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When Should You Get Screened for Lung Cancer? (video)

Interventional pulmonologist discusses diagnostic procedures

Interventional pulmonologist discusses diagnostic procedures

Lung cancer is the leading cause of cancer death in the United States and early detection is key to a better survival rate. Diagnosing lung cancer in its earliest stages has long been challenging due to the complex structure of the lungs, but new robotic-assisted technology is making more accurate early diagnosis possible.


In this video, San Diego Health host Susan Taylor talks with Samir Makani, MD, Scripps MD Anderson cancer specialist and director of interventional pulmonary medicine at Scripps Memorial Hospital Encinitas, about robotic bronchoscopy and how it improves lung cancer screening.

What causes lung cancer?

Cigarette smoking remains the number one cause of lung cancer; 90% of lung cancers occur among current or prior smokers. Lung cancer cannot always be prevented, but Dr. Makani says not smoking — or quitting if you currently smoke — is the best preventive step.


Other lung cancer risk factors include exposure to diesel fuel, radon gas, asbestos and other chemicals in the workplace or at home. Genetics also may raise the risk of lung cancer.


The main symptom of lung cancer is coughing. While coughing is a common symptom of mild illnesses like a cold or allergies, a cough related to lung cancer lasts for weeks or longer and doesn’t feel like a “normal” cough.


“If the cough is lingering on and it just doesn’t feel right to you, and you’ve just been living with it and thinking it is due to your sinuses or something else, it’s time to get it checked out,” says Dr. Makani.


Other lung cancer symptoms include coughing up blood, shortness of breath and chest pain.

How is lung cancer detected?

As with most types of cancer, early detection is extremely important. The earlier cancer is found, the greater the likelihood of successful treatment.


To detect lung cancer, doctors perform a chest X-ray or CAT scan to look for nodules, which appear as small white or hazy spots in the lungs. Nodules do not always indicate lung cancer; they also may be caused by scars from pneumonia or current infections.


If nodules are found, the next step is to do a bronchoscopy, a procedure to remove a sample of the lung tissue to check for cancer. Though bronchoscopy has been around since the late 1960s, getting an accurate sample of the nodule has been difficult.


“Over the years, we’ve had different tools that allow us to reach into the depths of the lung tissue with more precision,” explains Dr. Makani. “In the past few years, we’ve come up with newer platforms which are robotic-assisted and give us much better accuracy.”


Dr. Makani compares robotic-assisted bronchoscopy to taking a road trip. The first step is loading the image of the lungs into the system to generate a 3D “map.” The program generates a pathway to the actual tumor, which appears as a yellow dot. The doctor then inserts a thin, lighted tube called a bronchoscope through the patient’s nose or mouth and guides it to the lungs using a handheld controller.


“I’m essentially holding a game controller which allows us to navigate with extreme precision through the lung tissue to the spot,” says Dr. Makani. “Robotics allows those bends and turns within the lungs to be manipulated with better accuracy, so we get to within millimeters of the lesion.”


Once at the tumor, the doctor passes other tools through the incision to take a tissue sample for a biopsy.


Robotic bronchoscopy is done under general anesthesia, so patients are completely asleep and comfortable for the entire procedure, which takes about an hour.

When should I see a doctor?

If you have a lingering cough, cough up blood or feel short of breath, see your primary care physician sooner rather than later. Your doctor will evaluate you and determine the cause of your symptoms and whether you need treatment.


“Here at Scripps MD Anderson, we have the most innovative treatment available for the management of lung cancer,” says Dr. Makani. “We’re cutting edge and we’re going to take great care of you.”