Stacey Su, M.D. Now Performing Endobronchial Ultrasound (EBUS) at Crozer-Keystone Health System - Crozer-Keystone Health System - PA

Published on July 06, 2015

Stacey Su, M.D. Now Performing Endobronchial Ultrasound (EBUS) at Crozer-Keystone Health System

Media Contact:
Mary Wascavage
(610) 284-8619
Mary.Wascavage@crozer.org

Practice Contact:
Thoracic & Surgical Oncology
(610) 394-4744

To schedule an appointment with Stacey Su please call 610-394-4744.

To schedule an appointment with Dr. Su,
please call 610-394-4744.

Crozer-Keystone Health System now offers endobronchial ultrasound (EBUS) at Delaware County Memorial Hospital in Drexel Hill. The procedure, performed by Fox Chase Cancer Center thoracic surgeon Stacey Su, M.D., is the latest weapon in the health system’s arsenal to assist in the diagnosis and staging of lung cancer and other diseases of the chest.

When lung cancer is suspected, part of treatment planning and staging may include mediastinal evaluation. This helps to determine if cancers are localized or have spread to regional lymph nodes. This is done by obtaining tissue biopsies of suspicious areas or lymph nodes in the mediastinum or outside and around the airways.

Traditionally, suspected lung cancer has been diagnosed using mediastinoscopy, a procedure that uses an incision in the neck to place a special instrument with or without a camera in the chest. This method of mediastinal staging is invasive, and as is the case with many invasive procedures, it carries potential risk. EBUS is offered as a state-of-the-art, minimally invasive alternative. It is also a useful tool for patients who may not be able to undergo or tolerate the more invasive mediastinoscopy.

EBUS allows a specially trained physician to obtain tissue samples using transbronchial needle aspiration (TBNA) while avoiding invasive surgery.

During the EBUS procedure, a flexible bronchoscope that has been fitted with an ultrasound device is guided through the patient’s trachea, enabling the physician to identify, in real-time, structures outside of the bronchus in the mediastinum and hilum. The ultrasound image is displayed on a monitor. Once the targeted tissue is identified, a needle is passed through the scope, across the airway wall, and into the targeted tissue. The process is visually monitored at all times using ultrasound. Because the bronchoscope is inserted through the patient’s mouth, there is no surgical incision. In addition, EBUS offers a considerable advantage in reaching areas not previously accessible by mediastinoscopy alone.

“Mediastinal staging is part of lung cancer management, and the fact that we have EBUS here at Crozer-Keystone Health System means that we’re able to extend this technology to patients without necessarily a mediastinscopy incision,” explains Dr. Su, who serves as medical director of Thoracic Surgical Oncology at DCMH. She notes that this is particularly helpful for patients who have already been treated for prior lung cancers and who may not be able to withstand the incisions required for traditional mediastinscopy.

EBUS is a multidisciplinary effort involving a surgeon or pulmonologist, a specially trained OR staff and a pathologist, who facilitate accurate evaluation of tissue at the time of biopsy.

In addition to diagnosing and staging lung cancer, EBUS is used to diagnose benign diseases such as sarcoidosis. While sarcoidosis may look like cancer on scans, it is a noncancerous inflammatory disease. Findings in sarcoidosis, as well as other inflammatory or infectious conditions, are enlarged lymph nodes in the mediastinum and hilum. EBUS can be used to investigate and biopsy these lymph nodes to assist in diagnosis.

Dr. Su points out that EBUS is not just used for diagnostic purposes, but is also very helpful as a therapeutic tool. In particular, a leading treatment for lung cancer is CyberKnife radiation—a very focused form of radiation technology known as stereotactic body radiotherapy. In order to guide the robot to deliver the radiation to the correct spot, the CyberKnife machine requires fiducial markers to be placed in the chest masses in order for the radiation to be properly administered. EBUS is being used, with incredible accuracy, to place the fiducial markers into chest masses if a patient is deemed to be a candidate for CyberKnife treatment.

The EBUS procedure at Delaware County Memorial Hospital is available to all area residents.

Dr. Su also emphasizes the importance of lung cancer screening, particularly for patients who are deemed high-risk—such as current and former smokers. And, as always, she urges current smokers to quit immediately.

For more information about the Lung Health Services program at Crozer-Keystone Health System, which is Fox Chase Cancer Center partner, visit crozerkeystone.org/lung, or call (610) 394-4744.

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