Ep 7: Bronchoscopy for Lung Cancer: What It’s Really Like (From a Survivor)

If you’ve had a CT scan, a PET scan, and now they’re recommending a bronchoscopy—this video is for you.You’re probably feeling very nervous, anxious, and even scared. I know. I’ve been there myself. 

 Hi I’m Tina Powell, Stage 4 cancer survivor, thriver, patient, and your host for lung cancer strong. Since being diagnosed nearly three years ago, I’ve had a 2 bronchoscopies, which is the focus of today’s YouTube video. I’ve also had nearly 30 rounds of chemo, 33 rounds of radiation to my chest, and 3 rounds of cyberknife and 1 round of stereotactic radiosurgery to the brain. It’s why I started this YouTube channel 56 days ago. To share my experiences and to tell you guys what to expect. But please remember today’s video on bronchoscopies is not medical advice, but me sharing and documenting my own personal journey in hopes that it helps you. 

Transcript

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This podcast is strictly for informational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult with your oncologist, doctors, and medical team for questions specific to your own health, diagnosis and treatment. If you're listening to this, you or someone you love has just heard the words. You have lung cancer right now. You might feel scared, overwhelmed, shocked, or even numb. I know because I've been there. Hi, I'm Tina Powell, stage four, lung cancer survivor, thriver and patient advocate. And when I was diagnosed on January 16th, 2023, I had a thousand questions and nowhere to turn for real answers from those who have lived it. That's why I created lung cancer Strong. Here you'll find things I wish I had from day one. Real stories, honest answers, and the tools and hope to face every moment ahead. Here we get real about treatment, fears, setbacks, small victories, and finding purpose even on the hardest and the most crushing of days. Here we get strong through information, inspiration, and community, and most of all, we get through it together because this is a place of true connection, compassion, and unfiltered strength. So whether you're newly diagnosed, fighting with everything you've got or standing by someone you love, this is your invitation to live intentionally, powerfully, and with hope. One breath, one story one day at a time. Welcome to Lung Cancer Strong. If you've had a CT scan, a PET scan, and now they're recommending a bronchoscopy, this video is for you. You're probably feeling very nervous, anxious, and even scared. I know because I've been there myself. I'm Tina Powell, stage four cancer survivor, thriver patient, and your host for lung cancer. Strong. Since being diagnosed nearly three years ago, I've had two bronchoscopies, which is the focus of today's video. I've also had nearly 30 rounds of chemotherapy, 33 rounds of radiation to my chest, three rounds of CyberKnife and one round of stereotactic radiosurgery to the brain. It's why I started this YouTube channel 56 days ago to share my experience and to tell you guys what to expect. But please remember, today's video on bronchoscopies is not medical advice, but me just sharing and documenting my own personal journey in hopes that it helps you. So what is a bronchoscopy? According to the Cleveland Clinic, a bronchoscopy is a minimally invasive procedure that lets your healthcare provider look inside your airways and lungs with a bronchoscope. A bronchoscope is a thin tube with a light and a camera attached to it. It can help your provider diagnose, evaluate, and sometimes treat conditions that affect your lungs, your trachea, or your throat. So why perform a bronchoscopy in the first place? In my case, my first bronchoscopy was ordered weeks after my initial CT scan of the lungs and then after a PET scan, that CT scan of the lungs showed a suspicious mass measuring 2.6 centimeters on my right upper lung while the PET scan confirmed that metabolic activity. The reason why the bronchoscopy was ordered and needed was due to the following, number one, to confirm that this was indeed cancer and not an infection. You'll find that most thoracic surgeons, if not all, and oncologists, they love data, they love to be right, and they rely on scientific evidence. So we needed the bronchoscopy in order to confirm that that was cancer. Number two, the bronchoscopy was needed so that my pulmonologist could take a tissue sample and biopsy the mass that was identified on the CT scan as well as various lymph nodes that looked suspicious on both lungs. So even though that my CT scan showed nothing on the left lung, they still needed to go in and examine that side with the bronchoscope. Number three to assess the overall picture or lay of the land as I like to call it, prior to surgery. So at this stage, this initial stage, my oncologist and my thoracic surgeon were looking at robotic lobectomy surgery for me. So that's why the bronchoscopy was needed. They needed to see what the lymph nodes look like on both sides, and they also needed to determine what lymph nodes were going to be removed. Number four, the fourth reason was to stage me properly and we'll have a future video on this about staging. Staging is a moving target, you guys, and in short, my original tumor was measuring 2.6 centimeters and it was contained on the upper right lung, the size and the location of that specific tumor meant that I was staged to be, but the bronchoscopy was needed in order to confirm