New Technology Helps Beat Lung Cancer
From early diagnosis through treatment, Torrance Memorial brings in new advances to take on the deadliest cancer.
Lung cancer can be a killer, but it doesn’t have to be. While it remains the No. 1 cause of cancer deaths, over the past five years the five-year survival rate for lung cancer diagnosed at all stages has increased by 22%, to 26.6%. Among patients diagnosed with Stage I lung cancer, when the tumor is still less than 2 cm in size, long-term survival rates top 80%.
The key is early detection and treatment, says John Abe, MD, a Torrance Memorial Physician Network doctor specializing in internal medicine, pulmonary disease and critical care medicine. “It’s all about the stage at which it’s caught and treated. The smaller the tumor, the more time we have to treat it, and the easier it is to treat. At Torrance Memorial about 70% of our lung cancer detections are Stage I or II.”
One of the most important advances in early detection is increased early screening. “Large-scale trials showed that screening certain demographics for lung cancer improved survival rates by over 20% for those screened, and CT scans became the screening modality of choice,” notes Clark Fuller, MD, director of thoracic surgery and co-director of the thoracic oncology program.
Between 85% and 90% of lung cancer cases are smoking related, so early screening focuses on individuals with a history of smoking or past cancer diagnoses. There’s a catch to early and repeated screenings, though: Lung cancer is detected using CT scans, and over time the radiation from CT scans can itself become a health risk.
That’s why Torrance Memorial offers low-dose (also known as spiral or helical) CT scans for annual lung cancer screening of high-risk individuals. CT scans are essentially 3D X-rays. Spiral CT scans rotate the X-ray tube around the patient in a spiral motion. The process is eight to 10 times faster than a traditional CT scan, and the X-ray dose from a spiral CT scan is about one-third less than the dose from a regular CT scan. For high-risk individuals, the benefits of the screening outweigh the risks, Dr. Abe says.
Once a suspicious nodule in the lung is identified, the next step is confirming a lung cancer diagnosis. “This is where Ion comes in,” says Dr. Fuller. The Ion bronchoscopy platform is a robotic-assisted system that allows Torrance Memorial pulmonologists to conduct minimally invasive biopsies of even very small nodules.
The system, in use locally only at Torrance Memorial, uses CT imaging of a patient’s lung to create a 3D virtual model of the airways. During the biopsy procedure, this “road map” is presented along with real-time imagery of the patient, taken with a tiny video camera attached to a thin, maneuverable catheter. This allows the physician to precisely guide it to the nodule and retrieve a tissue sample.
Dr. Abe lays out the process: “With a CT scan, we can detect nodules that are very small, from 1 to 4 mm, and those are usually benign. The bigger they are, the more suspicious they are. Before we started using the Ion system, we could biopsy nodules as small as 15 to 20 mm. Now we can biopsy nodules 8 to 12 mm in size and confirm whether they’re benign or malignant.”
When patients undergo surgery to remove a lung cancer nodule, the surgeon may be aided by a new procedure that highlights the nodule, literally. “It can be difficult to be sure we’re removing all of the cancerous cells, so we end up excising tissue around the cancer,” explains Dr. Fuller. “We cannot compromise a safe margin around the cancer, but we want to preserve as much normal lung as possible.”
Torrance Memorial’s new Cytalux tool allows surgeons to spot and excise lung cancer cells precisely by lighting them up. Before surgery, patients are administered a single dose of a drug that combines a marker dye and a form of folate (vitamin B9) that binds to cancer cells. The marker dye fluoresces when illuminated with near-infrared light, making it easy for surgeons to spot them during surgery.
The ability to see the cancer nodule’s boundaries allows surgeons to dramatically decrease the amount of lung they need to remove to be sure they’ve gotten it all, Dr. Fuller says. “Cytalux helps us shift from removing an entire lobe to about one-third of the lobe.”
Cytalux was approved for use in lung cancer treatment by the FDA in 2022, and Torrance Memorial is the only Southland medical center to offer it. “We are the landmark institution on the West Coast for this procedure,” Dr. Fuller notes. “This is the kind of advance that saves lives.”
Is annual spiral CT lung cancer screening right for you?
Annual screening is recommended for individuals at high risk of developing lung cancer:
• Between 50 and 80 years old, and
• Smokes or has smoked within the past 15 years, and
• Has a history of heavy smoking for 20 years or more (heavy smoking is an average of one pack of cigarettes per day for one year).
