Questions & answers about pulmonary brachytherapy at UT Health Science Center at Tyler

Tuesday, January 27, 2009

What is pulmonary brachytherapy?
Pulmonary brachytherapy is a cutting-edge technique in which tiny cancerous tumors located in the edges of the lungs are zapped by high doses of radiation.

The University of Texas Health Science Center at Tyler and a facility in Heidelberg are the only two places in the world that couple pulmonary brachytherapy with electromagnetic navigation bronchoscopy – a global positioning system (GPS)-like technology – thus allowing high-dose radiation to be delivered right to these tiny lung tumors.

Pulmonary brachytherapy also can treat lesions or tumors that obstruct the airways, allowing people to breathe easier even if they are not well enough to undergo the rigors of open chest surgery.

How does it work?
With data from a special three-dimensional CT scan, Ted McLemore, MD, Ph.D., an interventional pulmonologist at UTHSCT, and his team plan out the route to the cancer through the lungs’ branching airways using the SuperDimension system and electromagnetic navigation bronchoscopy.

Dr. McLemore, director of interventional pulmonology at UTHSCT, introduces the SuperDimension system into the bronchoscope, a hollow flexible tube inserted into the patient’s nose or mouth that provides a view of the airways, and the system makes its way to the tumor.

The sedated patient receiving pulmonary brachytherapy is in a shielded room that protects those outside from radiation exposure.

In the adjacent room, Michael Kerley, MD, a radiation oncologist; Tim Ochran, Ph.D., a medical physicist; and Ron Jung, UTHSCT’s director of radiology and a certified radiologic technologist with an additional certification in magnetic resonance imaging, oversee the procedure.

A catheter is inserted into the tumor, and a robot delivers the capsule with the radioactive material into the tumor.

The tumor receives a high dose of radiation for just three or four minutes. The capsule then is withdrawn and shielded, the radiation ceases, and the patient is taken to recovery.

What are the benefits of pulmonary brachytherapy?
Pulmonary brachytherapy is a very accurate way to treat a tumor. Because the radiation is delivered right to the tumor, it provides patients with prompt relief while reducing damage to healthy lung tissue.

Pulmonary brachytherapy can treat cancerous lesions as small as 6 millimeters, slightly bigger than the length of a grain of rice. It tends to have fewer side effects and a shorter treatment time.

Pulmonary brachytherapy is a technique used in interventional pulmonology. What is interventional pulmonology?
Interventional pulmonology is a relatively new field, focused on developing non-surgical procedures to diagnose and treat both malignant and benign lesions inside the lung.

Many people with lung diseases such as chronic obstructive pulmonary disease and emphysema are not well enough to undergo the rigors of open-chest surgery.

Why is this treatment such a breakthrough in treating lung cancer?
Lung cancer is the No. 1 cancer killer in the United States. It kills more people than breast, colon, and prostate cancers combined. Just 15 percent of people diagnosed with lung cancer survive for five years after their diagnosis.

This new technology coupled with new radiology techniques enable physicians to diagnose and treat lung cancer at an earlier stage and thus improve lung cancer survival rates.

What do you need for pulmonary brachytherapy, besides extremely sophisticated technology?
Such advanced procedures require a great team of excellent radiologists, pulmonary pathologists, thoracic surgeons, oncologists, radiation oncologists, and nursing staff.

Crucial team members at UTHSCT include Ted McLemore, MD, Ph.D., director of interventional pulmonology; Timothy Allen, MD, the only board-certified pulmonary pathologist in East Texas; Michael Kerley, MD, a radiation oncologist; Tim Cochran, a medical physicist; and Ron Jung, director of radiology and a certified radiologic technologist with an additional certification in magnetic resonance imaging.

For 60 years, The University of Texas Health Science Center at Tyler has provided excellent patient care and cutting-edge treatments, specializing in pulmonary disease, cancer, heart disease, primary care, and the disciplines that support them. With an operating budget of more than $125 million and biomedical research funding that exceeds $10 million annually, UTHSCT has a major economic impact on East Texas. Its two medical residency programs – in family medicine and occupational medicine – provide doctors for many communities in East Texas and beyond.

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