Cover Story: Cutting-Edge Technology at UPMC Passavant

A One-Two Punch: Battling Lung Cancer with Cutting-Edge Technology at UPMC Passavant

A new robotic device — the first in southwestern Pennsylvania — allows doctors at UPMC Passavant–McCandless to navigate deep inside the lungs for earlier, more precise detection of cancer. Now a top user of this minimally invasive technology, the hospital is combining it with low-dose CT screenings to punch back at the nation’s number one cancer killer.

Kathy Trent

Kathy Trent considers herself lucky. The lifelong smoker was among the first high-risk patients to begin yearly low-dose computed tomography (CT) lung cancer screenings at UPMC Passavant. Now, five years later, she’s among the first to benefit from the hospital’s Monarch™ robotic bronchoscopy system — deemed an innovative tool in the fight against lung Kathy Trent cancer.

“This technology and the wonderful doctors at UPMC Passavant saved my life,” says Kathy, 69. “They caught my lung cancer early before I felt any symptoms.”

Early Diagnosis: The Key to Survival

More than half of all lung cancer patients die within one year of diagnosis. But when cancer is detected early — especially before it has a chance to spread beyond the lungs — the five-year survival rate rises from 5% to 56%.

“Early diagnosis is critical,” says Ryan Levy, MD, chief of thoracic surgery at UPMC Passavant and thoracic surgeon with UPMC Hillman Cancer Center. “When lung cancer is detected at an earlier stage, we’re able to offer our patients more treatment options—meaning patients have better outcomes and increased cancer-free rates.”

UPMC Passavant is among the first hospitals in the nation and the first in Pittsburgh to use the robotic bronchoscopy system. The device allows doctors to maneuver into the lung’s tiniest passages to inspect suspicious lesions and collect tissue samples to determine whether they are cancerous or benign.

“It takes us to a whole new level of cancer diagnosis and treatment,” says Dr. Levy.

Finding Cancer’s “Fingerprint”

Since robotic bronchoscopy was introduced in May 2020, specially trained pulmonologists and thoracic surgeons at UPMC Passavant have performed nearly 100 diagnostic procedures. Patients from across the state have been referred to the program making UPMC Passavant one of the busiest hospitals in the nation to use the device.

UPMC pulmonologist Peter Kochupura, MD, says the system’s “brilliant” design uses a minimally invasive endoscope to view deep inside the lungs.

The technology integrates robotics, software, and data science with endoscopy, using tiny cameras and tools to enter the body through the patient’s mouth. The result is a continuous, extraordinarily detailed 3D view of the lungs’ airway passages.

“We can direct the probe with a hand-held controller, see exactly where it is going, and identify the best spots to biopsy,” says Dr. Kochupura, who leads the robotic bronchoscopy program. “That’s critical because a certain number of cells is needed to identify the tumor’s ‘fingerprint’ and select the appropriate targeted therapy.”

A Suspicious Nodule

When Kathy learned she had emphysema in 2014, she immediately quit her pack-a-day smoking habit. Thomas Rice, MD, her pulmonologist at UPMC Passavant, also recommended that she begin yearly low-dose CT lung cancer screenings — a program the hospital had just introduced for high-risk patients.

“I was more worried about the emphysema, but I thought it was a good idea,” says Kathy, a resident of Emsworth, Pa.

In June 2019, a nodule appeared deep in the upper left lobe of her lungs. Although a PET scan determined it was noncancerous, Dr. Rice continued monitoring the suspicious mass with more frequent follow-up CT scans. In May 2020, a scan showed the nodule had suddenly doubled in size.

“Thankfully, we had the Monarch™. We needed it to obtain a more precise needle biopsy and make decisions about her care,” says Dr. Rice. “She already had emphysema. We didn’t want to subject her to surgery if she didn’t have lung cancer.”

Kathy was referred to Dr. Kochupura, who used the robotic bronchoscopy device to reach the nodule deep in her lung. The biopsy showed she had stage one lung cancer.

“Before this new technology, we couldn’t reach these areas of the lungs to reliably biopsy a nodule,” he says. “It’s remarkable.”

A Textbook Case

One month after her diagnosis, Dr. Levy removed the tumor and 16 lymph nodes in a minimally invasive robotic lobectomy procedure.

“The technology allowed us to fast forward her care,” says Dr. Levy. “Without it, Kathy likely would not have been diagnosed for another year or two. That time gap would have allowed her cancer to progress to a more advanced stage.”

“I feel good,” says Kathy, who recovered from surgery and did not need further treatment. “And I feel hopeful about my prognosis because my cancer was caught so early.”

All three doctors cite Kathy’s case as a “textbook example” of how UPMC Passavant’s comprehensive lung cancer program — with its early screening, advanced technology, and team approach to managing care as part of UPMC Hillman Cancer Center — benefits patients.

“It’s an awesome example of how our program works,” says Dr. Kochupura. “We work together as specialists to find earlystage cancer, diagnose and manage patient care, and surgically remove tumors for an early cure.”

“Big Wow” Possibilities

Dr. Levy says the robotic bronchoscopy technology has “big wow” possibilities for the future.

“This isn’t just another diagnostic tool,” says Dr. Levy. “The system is still in its infancy. The more we do with it, the further we realize its potential to revolutionize treatment.”

Doctors have begun using robotic bronchoscopy to mark lesions with dye or fluorescent material to identify the surgery site. Dr. Levy believes the technology eventually will be used to deliver chemotherapy and immunotherapy directly to a lesion.

Dr. Levy is optimistic that in the future we will be able to treat cancer using robotic bronchoscopy with microwave or radiofrequency ablation.

“UPMC Passavant is poised for the future,” says Dr. Levy. “We’re pleased to offer the highest level of lung cancer care. And we look forward to using more advanced technologies to treat our patients.” n