A Better Way to Screen for Lung Cancer

Doctors at Montefiore Hospital are using a less invasive way to screen for lung cancer. 

By Chirag Shah, MD, Director of Bronchoscopy and Outpatient Pulmonary Programs at Montefiore 

Bronx Voice

November 2, 2022

HEALTH - As a native New Yorker, born in Brooklyn and raised in Manhattan, I grew up going to the local hospitals for my care. I never questioned the quality of care I received. I just assumed that my parents and doctors knew what was best. I was fortunate. As I grew older and became a doctor myself, I came to realize just how lucky I was.

Every person doesn’t have the same access to care – and importantly, might not get all the information and education they need about pressing health issues. Overlay stigma associated with a disease like lung cancer, and we begin to see why there is so much work to do.

This November is Lung Cancer Awareness Month, a time to take stock of how we are doing with screening, communication, and care.

Our Lung Cancer Screening Program began at Montefiore in 2012. At that time, we offered CT scans to people who were between the ages of 55 to 75, and who had smoked at least one pack of cigarettes a day for 30 years and quit in the last 15. Last year, these numbers were expanded screening to people ages 50 to 80-years-old who had smoked one pack a day for 20 years. 

Much like screening mammograms, colonoscopies, or skin checks, the people who call in to undergo screening is limited, despite our efforts to raise awareness of this important program among our community. Our local clinics and hospitals know who needs these screens. Even still, only one out of 15 eligible people undergo the CT scan. 

As a provider, it is heartbreaking to see so many of my patients come into the clinic with cancers that could have been caught and treated in earlier stages. We see our Black and Latino community members disproportionately impacted by these later stage lung cancers.

Often during screenings, we find nodules, which are small and solid spots in the lungs that need close evaluation and monitoring. Most people who undergo screening end up getting yearly CT scans so we can keep an eye on their lungs. Some people may end up being monitored more frequently for several years, with the hope that these nodules don’t grow. 

For individuals needing to undergo biopsies, more and more, we do a procedure called a bronchoscopy to identify which nodules might lead to cancer. In the past, we used a thin camera, which went through a person’s mouth and into the lungs to try to biopsy a small nodule, all while a person is breathing. Not the most efficient procedure nor comfortable procedure for the person getting it. In the last two years, science has advanced dramatically and has answered our call to address these challenges. 

This past summer, we opened a state-of-the-art operating room and were among the first in New York to outfit it with the newest technology to help people with lung nodules and people who have lung cancer.

We use the Intuitive Ion – the most advanced Robotic Bronchoscopy system there. The Ion Robot uses a person’s own CT scans to help us create pathways to nodules. What this means is that we use the Ion controller almost like a video game to drive our cameras to the nodules.

This machine is stable and still, and moves with precision, more so than a person could ever be! 

The Ion is used with, and talks to, an advanced x-ray machine that can create CT scans in the room to make sure we are getting to the nodules we find at the time of biopsy. 

This room is as advanced and modern as any room at the biggest cancer centers in the country – something we feel is important in supporting our community. 

Screening and detecting lung cancer is now better than it has ever been before and exceedingly more comfortable for people needing to be screened than in previous years. By leveraging this new technology and continuing to spread the word, including via articles like these, we hope that more people in our community are informed about the latest prevention and treatment options for lung cancer.

It is imperative that we curb some of the deadly lung cancer statistics that exist and educate more people about the screening techniques that can help decrease lung cancer in our community. One step at a time, I hope we get closer to more people feeling that they are getting the high-quality care they deserve so they can feel like I did growing up.