Revolutionary Approach to Lung Cancer Diagnosis and Staging

Until recently, lung cancer diagnosis and determining a patient’s stage of cancer relied on CT and PET scans, as well as a biopsy, which often required an invasive operation.

Interventional Pulmonologist Matt Salamonsen from Murdoch Chest says the introduction of Endobronchial Ultrasound (EBUS) has revolutionised the field of respiratory medicine.

“EBUS is a non-surgical procedure used to diagnose lung cancer, infections, and other diseases causing enlarged lymph nodes (glands) in the chest,” Dr Salamonsen says.

“Performing the old surgical procedure was limited, depending on how well the patient was and whether they were healthy enough to cope with the procedure.”

“EBUS is a minimally invasive day procedure that requires some sedation, has fewer complications and effectively diagnoses and stages cancer.”

“It can be performed on the unwell, elderly, and those with significant medical comorbidities and now sets the international standard for diagnosis.”

It is critical to stage cancer accurately by identifying which lymph nodes (glands) in the chest are infiltrated with tumour, as this directs appropriate treatment between curative surgery and palliative chemoradiotherapy.

“In some situations, CT and PET scan have a 20 per cent false positive and false negative rate for detecting lymph node metastases,” Dr Salamonsen says.

“This means a significant number of patients are being denied surgery when they have operable early stage disease, or are undergoing futile surgery when they have more advanced disease.”

Aside from lung cancer, EBUS is also invaluable in the setting of other cancers or lymphoma involving the mediastinum, or non-malignant causes of mediastinal lymphadenopathy such as infections and sarcoidosis.

Dr Salamonsen also emphasises the need for a multidisciplinary team approach to patient care.

“It’s vital for the patient’s whole medical team – thoracic surgeon, oncologist, radiologist, interventional pulmonologist and respiratory physician – to meet as a group and discuss the patient’s treatment, so that we can decide the best tailored approach to maximise rates of cure and quality of life for each individual patient.”

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