New service at Westmead Hospital improves lung cancer diagnosis
A new lung cancer diagnosing service at Westmead Hospital is improving diagnosis and hoping to catch cancers earlier.
Dr Chinthaka Samaranayake, respiratory physician and interventional pulmonologist, and colleague Dr Peter Wu have introduced a new method of diagnosing lung cancers, and the improvements are staggering.
“We can now offer a procedure that has much higher rate of success with much lower rate of complications, so it's a big advantage for our patients,” Dr Samaranayake said.
One of the first steps to diagnosing early-stage lung cancer is by identifying nodules on the lungs.
“When we find a nodule on a scan, we often need to take a biopsy and look under the microscope to confirm what it is, because not all nodules are cancers,” Dr Samaranayake said.
A biopsy allows doctors to confirm the presence of cancer and there are two common ways to obtain a biopsy of the nodule.
The first method of biopsy, bronchoscopy, a patient is sedated and a camera is placed into the lungs from the throat and samples are taken under x-ray. The technique has less complications, with a 60 to 70 per cent success rate of identifying the cancer but is limited by the quality of the images.
“Using 2D X-ray doesn't give us a lot of information on exactly where we are,” Chinthaka said.
The second, more effective method which uses a needle from the outside of body to biopsy the nodule, has a 90 per cent success rate of identifying the cancer, though carries up to 25 per cent risk of lung collapse.
The new technique introduced at Westmead Hospital, a CT guided bronchoscopy, combines the best of both approaches by incorporating a CT machine in a ‘hybrid operating theatre’.
The CT scan provides a 3D image of the nodule, providing doctors with a more precise location of the nodule, improving the accuracy of diagnosing it.
“It almost gives us a pathway to get to it and then confirm that our biopsy tools are within the lesion so the success rate of the procedure increases to over 90%,” Chinthaka said.
Importantly, the new method carries only a 2 per cent risk of lung collapse.
“This kind of technology allows us to get a diagnosis fast, accurately and safely and get the correct treatment for our patients as quickly as possible,” Chinthaka said.
Chinthaka said lung cancers are often noticed or diagnosed when they have progressed.
“Lung cancer still has a five-year survival rate less than 25 per cent, which is much lower than breast cancer, prostate cancer and bowel cancer,” he said.
“It's the most common cause of cancer related death in Australia still because it presents late. Over 15,000 new cases of lung cancer are diagnosed each year, and on average 25 people a day die from it.”
There are symptoms for people to be aware of which may indicate lung cancer.
“A persistent cough, coughing up blood, chest pain, worsening breathlessness, those are the more common symptoms,” he said.
Most early-stage lung cancers don’t cause any symptoms. A national early detection screening program was introduced in July last year, to screen for people who may be more likely to develop lung cancer.