MDNews - Long Island

"Often, we see patients who are not surgical candidates for various reasons," Dr. McLarty says. "Many have smoked for a lon g t i me a nd h ave a dva nced emphysema or associated heart disease or other comorbidities that make them poor candidates for surgery. SBRT is a good treatment option that can control the disease in patients who might otherwise go on to have cancers grow and spread and be fatal sooner rather than later." INTERVENTIONAL PULMONOLOGY: A KEY DIFFERENTIATOR One of the important factors that dis- tinguishes the Lung Cancer Program at Stony Brook Cancer Center from similar programs in Suffolk County is the pres- ence of board-certified interventional pulmonologist Stephen Kuperberg, MD, Clinical Assistant Professor of Medicine, Pulmonary Critical Care Medicine, at the Renaissance School of Medicine at Stony Brook University, who is on the progra m's multidisciplina r y tea m of clinicians. Dr. Kuperberg 's extensive training in pulmonolog y went beyond pulmonary and critical care fellowships to include two years of interventional training, including one year of advanced diagnostic bronchoscopy followed by a year in diagnostic and therapeutic inter- ventional pulmonary procedures. This medical training exceeds that of most fellowship-trained pulmonologists. He performs a variety of advanced diagnostic and therapeutic procedures, including several types of bronchoscopy. " I u se a mu lt i moda l approa ch t o diagnose lung cancer with ultrasound, electromagnetic tools and advanced imag- ing," Dr. Kuperberg says. "We have tools in the bronchoscopy suite that may not be available in other areas of Long Island, namely ultrasound bronchoscopy and electromagnetic bronchoscopy. I think that separates our program in a big way." A ny patient w ith a n abnorma l CT result, such as a lung nodule with or without lymph node enla rgement, or abnorma l f luid accumu lation in the pleural cavity, is a candidate for referral to an interventional pulmonologist for evaluation and potential biopsy, according to Dr. Kuperberg. He estimates he has performed approximately 400 diagnostic procedures during the past two-plus years, including flexible bronchoscopy, rigid bronchoscopy, electromagnetic naviga- tion bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration, in addition to multiple proce- dure types for the pleural cavity. "We can perform advanced diagnosis of peripheral lung nodules, which requires multimodal techniques, including mul- tiple imaging techniques, to reach these nodules and sample them appropriately," Dr. Kuperberg says. "We can use endo- bronchial ultrasound, electromagnetic navigation and traditional fluoroscopy in a combined approach to reach those nodules and diagnose lung cancer. For cancers that lie in the pleural cavity or along the chest wall, we work with surgeons to diagnose them using thoracentesis and, sometimes, VATS." Treating lung cancer, including cancer that has not responded to other forms of therapy, is also an important part of Dr. Kuperberg's role. For patients with a tumor in their airway that is causing breathing problems, Dr. Kuperberg can use bronchoscopy, cryotherapy and balloon dilation to remove the tumor and open the airway. " W hen f lu id a ccu mu lates du r i n g end-stage lung cancer, which is known as pleural effusion, we specialize in the management of this condition using tho- racentesis and placement of an indwelling catheter," Dr. Kuperberg says. "This allows patients to have a better quality of life and avoid hospitalization by giving them the ability to drain fluid at home with the aid of a nurse." LOOKING AHEAD T he memb er s of t he Lu n g Ca nc er Progra m's multidisciplina r y tea m of specialists anticipate continued growth for the program, which is why they are preparing to welcome a new medica l oncologist and a new surgeon later this year. The team plans to add new diagnos- tic and treatment modalities and expand enrollment in clinical trials, which may add to the increasing number of new thera- pies available to patients. The program participates in national and international clinical trials, and its members can initi- ate their own investigations. A key tool for such investigator-initiated studies is an internal database of thousands of patients with lung cancer stretching back years that clinicians can use to evaluate outcomes for a variety of patient groups. "Stony Brook offers unbeatable care for patients with lung cancer," Dr. McLarty says. "We provide leading-edge, efficient and effective treatment, and we follow our patients for years to ensure they have the best possible outcome." n For more infor mation , v isit cance r. stonybrookmedicine.edu/lungcancer. Members of the Lung Cancer Program, top to bottom: Dr. McLarty, Dr. Keresztes, and Plank 1 0❱❱❱❱❱ C O V E R F E A T U R E

• Cover