lung nodule was small, we couldn’t get to it,” Dr. Mahajan explains. “Now we can navigate to small nodules and know it’s in the right place. We were among the first five centers in the country to get this technology.”
• Auris robotic study: A small, robotically controlled camera can reach small nodules at the edge of the lung — traditionally inaccessible to doctors — and enables doctors to view airways in real time and biopsy the lesions, Dr. Mahajan says. Inova Schar is one of five centers nationwide participating in the study, which aims to determine the technology’s safety and effectiveness.
• Biodesix: Potential genetic mutations contributing to a patient’s lung cancer growth can be identified within 24 to 48 hours using this blood test — much sooner than with traditional genetic testing from tumor tissue, which takes up to two weeks to produce results. This allows affected patients to begin targeted therapies — aiming directly at proteins from gene mutations — almost immediately. “Because we’re able to do treat early, we’re hopefully able to improve survival,” Dr. Mahajan says.

Get Tested for Lung Cancer

November is Lung Cancer Awareness Month. Learn more about being tested for lung cancer.