Calendar An icon of a desk calendar. Cancel An icon of a circle with a diagonal line across. Caret An icon of a block arrow pointing to the right. Email An icon of a paper envelope. Facebook An icon of the Facebook "f" mark. Google An icon of the Google "G" mark. Linked In An icon of the Linked In "in" mark. Logout An icon representing logout. Profile An icon that resembles human head and shoulders. Telephone An icon of a traditional telephone receiver. Tick An icon of a tick mark. Is Public An icon of a human eye and eyelashes. Is Not Public An icon of a human eye and eyelashes with a diagonal line through it. Pause Icon A two-lined pause icon for stopping interactions. Quote Mark A opening quote mark. Quote Mark A closing quote mark. Arrow An icon of an arrow. Folder An icon of a paper folder. Breaking An icon of an exclamation mark on a circular background. Camera An icon of a digital camera. Caret An icon of a caret arrow. Clock An icon of a clock face. Close An icon of the an X shape. Close Icon An icon used to represent where to interact to collapse or dismiss a component Comment An icon of a speech bubble. Comments An icon of a speech bubble, denoting user comments. Comments An icon of a speech bubble, denoting user comments. Ellipsis An icon of 3 horizontal dots. Envelope An icon of a paper envelope. Facebook An icon of a facebook f logo. Camera An icon of a digital camera. Home An icon of a house. Instagram An icon of the Instagram logo. LinkedIn An icon of the LinkedIn logo. Magnifying Glass An icon of a magnifying glass. Search Icon A magnifying glass icon that is used to represent the function of searching. Menu An icon of 3 horizontal lines. Hamburger Menu Icon An icon used to represent a collapsed menu. Next An icon of an arrow pointing to the right. Notice An explanation mark centred inside a circle. Previous An icon of an arrow pointing to the left. Rating An icon of a star. Tag An icon of a tag. Twitter An icon of the Twitter logo. Video Camera An icon of a video camera shape. Speech Bubble Icon A icon displaying a speech bubble WhatsApp An icon of the WhatsApp logo. Information An icon of an information logo. Plus A mathematical 'plus' symbol. Duration An icon indicating Time. Success Tick An icon of a green tick. Success Tick Timeout An icon of a greyed out success tick. Loading Spinner An icon of a loading spinner. Facebook Messenger An icon of the facebook messenger app logo. Facebook An icon of a facebook f logo. Facebook Messenger An icon of the Twitter app logo. LinkedIn An icon of the LinkedIn logo. WhatsApp Messenger An icon of the Whatsapp messenger app logo. Email An icon of an mail envelope. Copy link A decentered black square over a white square.

Hope for robotics to help diagnose and treat lung cancer in one procedure

Professor Pallav Shah guiding a catheter through a robotic arm to the site of the suspected cancerous nodule (Royal Brompton Hospital/PA)
Professor Pallav Shah guiding a catheter through a robotic arm to the site of the suspected cancerous nodule (Royal Brompton Hospital/PA)

There are hopes that lung cancer could be diagnosed and removed from patients in one sitting in the future thanks to robotics, according to medics trialling the technology.

The method allows doctors to target and remove nodules on the lung with millimetre precision.

Using robotics in this way has the potential to be “transformational” for both patients and NHS waiting lists, experts said.

Before the procedure, a CT scan is performed and passed through software to create a detailed 3D road-map of the inside of the patient’s lungs from the mouth to the location of the cancer.

A thin, robot-guided tube, or catheter, is then passed through the patient’s mouth and into the airways, following this road-map.

3D image of the lungs generated from CT scans. The suspected cancerous nodule is identified as the blue circle. The software generates a route for the catheter to be guided through the lungs.
A road-map of the lungs is produced using a CT scan, which the robotic catheter then follows to get to the cancer (Royal Brompton Hospital/PA)

Once located, cancer cells are destroyed using heat in a process known as microwave ablation.

