A Lung Cancer Diagnosis and Treatment Revolution

Interventional pulmonology, a relatively new medical subspecialty, is changing the way doctors diagnose and treat lung and airway conditions, including lung cancer.

1:00 PM

Author | Shelley Zalewski

Over the past 30 years, interventional cardiology has transformed heart care — replacing many interventions that used to require open-heart surgery with less invasive procedures.

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily audio updates on iTunes, Google Play and Stitcher.

Today, that same revolution has arrived for pulmonary medicine with interventional pulmonology, or IP. The subspecialty offers a variety of minimally invasive procedures to diagnose and treat both benign and cancerous disorders of the lungs and airways.

The IP toolbox

The foundation of IP is endoscopy, during which a doctor remotely manipulates tiny imaging or surgical tools through a thin tube placed in the body.

"In IP, we use a range of endoscopic tools to look for and treat tumors, bleeding or inflammation in the lungs or airways, and to obtain fluid samples or tissue biopsies for testing," explains Michigan Medicine interventional pulmonologist Jose Cardenas-Garcia, M.D. "And we do so without subjecting patients to surgery, hospitalization or lengthy recovery."

MORE FROM MICHIGAN: Sign up for our weekly newsletter

Most IP procedures involve some form of bronchoscopy: In flexible bronchoscopy, a bendable endoscope is passed through the patient's mouth or nose and into the airways in the lungs. In rigid bronchoscopy, a stiff endoscope is inserted that holds the airway open.

In either case, once the bronchoscope is in position, doctors can perform interventional procedures using tiny cameras or surgical tools passed through it. They can capture images, take tissue or fluid samples, dilate areas, implant stents, and remove or reduce tumors or blockages.

A number of these procedures use heat, cryotherapy or lasers to remove tissue or control bleeding. The Michigan Medicine team is also evaluating new endoscopic techniques to diagnose and treat lung lesions.

Improving lung cancer care with IP

Patients with primary lung cancer and those with other cancer types that have spread to the chest visit the Rogel Cancer Center's multidisciplinary thoracic oncology clinic. The center's weekly tumor conference brings together specialists from every related discipline to discuss the care plan for each patient. IP plays a prominent role, offering both diagnostic and treatment alternatives not available just a few years ago.

For some patients, tumors, bleeding or inflammation associated with cancer can block airways, making breathing difficult, especially when lying down. That can mean stopping treatments that require lying flat, like radiation therapy.

Minimally invasive IP procedures can remove obstructions or implant stents to clear airways. "The surgical alternatives require both a significant incision and a hospital stay," Cardenas-Garcia says. "Instead, patients can resume treatment and/or return home right away, breathing better."

Another complication of cancer is developing a pleural effusion, a buildup of fluid in the membrane surrounding the lungs that impairs breathing. IP procedures can drain pleural fluid, both easing the pressure and sampling fluid for testing.

SEE ALSO: How Radiation Therapy is Becoming More Personal

If the problem persists, doctors can insert a catheter that the patient can operate to drain fluid at home. "Our approach is different from many other centers," Cardenas-Garcia says. "We don't just place the catheter. We educate the patient, help coordinate home nursing visits and supplies, and follow up to manage any complications, all to keep the patient as comfortable and mobile as possible."

The IP team at Michigan Medicine also performs diagnostic and therapeutic pleuroscopy, an outpatient procedure done under minimal sedation that can provide tissue diagnosis and place chronic catheters in the pleural space at the same time.

For each of Cardenas-Garcia's patients, the goal is the same. "It's all about using interventional pulmonology to improve their quality of life," he says. "We're making it possible for them to breathe more comfortably and spend more time at home — and less in the hospital."

If you have questions about lung cancer and treatment options, call the Rogel Cancer Center Cancer AnswerLine and speak with one of our oncology nurses.


More Articles About: Health Management Cardiopulmonary Care Lung and Airway Surgery lung cancer Lung Disease Lung Disease Testing Lung Function Lungs and Breathing
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories lungs
Health Lab
The environmental toll of inhalers for asthma and COPD
In a JAMA research letter, Medicare and Medicaid claims data were used to estimate the greenhouse gas emissions of inhalers using propellants versus those that are propellant-free in the United States.
person handling medicine
Health Lab
Older adults want to cut back on medication, but study shows need for caution
The idea of deprescribing is popular among older adults who take prescription drugs, especially those taking medication for symptomless conditions like high blood pressure.
blue purple cell dots on white background all over in different patterns
Health Lab
Research finds possible therapies to target oncogenic transcription factors in multiple cancer types
A study from the University of Michigan Health Rogel Cancer Center furthers research that suggests the potential of developing new cancer treatments to target oncogenic transcription factors by indirectly affecting their ability to access enhancer DNA in chromatin.
doctor with patient talking
Health Lab
Considering the patient’s perspective in inducible laryngeal obstruction care
Exploring the main topic of concern patients have when it comes to the results of their treatment for inducible laryngeal obstruction can help to increase effective treatment methods.
crawling on floor
Health Lab
This anesthesia technique makes surgery safer, less scary for pediatric patients
The pediatric spinal anesthesia program offers a needle-based technique that provides sensory and motor block without the need for intubation or general anesthesia for pediatric surgical procedures below the belly button. This means the patient will not feel anything below chest level.
woman smiling with white short hair and earrings dark with orange background
Health Lab
Using biologic injections for severe asthma after COVID
Biologic injections end up being the best treatment for treating severe asthma after having COVID for one patient.