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Breathe easier

December 2, 2009

AHS Communications

'GPS for lungs' helps Alberta doctors diagnose, treat cancer

Three doctors using the latest technology are helping make life better for Albertans who suffer from lung diseases.

Drs. Alain Tremblay, David Stather and Paul McEachern are the only physicians in Canada using the In-Reach System, which is essentially a GPS for the lungs.

The system, based at Foothills Medical Centre in Calgary, is useful for getting to lesions and spots on the lungs that normally would be difficult or impossible to access without surgery. Being able to get to the lesion and take a biopsy without resorting to major surgery can make a significant difference for patients' medical care.

"This is a day procedure," says Tremblay. "Patients are here for four hours and then they’re done. It's much less invasive than surgery."

A CT scan is taken of a patient's lungs and the image is downloaded to a computer.  The doctors insert a small probe into the patient's lungs through a bronchoscope, using the computer to triangulate the exact position of the probe.

"There are some patients who have bad enough lungs that you can't even get a biopsy.  It's too risky, which means they can't get treatment," Tremblay adds. "This way we can more safely get their biopsies and then they can go on to the cancer centre and get their treatment. If it wasn't for this system, we would have no options for these patients."

One such patient is Florence Wyatt. A dime-sized nodule showed up on the Calgary woman’s lung during a routine CT scan but a surgical biopsy was out of the question because of the drugs she was taking for another condition.

The decision was made to use the In-Reach system do to a biopsy in June. The nodule was cancerous; Wyatt underwent radiation therapy in July and feels great today.

"I'm very fortunate," says Wyatt. "If it wasn't for this procedure, I guess the nodule would have kept getting bigger and it probably would have taken my life."

There is also a therapeutic use for the system. Instead of taking a biopsy, a marker can be placed on the affected area of the lung. Radiation doctors at the Tom Baker Cancer Centre or Edmonton's Cross Cancer Institute can then track the marker and give the area a more concentrated dose of radiation.

Tremblay says the system, in use since March, can prevent needless surgeries.

"Often people will go into surgery if they have a lump. It's a big surgery, a big incision and it requires several days in hospital," he says.

"If you get in there, take that piece of lung out and it turns out not to be a cancer, it would be nice to have avoided the surgery altogether."

According to Tremblay, Calgary is Canada’s leading centre for interventional bronchoscopy, a relatively small field that consists of advanced diagnostic and therapeutic methods using cameras down the windpipe.

Tremblay was one of Canada’s first trained interventional bronchoscopists. Since arriving in Calgary in 2001 he has started a fellowship program which has trained both Stather and McEachern.

The trio are an important resource for all Albertans in the battle against lung cancer, which is the leading cause of cancer deaths in Canada.

"This is not just for Calgary," says Tremblay.

"We work well with our colleagues in Edmonton; they send us their patients and we take patients from anywhere in the province.

"A provincial approach makes sense," he adds. "Even if we were going full-steam ahead I can't imagine we'd do more than 50 of these procedures a year province-wide, so it wouldn't make economic sense to have more than one or two of these systems in the province."