that. And finally, number five, the tissue samples and biopsies that were performed as part of the bronchoscopy would allow me to get genetic biomarker testing another future episode so that we could determine what type, if any, what subtype of lung cancer I had in order to treat it properly. I know that was a mouthful. To sum it up, the bronchoscopy provided my oncologist and the thoracic surgeon with the factual data and clarity needed in order to determine the next best course of action for me. And again, this was my case at the time. It was a robotic lobectomy that was the next move, and they needed to make sure that I was a candidate for that surgery. For you, it might be something different. However, your doctor is going to discuss everything with you. Who performs a bronchoscopy? A bronchoscopy is performed by a pulmonologist. A pulmonologist is the primary bronchoscopy expert. This is the one who usually diagnoses lung cancer and uses advanced bronchoscopic tools. Both of my bronchoscopies were performed by two different pulmonologists. One was at NYU Langone and the other was from Penn Medicine. The important was that I had the chance to speak to and interview both pulmonologists before the day of the procedure, which I think is one of the most important things. It is a non-negotiable for any cancer patient. Wherever you're being treated, please make sure you and a loved one talk to that pulmonologist, meet that pulmonologist to discuss everything, all the questions on your mind. It is such an important part of the bronchoscopy process, and I don't want you to shortchange yourself. So make sure that you have those interviews with the pulmonologist. So you're probably wondering, is it painful having a bronchoscopy before having my first bronchoscopy, I worried about the same exact thing. In fact, I was nervous, I was scared. I was anxious even though that I had met both pulmonologists and I was confident with both pulmonologists. But still the fact was is that I had no friends. I had no relatives. I literally knew no one that had the procedure. And to make matters worse, you guys, I found videos on YouTube that were so inaccurate and so far from the truth, which is part of the reason why I wanted to record my own episode on what to expect for the bronchoscopy. Specifically those videos that I'm talking about that live on YouTube show the patient that was in a semi-conscious state, I want to tell you exactly how my bronchoscopy was. In short, I felt absolutely no pain. In fact, I was totally unconscious during the procedure, and I want to emphasize totally unconscious like a colonoscopy. This is exactly that same type of effect. You are completely out. I was floored to find videos that made it look like patients are awake for this. During a bronchoscopy, you have to remain absolutely still so that the pulmonologist can literally sample the exact spot on your lungs. They can't afford for you to be moving around while they're in there. So be rest assured during the procedure, you will be totally unconscious. So you're probably also wondering how long does a bronchoscopy take? Usually a bronchoscopy takes anywhere from 30 to 90 minutes. Now, timing of that bronchoscopy depends on several factors, including the complexity of your specific case and which type of bronchoscopy you'll undergo. Yes, there are various types of bronchoscopies, which I will discuss two methods, but before that, again, where your specific samples are and where the pulmonologist needs to sample, that will determine the length of your bronchoscopy. If it's in a difficult or hard to reach place, it might take longer. So the first type of bronchoscopy, the one that I had is called an endo bronchial ultrasound EBUS for short. So my first bronchoscopy was performed at NYU Langone nearly three years ago. Today. The type that they used was that endo bronchial ultrasound or ebus for short. It combines a bronchoscope with an ultrasound probe. It's used specifically to provide detailed images of lymph nodes and tissues between the lungs using needle biopsy for cancer staging. For me personally, the size and the location of my tumor, which I mentioned was 2.6 centimeter tumor on the upper right lung and the location of my lymph nodes. The ebus method was the method that was right for me. This was a decision that was made with my pulmonologist and my oncologist. There is another type of bronchoscopy that you need to be aware of. This technique. It's being used right now, and this is called ion robotic bronchoscopy, and that's made by a company called Intuitive Surgical. They're actually listed on the nasdaq. Their ticker symbol is ISRG. They are headquartered in California. This type of bronchoscopy was first introduced in 2019. It's a type of modern technology that's used to this according to the company, to help shorten the patient journey by making it possible to biopsy small and difficult to reach nodules that are in the peripheral. Let's try that. Let's say that again, peripheral. There we go. Finally, lung, where more than 70% of lung cancer nodules may be located. I'll put a link in today's video description to intuitive, which lists both the physicians and the surgeons and the different cancer centers that perform the ion robotic bronchoscopy method. They also list, which I thought was really super interesting you guys, how many ion procedures that particular pulmonologist has performed, which range anywhere from the single digits to the