What tests are used to diagnose lung disease?
Often the initial test is a chest x-ray, and if an abnormality is found, a CT scan is typically performed to help better define the problem. If malignancy is suspected, your pulmonologist may order a CT-guided biopsy to obtain tissue from the mass to confirm cancer. A PET scan usually follows to see if the cancer has spread to the lymph nodes in the chest or to other sites in the body. If cancer is suspected in the mediastinal (chest) lymph nodes, they are sampled using either endobronchial ultrasound (EBUS) or mediastinoscopy. A bronchoscopy and pulmonary function tests are also necessary to help determine lung resectability.
How is lung surgery performed?
There are three ways to access to the lung for surgical intervention: thoracotomy, thoracoscopy (VATS), and robotically using the da Vinci system.
What is a thoracotomy?
A thoracotomy is an incision in the chest cavity to allow access to the chest organs, such as the lungs, for surgical intervention. The incision is typically located on the patient’s side under the shoulder blade; this is known as a posterolateral thoracotomy. It may also be used anteriorly or in the axilla, depending on the procedure being performed.
What is a thoracoscopy (VATS)?
VATS stands for video-assisted thoracoscopic surgery. It entails making small incisions in the chest and inserting a camera to inspect the organs and contents of the chest. It is used in surgical procedures such as lung resection, fluid drainage, biopsies and pleurodesis. It is less invasive than a thoracotomy, with faster recovery. Your surgeon will determine if a VATS is appropriate for your particular condition.
What is robotic-assisted thoracoscopic surgery?
Small incisions are made on side of the chest wall near the shoulder blade to place the robotic camera and arms into the chest cavity to operate on the organs of the chest. The surgeon sits at a console controlling the robotic arms remotely. It is less invasive than a thoracotomy, with quicker recovery times and typically a shorter hospital stay. Your surgeon will determine if robotic-assisted surgery is appropriate for your disease process.
How is lung cancer diagnosed?
The major risk factor for lung cancer is smoking. Lung cancer may be asymptomatic, or you may have symptoms such as a new cough or unexplained weight loss. Often a lung nodule or mass is found on a chest x-ray, which is evaluated further with a CT scan of the chest. If the lesion appears concerning for cancer, a CT-guided biopsy may be obtained. If this is found to be positive for cancer, a PET scan is performed to ascertain whether the cancer has spread to the lymph nodes in the chest or to distant organs (known as metastasis). The lymph nodes may be biopsied using endobronchial ultrasound (EBUS), a mediastinoscopy or a Chamberlain procedure. The purpose of these diagnostic tests is to try to identify the stage of your cancer and determine your appropriate treatment. This could entail surgery, chemotherapy and radiation therapy, or a combination of all three modalities, which would be determined by your pulmonologist, surgeon and oncologist.