MDNews - San Antonio

COVER FEATURE thoracic malignancies, which are the most common and deadly types of cancer. I believe our coordinated, team approach to multidisciplinary care for lung cancer is unique to the city of San Antonio. The level of expertise, the extra time and effort spent by each physician, and the academic environment "We have assembled a superb team of specialists who provide individualized care for patients with lung cancer and other allow for state-of-the-art management and maximize patient benefit. As part of an NCI-designated cancer center, we are fully committed to serving the needs of our community." — Ethan Argiris, M.D., Chief of the Division of Hematology and Oncology at the Cancer Therapy & Research Center assistant professor in the Department of Cardiothoracic Surgery at the UT School of Medicine, to care for patients whose poor lung function necessitates an alternative to lobe removal. The surgeon administering brachytherapy first places a long, straw-like catheter along a staple line created in the operating room that isolates the tumor from non-cancerous tissue. The straw allows the robotic placement of a pellet, which delivers radiation to the staple line and the tumor. Dr. DeArmond and fellow thoracic surgeon Scott Johnson, M.D., also utilize minimally invasive techniques to resect lung tissue. Rather than employing con- ventional, open approaches that require large chest incisions, division of the major chest wall muscles and rib fracturing, the two specialists have developed expertise in video-assisted thoracoscopic surgery. "The gold standard for long-term sur- vival of lung cancer is to remove the lobe of the lung. What that involves is dissecting along the trunk of the lung, which means we have to find the artery, the vein and the windpipe that go to the lobe where the cancer resides," says Dr. DeArmond. "That can be a tricky thing to do, so a lot of practitioners continue to rely on having their hands in the chest to maintain control of those vessels. Over the last 20 years, the real advancement has developed with more and more surgeons getting to the trunk of the lung through small incisions, using the television camera to guide them." The Thoracic Clinic's surgical Thoracic surgeon Daniel DeArmond, M.D., examines a patient in CTRC's Thoracic Clinic. 8 | San Antonio MD NEWS ■ MDNEWS.COM specialists can access tumors in the esophagus, lungs and chest wall by making an incision of minimal length at the ribs and maneuvering their instrumentation to delicately separate the arteries and vessels from the cancerous tissue with the aid of high-definition cameras. According to Dr. Argiris, the kind of collaboration seen at CTRC between radiation oncologists and surgeons is not only positive for patient outcomes, but also necessary for the treatment of complex thoracic diseases. The model of multidisciplinary teams of specialists used at CTRC has been well recognized by the medical community as the optimal structure for successful patient care. Looking Forward As CTRC delves deeper into cancer genomics, its specialists are also working to develop more rigorous screening protocols. Dr. DeArmond notes that, while more cases of other types of cancers are being identified in the stage 1 and stage 2 periods, lung cancer remains primarily diagnosed in the stage 3 and stage 4 periods. While computed axial tomography scans of the chest have been proven effective for iden- tifying lung cancer in high-risk patients, clinical trials conducted at the IDD may provide data to support the development of incorporating biomarkers into additional screening processes for lung cancer. To learn more about the Thoracic Clinic or any of the treatment teams at the Center Therapy & Research Center, visit www.ctrc.net. ■

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