Lung Cancer
Technology, Hope and Expectations

Patients with early stage lung cancer have a much higher chance of cure thanks to new technology available at Greenwich Hospital. Thoracic surgeon Paul Waters, MD, (second from right) uses minimally invasive guided imagery to biopsy suspicious areas without conventional surgery. With him are surgical team nurses (l-r) Rey Delacruz, Madelaine-May Abille, and Florentino Valerio.

But, there is fresh hope, real hope, to change these statistics. New technology has the potential to find lung cancers in their earliest stage, when up to 92 percent can be cured.

Advances in technology at Greenwich Hospital

“We have the technology, including new forms of CT and PET scans, to diagnose lung cancer earlier,” explains Paul Waters, MD thoracic surgeon and chief of oncological surgery at Greenwich Hospital. “Procedures are less invasive now. We use small incisions that result in minimal pain and fewer complications. And doctors tend to be more aggressive.”

For example, just a few years ago, if an X-ray showed a shadow on a lung, it was difficult to perform a biopsy. In case of uncertainty, it might have been flagged as something to watch. “Now, if you have a shadow that looks suspicious, we have the tools that allow us to explore further,” Dr. Waters continues. “If it turns out that the shadow is cancerous, we’re months ahead of the game.”

One of the new tools used at Greenwich Hospital is called iLogic®. This computerized system provides a virtual road map of a person’s lungs, similar to a GPS, or global positioning system. The surgeon guides a thin tube called an endoscope into the affected area to gather information and grab cells for a biopsy if needed. When the scope approaches the smaller airways, the surgeon can activate a steerable catheter to navigate hard-to-reach areas and collect cell samples for analysis.

If the diagnosis is cancer, and if the patient is not a candidate for surgery, the physician can use the iLogic® to insert tiny metal chips, the size of a grain of rice, to mark targets for precise radiation treatment.

Another GPS-like procedure is EBUS – endobronchial ultrasound. This technology allows the physician to use a needle aspiration technique instead of conventional surgery to get tissue or fluid samples from the lungs and surrounding lymph nodes.

Improvements in chemotherapy

“Chemo now is like a sledge-hammer approach; we pound the table looking for the ant and we destroy part of the table in the process,” says Dr. Waters. He points to side effects such as hair loss and problems with the body’s gastrointestinal and other systems as examples.

Fortunately, chemotherapeutic agents are improving to attack cancer cells in new ways, he notes. “What we know now is that tumors will often secrete a factor that encourages blood vessels to grow and keep the tumor nourished. By inhibiting or halting this growth, we work to stop or even kill the cancer.”

On the horizon is “personalized medicine,” the catchphrase for efforts to tailor medical treatment to a patient’s individual genetic profile. A customized “drug cocktail” would be created to attack specific oncogenes, which are genes with the potential to cause normal cells to become cancerous.

A winner always quits

Heredity and environmental factors can play a role in causing lung cancer, but smoking, of course, is a prime culprit. Smoking also triggers emphysema and other health problems, and secondhand smoke poses considerable risk as well. Smokers may not think that their smoking can cause lung cancer in their spouse or children, but it can.

The good news is that if a person stops smoking today, some of these negative effects actually get better, and the risk of getting lung cancer will stop rising. It’s recommended that current or former heavy smokers have periodic physicals and a screening CT scan that is specially designed to pick up cancers that don’t show up on X-rays. This early detection is known to improve chances of survival.

And by all means, if you smoke, do whatever it takes to quit the habit.

Check out our Great American Smokeout Event on Nov. 17 for supportive information.

Highest standards at Greenwich Hospital

Greenwich Hospital’s Cancer Institute makes cancer care as convenient as possible for patients in lower Fairfield and Westchester counties. Our medical specialists work together as a team to offer a full spectrum of services in a warm and nurturing setting. As part of the Yale New Haven Health System, Greenwich Hospital physicians have access to the Smilow Cancer Center at Yale-New Haven and some of the brightest medical minds in the nation.

Greenwich Hospital is also part of I-ELCAP, the International Early Lung Cancer Action Program. This group of lung cancer experts from 48 institutions in nine countries is dedicated to studying the health benefits associated with early detection.

Patients who qualify can also take advantage of clinical trials that provide access to the newest treatment protocols.

For more information, contact Jennie Melendez, RN, at 203-863-3768 or Diane Perry, RN, at 203-863-3698.

Lung cancer is still one of the most challenging illnesses to confront. Yet the medical world, with the help of developing technology, is gaining a better understanding of how to approach this disease so that survival isn’t just something patients hope for, but something they can expect.

Know the Risk, Know the Symptoms

• While smoking is the #1 cause of lung cancer, radon is the second leading cause in the United States.

• Lung cancer mainly occurs in older people, with the average age at the time of diagnosis about 71.

• Lung cancer runs in families, but so does smoking, so the extent of an inherited risk is debatable.

• Most people diagnosed with early stage lung cancer have no symptoms; this is why screening is vitally important for people known to be at risk.

• Later symptoms include spitting up blood, chest pain, shortness of breath, difficulty swallowing and hoarseness that doesn’t go away. These can also be symptoms of other conditions, so they don’t necessarily mean you have cancer. But they definitely are a strong sign that your body needs medical attention.

November is Lung Cancer Awareness Month Join us for these special events.

Insights into Lung Cancer
Tuesday, Nov. 29
12noon-1pm
Noble Conference Center
Speaker: Paul Waters, MD, Thoracic Surgeon, Chief of Oncological Surgery
Learn more »

Great American Smokeout 2011
An American Cancer Society Event
Thursday, Nov. 17
9:30-11am
Greenwich Library, 1st floor
and 11:30am-1pm
Greenwich Hospital Cafeteria Atrium
Learn more »