New Lenox hospital using new technology to diagnose lung cancer at early stage

Silver Cross Hospital in New Lenox is now using a new technology that lets doctors precisely locate and diagnoses cancerous tumors in one minimally invasive procedure.

ION is a robotic-assisted bronchoscopy that uses a fully articulating, ultra-thin catheter so doctors can precisely reach all 18 segments of the lungs.

“This is an exciting service to offer,” Dr. Kristopher McDonough, a board-certified pulmonologist on staff at Silver Cross, said.

Here’s how it works.

McDonough and Dr. Gillian Alex, a thoracic surgeon on staff at Silver Cross, collaborate to identify and surgically remove suspicious lung nodules.

First, McDonough takes the flexible robotic catheter and moves it outward in the lung toward the area of the nodule. This is more complicated than it sounds. He compared the lung to a tree. The branches farthest from the trunk are also the smallest.

Also, the patients are breathing while the doctor is trying to access the nodule, he said. So if the nodule is only 11 millimeters, the doctor is trying to reach a small, moving target, he said.

Older technologies could not compensate for the movement, especially if the pathologist needs a second or third tissue sample, McDonough said

After McDonough accesses the nodule, he removes some tissue and shows it to the pathologist, who is also in the room, he said.

When the pathologist confirms cancer, McDonough stains the area with dye so Alex can then remove the cancer, he said. The patient has one procedure and one exposure to anesthesia, McDonough said.

Before ION, “In the past, bronchoscopes could reach just 20 to 30% of the lungs, McDonough said. ION allows doctors to reach more than 90%, he said.

“Our older system allowed us to get into most are of the lung with about 60% diagnostic accuracy,” McDonough said. “Currently, in our first 60 cases with the news system, we’re are 92% diagnostic accuracy. That’s a significant improvement over the old system.”

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The only other way to determine if a node was cancerous was to surgically remove it from the chest, McDonough said. That meant removing part of the lung, too, he said. If the nodule is benign, the patient has now lost part of a lung, he said.

“A lot of times we’re doing these procedures hoping to prove someone doesn’t have cancer,” McDonough said. “And we’re hoping to do it minimally invasive.”

McDonough said that wasn’t the case 15 years ago, at the start of his career.

“It wasn’t uncommon for someone to go to the operating room to have part of their lung removed only to find out they [only had] had an infection,” McDonough said.

By finding the cancer early and precisely locating it, only 10% of the lung is removed. But once the tumor is larger, the doctor may have to remove 30% of the lung to ensure all the cancer is gone.

Now, a client with healthy lungs might not notice the 30% reduction too much, McDonough said.

“Very few of our patients have normal lungs,” McDonough said.

McDonough said many of those patients are longtime or former smokers. They may have also chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis, he said.

So a 30% reduction in lung capacity makes a huge difference to patient who’s already breathing with just 50% lung capacity, McDonough said.

“This [ION] has the potential to cure the cancer and not impair the patient’s respiratory function,” McDonough said. “And boy! That is a great outcome.”

McDonough said the technology lets doctors localize cancer with a high degree of accuracy that one day – perhaps in five years – doctors will be able to perform microwave ablation or administer therapy directly into the tumors, “instead of putting chemo into the veins and causing toxicity throughout the body.”

Because most lung cancer patients have lungs “so thick with other diseases,” they are not good surgical candidates, even if surgery could cure their cancer, he said.

“We can’t remove any part of their lung lest we leave them incapacitated from a respiratory standpoint,” McDonough said.