New methods enhance lung cancer treatments

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A 61-year-old Bartholomew County man recently diagnosed with lung cancer made the decision to stay as close to home as possible while receiving treatments.

Fortunately for Howard Smith of Columbus, one new treatment option was available less than 20 miles away in Seymour.

That new treatment, photodynamic therapy, uses light-activated drugs and a laser to kill tumors, opening up airways so a lung cancer patient can breathe more easily, according to Dr. David Wilson.

That in turn means Smith will do better when he starts receiving chemotherapy treatments and won’t get into trouble with bleeding and pneumonia behind the cancer, the Columbus pulmonologist said.

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And that’s the whole point of the therapy, Wilson said.

He said photodynamic therapy is unique to Schneck Medical Center.

“This is probably the only existing program in the state of Indiana,” he said.

Born and raised in Madison, Wilson said both sides of his family were tobacco farmers.

“I have seen lung cancer and lung diseases affect them and everyone I deal with in a really tremendously negative way,” he said.

“So given all of that, it has always been my desire wherever I practice to address these problems,” he said.

“Lung cancer is underdiagnosed and undertreated. We need to find it earlier, and we need to have more creative approaches because it is the most deadly form of adult cancer in the United States, and it has been for over 35 years in both sexes.”

In 2013, the number of lung cases diagnosed in Jackson County rose to 45. That surpassed the number of breast cancer cases (35) diagnosed that year for the first time since Schneck started collecting cancer data in 1986.

All of the lung cancer cases were linked to smoking, according to Sally Acton, director of cancer and pain services at Schneck.

Smith, who didn’t want to travel to a bigger city for treatment, said he was able to breathe more easily after therapy, and it’s something he would recommend to others facing fights with lung cancer.

Schneck also introduced a new procedure a year ago that is more effective when it comes to a lung cancer diagnosis and early treatment.

Tyler Wessel, manager of ambulatory services at Schneck, said the process begins when a person potentially suffering from lung cancer comes to the hospital after a consultation with a doctor.

That consultation might have occurred by a lung screening revealing a potential problem; the person has a history of smoking; or lung cancer is prevalent in their family, Wessel said.

In the past, doctors looking for lung cancer lesions had to rely on a bronchoscope (a long tube with a camera on the end) inserted into the airways generally through the nose or the mouth. That would occur after a chest X-ray or CAT scan revealed the possibility of lung cancer.

Almost a year ago, Wilson started using the Veran Medical Technologies electromagnetical navigational system in conjunction with the bronchoscope as a means of better finding cancerous lesions in the lungs.

Since Schneck started using the system Oct. 22, 2014, 42 patients have utilized it. The system provides doctors with a virtual 3-D image of the lungs as they move when the patient breathes.

The process of undergoing the procedure begins on a Monday when the patient receives a dose of medication at the Don and Dana Myers Cancer Center across the street from the hospital. That medication, which also helps treat the cancer, makes the body light sensitive.

“We have to keep these people out of direct sunlight for a month because it really will cause a burn,” Wessel said.

Smith said he had to wear special sunglasses, long-sleeved shirts and long pants but still managed to burn his lip, so he eventually avoided going out at all in the daytime.

The system produces the virtual 3-D image by using leads placed on the patient’s chest. That helps the physician guide the scope along with bronchoscope to take a biopsy of a suspected lesion.

Wilson said the point of the system is to help find small pulmonary lesions at a point much like breast cancer in terms of the development.

“Find the small lesions, take care of them at an early stage and be cured as opposed as to waiting for it to get worse,” he said.

Wilson said the nice part about the Veran system is it also has the ability to do it through the chest with a needle biopsy if the lesion is close enough to the surface.

“So it’s a real advantage and way ahead of others in the area in terms of being able to have a lot of different ways to get at lung lesions,” Wilson said.

It’s also an outpatient procedure that doesn’t take long.

“It takes maybe three hours overall and 15 or 20 minutes for the procedure,” he said.

Smith said the procedure is not real painful, and the length of the stay afterward just depends on the patient’s recovery time.

After it’s determined a lesion is cancerous, the photodynamic therapy is used to go to the lesion and laser it out, Wessel said. The therapy also is used to go back and remove damaged tissue in the area.

Once the lesions are removed, the patient will still have to undergo radiation and/or chemotherapy treatment to ensure the cancer is gone, Wessel said.

Wilson said the procedure is just one of many advances being made in the diagnosis and treatment of lung cancer. Generally, the new procedures are becoming more efficient and less invasive, he said.

“Both of these are that,” Wilson said.

The new therapies also are all part of a broader attempt to establish a lung cancer program at Schneck, Wessel said.

Wilson is a key part of that effort, but many others also are involved in a variety of ways, Wessel said.

Dr. Luyen Le, a surgeon, performs a procedure known as a lobectomy, which is the removal of some of the five lobes of the lungs.

A lobectomy isn’t for lung cancer patients who have cancer that is spread outside the lungs, and it permanently limits a patient’s range of activities.

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