Professor Pallav Shah, a consultant respiratory physician based at Royal Brompton Hospital in London, told the PA news agency: “We can get to the nodule really precisely.

“The first patient we treated was quite interesting – she had already had lung cancer and chemotherapy and radiotherapy, but then developed a spot in the radiation field.

“She couldn’t have more radiotherapy and wasn’t eligible for surgery. We had to be millimetre precise – and we were. She’s now – over six months down the road – doing really well.”

The team has treated a further six patients since then. Prof Shah added: “Generally we’re getting good results, but it’s just early days.”

Current ablation treatments involve performing a CT scan on a patient to locate the cancer and inserting a needle through the skin and straight into the tumour in order to destroy it.

This can involve multiple ablation attempts, taking “well over an hour, maybe 90 minutes”, according to Prof Shah, and carries a risk of puncturing the lung.

The procedure being trialled Prof Shah and his team takes between 40 and 45 minutes, although the ablation stage only takes three minutes.

Navigational bronchoscopy – when a narrow tube is passed through the mouth into the airways, allowing doctors to examine nodules – is successful in identifying lung cancer about 65% of the time, according to Prof Shah.

However, introducing robotics increases the success rate “dramatically”, bringing it “close to 95%”, he added.

He told PA there is “a lot of work to be done, but a lot of early promise” and in the future, he would like to see diagnosis and treatment of lung cancer in the same sitting.

A current trial is aiming to treat 32 lung cancer patients who are not fit or eligible for surgery to determine the safety of the procedure and the recurrence rate of cancer.

The next step will be a trial that uses the method on patients who are eligible for surgery.

One of the biggest comparisons of the new method’s safety will be radiotherapy, which works by using radiation to kill cancer cells but has a number of side effects.

One such side effect is pneumonitis – or inflammation of the lung – which Prof Shah said can be “very unpredictable and can lead to profound damage and breathlessness”.

According to the NHS, more than 43,000 people each year are diagnosed with lung cancer in the UK. Smoking is the most common cause, accounting for about 70% of cases.

The disease is more likely to be treated successfully if caught early.

Last June, NHS England announced it would be rolling out its targeted lung health check programme (TLHC) with the aim of detecting the disease early and before any symptoms.

Those eligible for screening are people aged between 55 and 74 who are current or former smokers.

“It’s really important to find these tumours early,” Prof Shah said. “Usually we only intervene if the nodule is more than 10mm in size or has been showing some suspicious changes, or growing.

“If it’s between six and 10mm we’d be following up with a scan in three months. But patients don’t like not knowing what it is.

“We don’t want to be overenthusiastic, but we don’t want to miss cancer.”

Prof Shah and a colleague looking at the route generated by the mapping software which shows how the catheter should be guided through lungs (Royal Brompton Hospital/PA)

Creo Medical is a medical device developer which designed the microwave ablation tool used in the procedure.

The company’s chief executive, Craig Gulliford, said: “Combining diagnosis and treatment in one procedure could potentially be transformational – this reduces the need for the patient to return for a separate, more invasive procedure, which is the current standard of care.

“By removing the gap between diagnosis and treatment, it eliminates the long anxious wait for potential treatment that patients currently have to go through, but it also means that patients can get treatment before a nodule has time to grow in size or spread to other parts of the body.

“Currently, there is no early screening that takes place for cancer as there are no effective treatments for these early nodules, but this technology can allow treatment to take place earlier, at the point of diagnosis and in a less invasive manner, before these nodules become more serious.”

He added that the adoption of technology in this way “could be of great benefit” when it comes to bringing down NHS waiting lists.

Prof Shah told PA adoption of these types of technologies by the NHS is “a complex situation”.

He added: “Robotics are going to be expensive, but if you look at the bigger picture you’re going to save time.

“If you look at the NHS overall, if we can diagnose these tumours early and treat them early, we’ll save an absolute fortune on chemotherapy and radiotherapy.”