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A new robotic-assisted technology, used for the first time in the UK by our team at Royal Brompton Hospital, allows specialists to take biopsies of very small lung tumours which would otherwise be difficult to reach. The Ion endoluminal system (Ion) means that lung cancer can potentially be diagnosed earlier, when the likelihood of survival is highest.
Lung cancer often detected too late
Almost 50,000 people are diagnosed with lung cancer each year in the UK, making it the third most common type of cancer and the leading cause of cancer death. It is often difficult to identify and therefore over two-thirds of cases are diagnosed late, at an advanced stage of progression.
The outlook for lung cancer is typically worse than that of other types of cancer, with 60% of patients dying within the first year of their diagnosis. Current treatment options for lung cancer include surgery, chemotherapy and radiation therapy, but the factor that increases the chance of survival more than anything else is early diagnosis.
Professor Pallav Shah, consultant physician in respiratory medicine at Royal Brompton and Harefield hospitals, and Dr Christopher Orton, consultant in respiratory medicine, worked on the Ion Robot trials to achieve early diagnoses of lung cancer for their patients.
What are the symptoms of lung cancer?
In the early stages of lung cancer, there are usually no signs. However, as the disease progresses, symptoms will develop and gradually worsen. Common symptoms include:
- a persistent cough that worsens
- a dull ache in the chest
- a sharp pain when breathing in deeply
- coughing up blood
- breathlessness
- unexplained weight loss
- fatigue or lack of energy
- chest or shoulder pain
Lung cancer is often not detected until it is at an advanced stage when it has spread, either within the lungs or throughout the body. “Detecting lung cancer early leads to the greatest chance of a curative treatment, potentially increasing a patient’s chance of survival,” explains Dr Orton. “The Ion system helps us diagnose our patients while their lung cancer is still small enough to be removed through a simple surgery.”
What is the Ion endoluminal system?
Ion is a new biopsy platform which is designed to collect biopsies (samples from lung tumours) to test whether they are cancerous. Although the system is robot-assisted, the collection of the biopsies is fully controlled by the operator carrying out the procedure.
The procedure using Ion involves inserting a very thin and flexible catheter (a thin tube) into the patient’s airways through their mouth. The catheter has a camera on the end to provide a view of the patient’s airways and lungs, while offering better flexibility and precision. The Ion system can also provide better access to hard-to-reach areas of the lung, where it previously may not have been possible to collect biopsies.
Once the Ion catheter has been inserted into the lungs via the patient’s mouth, the operator can use the tool to take multiple biopsies from an area of tissue, with a high level of accuracy. “This means we can potentially diagnose lung cancer earlier, as we can take samples from lung tumours of only 6mm or even smaller,” explains Professor Shah. “This allows us to provide treatment to patients quickly, reducing uncertainty and worry, and increasing survival rates.”