Diagnosis: Right From the Start

Getting the right diagnosis means getting the best treatment, and increasing the chances for the best outcomes. Roswell Park offers state-of-the-art technology that is not offered elsewhere, except at designated cancer centers.

Accurate diagnosis and a personalized treatment plan improve the odds of beating cancer. Dr. Demmy and a team of thoracic experts collaborate on every case to offer patients optimal care.

Standard diagnostic tests for lung cancer at Roswell Park include: 

Roswell Park continues to add advanced technology procedures to its arsenal of tools for fast, early and accurate lung cancer detection and diagnosis. The latest include:

  • Endobronchial ultrasound (EBUS), which provides a minimally invasive way to examine, assess and biopsy lymph nodes or other masses outside the bronchial tubes — without an incision. EBUS uses ultrasound imaging from inside the trachea to guide needle insertion to the lymph node or mass for biopsy. Patients usually go home the same day. Roswell Park is the only Western New York center equipped for EBUS.

EBUS helps us diagnose whether a mass or enlarged lymph node is cancerous, infected or related to sarcoidosis, and we can do this without surgery. - Samjot Dhillon, MD

  • Navigational bronchoscopy, which takes the bronchoscope to difficult-to-reach places further and deeper in the lung than ever before for diagnosis, staging and lesion marking, and helps avoid more-invasive procedures such as thoracoscopy and mediastinoscopy. This tool uses a CT scan and proprietary software to create a three- dimensional lung model and roadmap for the fiberoptic-equipped bronchoscope to navigate to the tumor. Our doctors can now reach lesions and nodules very deep in the lungs and those close to blood vessels — ones we could not reach by CT guidance, or where other methods of biopsy are associated with higher risk.

The RPCI Advantage: TEMLA

"[TEMLA] allows us to gain a more accurate mediastinal staging. Some patients may be able to avoid further surgery and some may learn they need to add chemotherapy to their treatment, and they would not have known that otherwise." — Todd Demmy, MD, FACS

The best outcome for patients with lung cancer depends on the use of chemotherapy, radiotherapy and surgery in an integrated fashion. Treatment decisions using these therapies depend on accurate staging of the mediastinum. Roswell Park is one of a few centers in the world that uses TEMLA to enhance mediastinal staging.

TEMLA (Transcervical Extended Mediastinal Lymphadenectomy)

Unlike standard mediastinoscopies that only sample mediastinal lymph nodes, TEMLA involves the surgical removal of the lymph nodes. This decreases the chances of missing the detection of cancer in these lymph nodes due to sampling error. Results obtained from TEMLA may avoid unnecessary surgery in some patients and it may lead to the addition of chemotherapy to improve the cure rate in others.