Dec. 15, 2023
Even with advancements in lung cancer screening, detecting the disease in its early stages and ensuring timely treatment continue to be a challenge. Ideally, the time from detecting a lung nodule to its surgical removal should be less than four weeks. However, even in an "ideal" situation, this period can lead to heightened anxiety and stress for patients. The conventional process often necessitates multiple hospital visits for biopsy, imaging, work-up and, finally, treatment. Each of these separate trips adds to the patient's overall burden.
"The goal is to reduce strain and anxiety on patients and families that have to take time off of work, time to travel, cost and, of course, from a cancer standpoint, minimize that time to treatment."
With the goal of advancing patient care, Janani S. Reisenauer, M.D., has developed a first-in-class lung cancer procedure — what she calls the single anesthetic lung surgery pathway. Dr. Reisenauer is an interventional pulmonologist, a thoracic surgeon and the chair of Thoracic Surgery at Mayo Clinic in Rochester, Minnesota. She is also one of the first thoracic surgeons in the U.S. to use robotic bronchoscopy to access previously inaccessible lung nodules.
For eligible patients, this all-in-one procedure consolidates diagnosis, staging and treatment of lung cancer, thus reducing hospital visits, time away from family, recovery time and the emotional strain of awaiting treatment. It also lowers overall risk by reducing a patient's time under anesthesia.
"The goal is to reduce strain and anxiety on patients and families that have to take time off of work, time to travel, cost and, of course, from a cancer standpoint, minimize that time to treatment," says Dr. Reisenauer.
Evaluating patient eligibility and the comprehensive surgical approach
Overall, a good candidate for the consolidated pathway meets the following criteria:
- Healthy enough to undergo surgery.
- Possesses a lung nodule with a high suspicion of being cancerous.
- Does not appear to have metastatic cancer.
To confirm a patient's candidacy for surgery, the patient undergoes comprehensive pre-surgical testing, including breathing capacity assessment, as well as CT and PET scans to ensure that the cancer hasn't spread.
During the surgery, which takes place under general anesthesia in a hybrid operating room, a robotic bronchoscopy guided by CT imaging is used for a precise biopsy of the lung nodule. Pathology services in the room allow for immediate analysis of the biopsy, facilitating a swift transition to minimally invasive lung resection if cancer is suspected.
If staging is indicated to rule out, for example, spread to the lymph nodes, this also can be done during the same procedure.
Driving innovation beyond the single anesthetic pathway
Dr. Reisenauer stresses that the single anesthetic lung surgery pathway is just one tool in a vast array of diagnostic and treatment options at Mayo Clinic Comprehensive Cancer Center.
For patients not eligible for single-stage surgery, Mayo Clinic offers customized treatment plans supported by a multidisciplinary team, emphasizing the team's role in personalized cancer care. Among a wide range of ongoing studies, current research includes leveraging the genetic profiles of patients with lung cancer to individualize treatments further and using artificial intelligence to better understand how tumors behave.
Dr. Reisenauer believes that a combination of Mayo Clinic's cutting-edge research and recent innovations, such as the single anesthetic pathway, will provide a stepping stone for future advancements.
"Ten years from now, the way we treat lung cancer may shift. I view the single-stage pathway as just one of the foundational building blocks of that change implementation," says Dr. Reisenauer.
For more information
Refer a patient to Mayo Clinic.