This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on May 6, 2022.
Your lung cancer care team is a group of different experts who work together before, during and after your cancer treatment.
For lung cancer especially, your team will likely include a pulmonologist—a doctor with expertise in conditions that affect the lungs. A pulmonologist takes an active role in diagnosis, staging and treatment planning, in addition to performing certain procedures and tests.
At City of Hope, we treat lung cancer using these interventional pulmonology procedures:
Central airway obstruction: Locating and clearing central airway obstructions may help you breathe more easily and fully. This approach also enhances your lung capacity to allow you to receive adequate doses of lung cancer treatment.
Advanced airway diagnostics: We use imaging technology to look for the cause of symptoms, including wheezing, coughing and labored breathing. Our cancer doctors identify tumors, blockages or internal bleeding, and use evidence-based lung cancer treatments to reduce or eliminate symptoms.
Pleural effusion: Many people with lung cancer accumulate excess fluid around the lungs. This condition, called pleural effusion, may cause pain, shortness of breath and other complications. We use minimally invasive techniques to drain this fluid, allowing lung cancer patients to breathe more easily. These techniques also help reduce the recurrence of excess fluid in the lungs.
Treatment-related side effects: Some lung cancer treatments, such as chemotherapy, may cause scarring in the lungs. While we try to reduce these side effects, aggressive lung cancer treatment may cause unavoidable complications. We use certain interventional pulmonology procedures to treat your symptoms, and to distinguish between a side effect of treatment and the progression of the cancer.
The lung cancer team at City of Hope is trained and experienced in delivering minimally invasive bronchoscopy techniques for many of our interventional pulmonology procedures. Bronchoscopy is a sophisticated technology that uses a flexible tube with a camera at the end (a bronchoscope) that allows us to look inside the lungs and airway.
We use the bronchoscope to deliver laser and other cancer-killing technologies to tumors buried deep inside the lungs. As a result, we can manage symptoms like bleeding or coughing, open up a blocked airway, and treat a very early-stage lung cancer or a previously treated area.
Our lung cancer patients benefit from bronchoscopy procedures because they reduce the risks of more invasive treatments.
Interventional pulmonology procedures are used to treat lung cancer in a variety of ways. For example, an indwelling pleural catheter gets its name from what is known as the “pleural space,” which consists of two thin membranes, one lining the lung and the other lining the chest wall. When lung tissue expands normally, the pleural space compresses against the chest wall but remains dry.
Tumors in the lung or tumors that have metastasized from other organs may spread into this space and cause fluid to build up. This condition is called malignant pleural effusion, which your doctor would diagnose by performing a physical examination of the chest, a chest X-ray, computed tomography (CT) scan or chest ultrasound.
Malignant pleural effusion prevents the lung from functioning properly and leaves you short of breath. Some patients may also experience chest pain, a cough and/or fever. We use indwelling pleural catheters to help make fluid drainage as simple and pain-free as possible. Your breathing should improve once the fluid is removed.
Interventional pulmonology procedures for lung cancer include:
Airway stent: If other treatments did not help in relieving your symptoms or treating airway blockages, your doctor may place a stent to maintain an open airway and help you breathe better.
Argon plasma coagulation (APC): Our doctors may use APC to cauterize blood vessels that are bleeding and causing a patient to cough up blood. The doctors “paint” the area with the plasma to stop bleeding. APC is safe to use on thin tissues, such as those that line the lungs and airway.
Pleurodesis: Our doctors may perform a pleurodesis for patients with recent accumulation of excess pleural fluid in the area around the lungs.
Navigational bronchoscopy: A navigational bronchoscopy combines imaging techniques with electromagnetic navigation to help find and treat cancer anywhere in the lungs. This procedure allows doctors to reach distant tumors by advancing the scope into smaller bronchi or bronchi that are blocked by a tumor. Navigational bronchoscopy procedures may be used to:
Photodynamic therapy (PDT): PDT for lung cancer may be performed on an outpatient basis. It typically is pain-free, requires limited sedation and involves less risk than surgery and fewer side effects because healthy tissue is spared. PDT also generally takes just minutes to complete.
Thoracentesis: Some patients with lung cancer accumulate excess fluid in the space that surrounds the lungs. Draining that fluid with thoracentesis may help restore fuller, more comfortable breathing and supports other treatment approaches.
Hypoxia altitude simulation test (HAST): HAST allows your physician to screen for respiratory symptoms and estimates your supplemental oxygen needs for air travel.
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