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Lung Diseases

Lung diseases are some of the most common medical conditions people suffer from in the United States. Symptoms of lung disease may include: cough, shortness of breath, coughing up blood, pain in chest, shoulder, upper back or arm, wheezing, fatigue, repeated pneumonia or bronchitis, loss of appetite, hoarseness, swelling of the face or neck. Many of these symptoms are similar to other common illnesses, but if a symptom persists, it is important to be examined by your primary care physician.

Lung Cancer Screening Program

Lung cancer is a very serious disease and often will not exhibit symptoms until the disease has progressed. Recognizing this fact, Milford Regional has developed a comprehensive lung cancer screening program (done with low-dose computed tomography) to detect the disease early when it is most treatable.  This program includes leading edge surgical technology, a coordinator to track patients and the creation of a pulmonary lung nodule review board.  Brigham and Women's thoracic surgeon Brian Whang, MD is the Chair of Thoracic Surgery at Milford Regional and has been an integral part in developing this program.  

Tracking System

The lung cancer screening coordinator holds a vital role in the efficacy of the program as she tracks every patient from their first CT scan to the review board's assessment to the primary care physicians's plans which may include specialist appointments with a pulmonologist or thoracic surgeon.  A state-of-the-art tracking software allows her to maintain meticulous records on every patient.

SPiN Thoracic Navigation System

Patients benefit from a revolutionary thoracic navigation system that allows our thoracic surgeons to accurately navigate to lung nodules, and then biopsy those nodules that were previously unreachable due to their size or location.  With this system, data from the chest CT scans helps to build a 3D map using the natural airways of the lungs as a guide.  Special instruments then track the exact location of the nodule for biopsy.  This leading edge technology is able to pinpoint the precise location of the lung nodule, which can spare the patient from a larger resection of the lung at the time of surgery.

Pulmonary Lung Nodule Review Board

Patients have the added assurance that an expert group of specialists, including thoracic, pulmonary, radiology, oncology, primary care, Chief Medical Officer and diagnostic imaging, meet twice monthly to review and assess lung cancer screenings. The Review Board addresses screening results with the ordering physician and provides their recommendations.

Lung Cancer Screening Test Criteria

Early detection can dramatically affect the outcome of the disease which is why patients are encouraged to speak to their primary care physician about the lung cancer screening test. Whether or not you should have the CT screening test will depend on your smoking history, along with your age, medical history and family history.

Patients at high risk include those who meet all of the following criteria:

  • Are 55 to 80 years old
  • Have a smoking history of 30 or more pack years (pack years are the number of cigarette packs smoked per day multiplied by the number of years a person has smoked).
  • Are currently smoking or who have quit within the last 15 years.

The lung cancer screening test is covered by Medicare for patients 55 to 77 years old and by most commercial insurance plans for patients 55 to 80 years old.

If you fit the criteria, speak to your doctor about obtaining a referral for this lung cancer screening test.

Lung Cancer

If lung cancer is confirmed, it usually will fall into one of two categories:

  1. Non-small cell lung cancer – is the most common form of lung cancer (approximately 85% of all cases fall into this category). Within this category, the main forms include:
    • Adenocarcinoma
    • Squamous cell carcinoma
    • Large cell carcinoma
      These forms of lung cancer are further categorized into one of four stages depending on the size of the tumor and if and where the cancer has spread.
  2. Small cell lung cancer – cells are much smaller and tend to spread quicker to other parts of the body. It is staged as limited, extensive or recurrent.

Treatment for lung cancer will often include surgery and either/or chemotherapy and radiation therapy. In order to develop the best possible treatment plan, each patient’s case is presented to a multi-disciplinary board of cancer experts in medical oncology, radiation oncology, radiology, pathology and thoracic surgery. Additional oncologists are teleconferenced into these meetings from Brigham and Women’s hospital and Dana Farber Cancer Institute. Collaboration among these highly experienced specialists produces the best possible treatment plan for each patient.

Most often the patient will undergo surgery first, followed by chemotherapy and/or radiation therapy. The size of the tumor and how wide-spread it is will determine which surgery is warranted:

  • Wedge – to remove small section of lung
  • Segment – to remove a larger portion but not the entire lobe
  • Lobectomy – to remove entire lobe of one lung
  • Pneumonectomy – to remove entire lung

When you are discharged from the hospital after surgery, you will be given a follow-up appointment with your thoracic surgeon. You will also be given discharge instructions, any prescriptions you may need and you will also follow-up with your oncologist for treatment at the Cancer Center.

Benign Lung Disease

Lung diseases that are not malignant but may be referred to a thoracic surgeon for treatment includes:

Benign tumors of the lung
Pulmonary cysts
Emphysema
Benign strictures
Effusion (accumulation of fluid in the chest)
Pneumothorax (collapsed lung)
Sarciodosis
Lung infections

Treatments for benign lung disease, depending on the condition, may include:
Surgery to remove tumors or cysts
Drainage procedures
Lung volume reduction (for emphysema)
Stent insertion for strictures
Simple surveillance

Pulmonary Rehabilitation

After discharge from the hospital following lung surgery, many patients benefit from our Outpatient Cardiopulmonary Rehabilitation Program. This is an exercise and educational program that helps patients with lung disease improve their quality of life. Read more about this program.

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