Dr. Wayne Holley

Dr. Wayne Holley, McLeod thoracic surgeon, performs robotic-assisted lung cancer surgery at McLeod Regional Medical Center.

Advancements in lung cancer treatment have improved in recent year’s thanks in part to robotic-assisted surgery and low-dose CT screenings.

A form of minimally invasive surgery, a robotic-assisted procedure allows the surgeon to perform many types of complex surgeries with more precision, flexibility and control than traditional techniques offer.

During a robotic-assisted surgery, the surgeon operates through a few small incisions, controlling the robot’s every move while seated at a console in the operating room. The surgeon’s hand, wrist and finger movements guide the robot, manipulating the surgical instruments inside the patient.

In essence, the robot becomes an extension of the surgeon’s hands. The surgeon views the surgical site through a high-definition 3-D camera. This magnified imagery provides enhanced visibility and improved precision for exact treatment and greater dexterity for the surgeon.

In addition, thoracic robotic-assisted surgery allows the surgeon to reach the lungs without spreading the ribs. Twenty years ago, we performed this very same operation through large incisions in the chest and the side of the patient.

Minimally invasive thoracic surgery also produces better outcomes, much less pain, better staging of lung cancer, fewer post-operative complications and a two-day hospitalization as opposed to eight to 10 days.

This means the patient can return to work within two to four weeks instead of 12 weeks, which benefits the patient and the employer.

All McLeod surgeons who offer robotic-assisted surgery as an option for their patients undergo additional specialized training. These surgeons perform robotic-assisted procedures in general surgery, thoracic surgery and gynecology at McLeod Regional Medical Center and McLeod Health Seacoast.

McLeod Regional Medical Center has two da Vinci Robotic Surgical Systems. One is the latest version available, the da Vinci Xi, a fourth-generation robot.

Importance of lung cancer screenings

Another improvement in lung cancer has been the use of low-dose CT scans to screen high-risk individuals for lung cancer. At McLeod, we offer a lung cancer screening program that allows us to detect lung cancer earlier, offering patients more options for treatment.

In 2011, results of a national study of more than 53,000 patients – both former or active smokers – indicated that a low dose CT scan of the chest provided greater detection of lung cancer than a chest X-ray. In the study comparing CT scans to chest X-rays in patients 55 to 75 years of age with a 30-pack-year history of smoking (smoking one pack a day for 30 years or two packs a day for 15 years), researchers found a 20 percent reduction in mortality using CT scans for diagnosis.

Based on the results of this trial, in December 2013, the United States Preventive Services Task Force recommended screening for lung cancer using a low-dose CT scan in patients age 55 to 80 who meet the following criteria:

  • Cumulative smoking history of 30-pack years or more,
  • Who still smoke or who have this history but stopped smoking in the past 15 years,
  • And currently do not exhibit any symptoms of lung cancer.

If these people meet this criteria, they qualify to receive annual low-dose CT scans.

The prevalence of lung cancer in this area reflects what we expect given this population and demographics. It seems like our lung cancer patients come in at higher stages. Instead of early detection of the cancer, we now see more patients at stages three and four – often the inoperable stages.

We now know that this screening plays a crucial role in detecting lung cancer at earlier, more treatable stages. It simply has not gained the same level of awareness of other screenings, such as mammography for breast cancer and colonoscopy for colon cancer.

For more information on lung cancer screenings

Medicare and most private insurance companies now cover the cost of the low-dose CT scan if an individual meets the criteria for a lung cancer screening. Ages covered by Medicare range from 55 to 77; private insurance will pay for those 55 to 80.

If an individual does not have Medicare or private insurance or cannot afford the deductible (and meet certain financial criteria), the McLeod Foundation offers scholarships through two groups – McLeod Men and McLeod Angels – to assist in paying for the screening.

For additional questions on the screening or scholarships, call the McLeod Lung Cancer Nurse Navigator at 843-777-5640.

A board-certified thoracic surgeon, Dr. Wayne Holley received his degree in medicine from Vanderbilt University School of Medicine in Nashville, Tennessee. He completed a general surgery residency at the University of Tennessee Health Sciences Center in Memphis. Dr. Holley also completed a thoracic surgery residency at the University of Mississippi Medical Center in Jackson, Mississippi. In 2014, he received training in robotic-assisted surgery during a one-year thoracic surgical oncology fellowship at Memorial Sloan Kettering Cancer Center in New York. He has more than 30 years of experience caring for patients.