Dr. Ivanick on the Diagnostic Role of Interventional Pulmonologists in Lung Cancer

Nathaniel Ivanick, MD, FCCP, assistant professor of oncology, thoracic surgeon, Roswell Park Comprehensive Cancer Center, discusses the role of interventional pulmonologists in advanced diagnostics in lung cancer.

Interventional pulmonologists serve 2 main roles in the management of lung cancer: advanced diagnostics and therapeutics, Ivanick explains. Advanced diagnostics are done for patients with early- and late-stage disease.

Advanced diagnostics may include obtaining biopsies of small peripheral lung nodules that were historically inaccessible by robotic navigational scopes, Ivanick says. These technological advances allow for earlier-stage disease to be diagnosed when patients are eligible for surgery.

In cases of lung cancer that have spread to the hilar and mediastinal lymph nodes, linear endobronchial ultrasound (EBUS) can identify lymph nodes near the surface of the airway to be biopsied, Ivanick explains. Linear EBUS represents a significant advancement as this was previously accomplished by mediastinoscopy or CT-guided lymph node biopsies. With linear EBUS, malignancies in lymph nodes as small as 5 mm can be identified, Ivanick adds.

Finally, in patients with pleural disease, interventional pulmonology can identify malignancies within the pleura and match patients to optimal treatments, Ivanick concludes.