hundreds. So now in order to determine the best type for you, you're going to need to sit down with your doctor and medical team to understand all of your options, again, based on the areas of the lung that they need to examine. Let's talk now about the risks of bronchoscopy because I know that you are probably wondering about that. Now, keep in mind, every type of procedure has risks. I'm not going to lie. I was very worried about the potential risk of cancer spreading as a result of performing biopsies and a bronchoscopy in the first place. Now, whether or not that this is a myth or truth is still debatable. I'm not here to weigh in on either side. Again, you have to do what's right for you. For me, and to my understanding, no bronchoscopies do not spread cancers, bronchoscopy, biopsies, even when multiple samples are taken do not spread cancer. However, they are extremely critical for getting the right type of diagnosis and the right type of treatment that is needed for you. In fact, I don't think that I would be alive today if my medical team and oncologist didn't have the information from the bronchoscopy, which ultimately led them and led all of us to know what type of cancer I have, which is non-small cell lung cancer subtype, EGFR Exon 21 L 8 5 8 R. Another thing that you're probably wondering is how the bronchoscopy. What were the side effects? For me, the side effects was that I had a sore throat for a few days. I had a hoarse voice. That sore throatness is completely normal, but also you guys, I felt a sense of relief. And that relief was that I finally had answers about my particular type of cancer so that my oncologist and my thoracic surgeon could build a treatment plan that was specific to me. So again, it provided a lot of clarity and a lot of information that we were missing that was desperately needed. When do you get results after a bronchoscopy? So for me, the results of the bronchoscopy procedure showed a pretty rapid about one to two days. In my MyChart. However, and this is the important part, you're going to have to wait about one to two weeks for that biomarker genetic testing report to come back depending on where you're receiving your cancer care. So again, a lot of times, most times with a bronchoscopy, there will be this biomarker genetic testing report. We'll talk about that in a future episode, but that is the specific report that is needed to determine what specific subtype, if any, you have, such as EGFR, ALK positive ROS one, and there are so many mores. In fact, we'll have a future episode with a medical professional to talk about all of this. But the most important thing for you to know as lung cancer patients is that immunotherapy and even targeted therapy where you actually take a medicine in the form of the pill have been developed to target these particular genetic mutations which turn cancer cells and signals off and on. So these new therapies have been complete game changers. They've been helping patients live longer lives, more high quality lives. It is such an integral part of this whole bronchoscopy process. Again, the bronchoscopy is one report from the pulmonologist, but the biomarker testing and all of the testing on the lymph nodes, on the tissue sample, on the biopsies, those come later in the game and you will have to unfortunately wait for those and that you guys is really the hardest part. You've got to have a lot of patience for that. I know that it's hard. I've been there and like I said, I had this done twice, but it, it's just so important. It's such an essential part of So putting it all together, you guys, if you've had a CT scan, a PET scan, and now your doctor is recommending a bronchoscopy, it's normal to feel nervous. Like I said, I've been there twice, but the bronchoscopy is how your medical team gets real answers and the data that it was talking about that's really necessary for your oncologist and your thoracic surgeon to determine what is going to be needed and what the next best course of action. The bronchoscopy also helps to confirm the diagnosis properly, stage the cancer, and gather the tissue that's needed for genetic testing. And that alone can be a game changer to how your cancer is treated. So the procedure is done while you're fully asleep. It's not painful. And while you might have a sore throat or even a hoarse voice, the doctors are going to build a treatment plan that is personalized, that's precise, and that's designed to give you the best possible outcome. That's why I personally believe in the procedure. You don't walk away with more fear. In fact, you walk away with information direction, and in my case, a clear path forward. So I want to thank you all so much. I hope that this video has been helpful. Thank you for watching and listening. One breath, one story one day at a time. This is Tina Powell for Lung Cancer Strong. Thank you for joining me today on Lung Cancer Strong. Remember, this podcast is strictly for informational purposes and does not constitute medical advice. Always talk to your oncologists, doctors, and healthcare team about your individual situation. If you'd like to reach out to me or share your thoughts, please email me at tina@lungcancerstrong.com allow 48 hours for or reply. And don't forget, you can find us on YouTube and on all the major podcast outlets. Hit subscribe so you never miss an episode and get notified when something new drops one breath, one story one day at a time. This is lung cancer Strong.