Endobronchial Ultrasound (EBUS) - A New Lung Cancer Diagnosis Technique

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Tracy Weigel, MDMADISON - Maggie Sullivan of Verona was shocked to learn her nagging cough was lung cancer, even though she quit smoking decades ago.
But after a life-changing diagnosis, Sullivan still was able to avoid unnecessary surgery, thanks to a new diagnostic innovation used by UW Health lung surgeon Tracey Weigel, MD (pictured, left).

Sullivan underwent an Endobronchial Ultrasound (EBUS), a more precise way of assessing the lymph nodes and determining if lung cancer has spread. UW Hospital is one of only two hospitals in Wisconsin that use the technology.

A PET scan (positron emission test) suggested Sullivan's lung cancer was localized but at stage three - already in the lymph nodes near the windpipe (trachea). But Dr. Weigel performed an EBUS just before surgery to remove a tumor from Sullivan's right lung. Dr. Weigel inserted a bronchoscope (with a special ultrasound at its tip) into Sullivan's windpipe and used the probe’s detailed images to assess if the cancer had spread within the windpipe and nodes on either side.

The EBUS found Sullivan's lung cancer was just stage one and not present in any lymph nodes on either side of the trachea. That meant Sullivan was able to have surgery that did not damage nerve and muscle tissue. She spent only two days in the hospital and needed only over-the-counter pain medicine a week after the procedure.

Lung cancer is typically diagnosed after it has already spread, and long-term prognosis for patients is usually poor. But with the innovation of EBUS and its ability to accurately show the cancer stage, patients with early-stage lung cancer may avoid more extensive surgery, leave the hospital sooner and use less pain medication.

"The type of treatment we recommend for lung cancer patients depends to a large degree on the stage of their cancer," says Dr. Weigel, who is also a member of the University of Wisconsin Carbone Cancer Center. "The great advantage of this technology is that people who will benefit from surgery will not be written off as a poor candidate because of less accurate conventional staging with CT and PET scans."
Dr. Weigel says it also means people with advanced lung cancer will not have to endure surgery.

Dr. Weigel and colleague James Maloney, MD, have performed 22 EBUS procedures at UW Hospital.

Sullivan, an assistant dean at the UW-Madison College of Letters and Science, is planning to return to full-time work soon.

Date Published: 01/10/2008

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