Published on December 12, 2019

Treatment Strategy Eases Breathing for Lung Cancer Patients

Concord Hospital is one of the few hospitals in southern New Hampshire offering cancer patients a new range of treatment to ease breathing when airways are blocked or compressed by tumors. 

Therapeutic bronchoscopy is a treatment strategy in which doctors can remove or destroy tumors blocking the airway from the inside and help keep the airway open when it is being squeezed by tumors from the outside.

Options include destroying or shrinking tumors by burning or freezing them, removing them surgically or targeting them with radiation or chemotherapy.

Therapeutic bronchoscopy procedures do not cure a patient’s cancer, said Dr. Martin Black of Concord Hospital Medical Group Concord Pulmonary Medicine. They are forms of palliative care that can help decrease symptoms such as shortness of breath, coughing up blood and the risk of pneumonia. The treatments can also be used as part of a curative treatment strategy when combined with chemoradiotherapy.

“The idea is to get someone’s lungs to be functioning as soon as you can,” said Dr. Black.

Patients who benefit from therapeutic bronchoscopy include those suffering from cancer that has spread from other organs to the airway or the area around it. The most common is lung cancer. The treatment options were introduced at Concord Hospital in 2017. Before then, patients from the region were referred to Boston hospitals.

In some patients, when the airway is debulked, or cleared, from the inside, but still compressed by outside tumors, doctors can place a stent or tube inside the airway to keep it open and allow a patient to breathe. Patients for whom surgery to remove advanced tumors in the airway is too much of a risk also can benefit from a stent. Stent procedures as part of therapeutic bronchoscopy treatment will be available at Concord Hospital later this year.

Therapeutic bronchoscopy care is part of a multidisciplinary approach at Concord Hospital. For most patients, Dr. Black and thoracic surgeon Dr. Alexandru Mihai Vaida of Concord Hospital Medical Group Cardiothoracic Surgery perform procedures in tandem. The approach gives patients the benefit of two specialists providing care in a single procedure.

It also means more timely treatment for patients in this region, no referrals to other facilities, no multi-day hospital stays as patients wait for a bed to become available elsewhere and follow-up care close to home.

“We know the treatment is not going to cure their cancer, but it improves their ability to get into their next step,” said Dr. Black. “A medical oncologist would be limited in giving chemotherapy to a patient who is breathing with the aid of a ventilator. But, if we can improve a patient’s breathing so they can walk into the oncologist’s office under their own power, they have a better chance of getting the full treatment that they want to pursue.”