Lung cancer is the leading cause of cancer-related deaths. In 2014, approximately 160,000 deaths occurred in the U.S. alone.  Early detection is key for decreasing the incidence of death from lung cancer. 

Lung cancer is typically asymptomatic in early stages and is usually diagnosed in advanced stages when the chances of a cure are lower. With effective treatment, only 15 to 16 percent of all patients diagnosed in various stages of lung cancer manage to survive five years. 

There are four stages of lung cancer: from early, when the cancer is self-contained and surrounded by normal lung tissue; to advanced, when cancer cells have spread outside the lung to organs like the liver or brain. Treatment outcomes for lung cancer are highly dependent on the stage in which it is first diagnosed. Early stage one and two cancers can typically be cured with surgery to remove the affected part of the lung. More advanced stages require a combination of chemotherapy and radiation. Most patients with lung cancer are diagnosed when they present with cough, chest pain, weight loss or shortness of breath; unfortunately, most patients with these symptoms have advanced lung cancer.

Until now, the Achilles Heel of the fight against lung cancer has been the inability to detect it in the early stages, before it becomes symptomatic and incurable. The success of screening programs is improving the survival for cervical, colon and breast cancers. Recently, a clinical trial of low-dose computed tomography (LDCT) of the chest to patients who were deemed to be at high risk for lung cancer showed it to be effective in decreasing the chances of dying from lung cancer by 20 percent. As a result of these findings, a yearly low dose screening CT scan of the chest is now recommended as part of national medical guidelines for patients between the ages of 55 and 79 who have a significant smoking history (e.g. one pack a day for at least 30 years). Physicians use the National Comprehensive Cancer Network (NCCN) guidelines to apply stringent criteria for patient selection and treatment recommendations. This minimizes the risk of complications and maximizes the benefit in performing this procedure.

Once a suspicious spot is detected in the lungs, the challenge then becomes to accurately diagnose it by obtaining a piece of tissue. With the help of advanced CT scan technology, combined with cutting edge computer guided biopsy techniques, lung cancer can be accurately detected and diagnosed in its earliest stages. This technology (called Electromagnetic Navigation Bronchoscopy or ENB) is based on high resolution computerized scans of the patient’s chest that are turned into a virtual three dimensional reconstruction of the patient’s lungs. A specialized lung cancer treatment team then views the virtual rendition of the lungs to locate suspicious spots and mark them as targets. The digitized navigation plan of the procedure is then loaded into a special computer and used on the day of the actual procedure to guide the specialist to the target area, using specialized tools. The whole process is akin to the use of GPS-like technology to guide a vehicle to its destination. 

Navigation Bronchoscopy, performed under anesthesia, is less invasive, does not involve any surgical incisions and is generally painless. The procedure typically lasts an hour and patients generally go home the same day. Most people resume normal activities the day of the procedure. Older techniques are fraught with a higher risk of complications, such as collapsed lung, bleeding, painful incisions or a required hospital stay. Navigation Bronchoscopy is commonly used in conjunction with other sophisticated complementary technologies, like ultrasound-guided biopsy of lymph nodes in the chest.

The goal of this new screening technology is to detect lung cancer at a stage when it is not causing symptoms and treatment will be most successful. It is designed to benefit the individual patient by increasing life expectancy and quality of life.

Garden City Hospital offers cancer treatment and is fully equipped with this new, cutting-edge technology for the early detection of lung cancer, including Low-dose Computed Tomography and Electromagnetic Navigation Bronchoscopy. The hospital has a specialized multi-disciplinary team of physicians, consisting of pulmonologists, oncologists, radiologists, surgeons and radiation specialists, to provide excellent care locally.

For patients whose insurance does not cover the cost of this screening, GCH offers LDCT for $50, with a physician prescription. Effective this past February, Medicare has decided to cover these screenings for patients that meet certain (high risk) criteria.

If you feel you or a loved one is at high risk for lung cancer due to tobacco use, please contact Garden City Hospital at 877-717-WELL. 

-Dr. Salik A. Jahania is a cardiovascular/thoracic surgeon at Garden City Hospital.