Early detection and treatment 'saved my life'

Jackie Marino Story: Early Detection and Treatment 'Saved My Life'

How two innovative technologies helped her through lung cancer


Right around her birthday, in September 2014, Jacqueline “Jackie” Marino had a nagging sinus infection. Otherwise she considered herself in great health.

More than one year earlier, Jackie — a wife, mother, and teacher who smoked for most of her life — had decided to quit. It was a fiftieth birthday resolution, and a response to her son’s constant pleas. 

Jackie went to an allergist about her sinus infection. Because she had coughed up blood, the doctor sent her for an imaging evaluation; it showed a spot on her lung.

Each year, lung cancer claims more lives than breast, prostate, and colon cancers combined. Dubbed an “invisible disease,” it often doesn’t become apparent until diagnosed in later stages, when there are significantly reduced chances for long-term survival.

Doctors perform surgery on Jackie.

"GPS for the lungs"

The innovative technology allows doctors to receive a "virtual recreation" of the lungs.

Jackie needed a biopsy, but the tumor was deep in the lower left part of her lung, very close to a vessel. Her doctors weren’t sure if they could perform a traditional needle biopsy or bronchoscopy.

That’s where Dr. Amit “Bobby” Mahajan, an interventional pulmonologist with Cardiac, Vascular, and Thoracic Surgery Associates at Inova Fairfax Hospital, stepped in. His solution: an innovative technology described to Jackie as a “GPS system for the lung.”

“When we do biopsies without having a good idea of where the lesions are, there’s a risk of not getting an answer,” said Dr. Mahajan. “The superDimension™ system with LungGPS™ technology lets us make a three-dimensional recreation of the pathway of the lungs down to the lesion so we can easily locate it, which helps aid in a  diagnosis. Instead of having to do other biopsies or procedures we can get an answer in short order and get the patient treated and on the road to recovery.”

“A traditional bronchoscopy wouldn’t get us reliably to the tumor,” said Dr. Sandeep Khandhar, surgical director of thoracic oncology at Inova. “We’d go down as far as we could see and — with some X-ray guidance and knowledge of the anatomy — we could randomly sample the area of concern. But the diagnostic yields were very poor. The superDimension™ system helps us make a more complete and accurate diagnosis to take into the operating room.” 

Jackie looks at family photos.

Raising Awareness

"I had a chance because I was diagnosed early. I'm hoping other people have that opportunity also," says Jackie.

Jackie’s diagnosis: Her tumor was cancerous.  

“Before the diagnosis, I was making a concerted effort to be more active,” she says. “To be told I had lung cancer after I felt so much healthier was shocking and scary.”

Dr. Khandhar used reloads with Tri-Staple™ technology to remove the left lower lobe of Jackie's lung. This let him simultaneously cut the affected area and seal it with staples on both sides through a tiny incision in her chest instead of cracking open the chest to operate.

Thanks to this minimally invasive approach, Jackie was discharged the day after surgery.

“The recovery was one of the simplest things I had to go through, considering the gravity of the situation,” says Jackie. “There was no need to crack my ribs and I felt very little pain after the operation. I was able to get back to my family and my life so quickly and haven’t had to go through another treatment since the surgery. If the doctors hadn’t found the cancer so early, I don’t know what would have happened.”

Jackie appreciates everything a little bit more now — from gardening to spending time with her husband, Rob, children, Elisa and Nick, and their pets — because she knows how close she was to losing everything.

“It’s so important to get screened for lung cancer, whether you have a history as a smoker or not,” said Jackie. “If I hadn’t, I know I wouldn’t be here today. It saved my life.”


Important Safety Information

Indications for use are:

superDimension™ navigation system 

Indications for Use:
Indicated for displaying images of the tracheobronchial tree to aid the physician in guiding endoscopic tools or catheters in the pulmonary tract and to enable marker placement within soft lung tissue. It does not make a diagnosis and is not an endoscopic tool. Not for pediatric use.

See product labeling for relevant contraindications, warnings and precautions.
Federal law (USA) restricts this device to sale by or on the order of a physician.

Contraindications

Flexible bronchoscopy should be performed only when the relative benefits outweigh the risks.

Absolute contraindications include, but are not limited to:

  • Absence of consent from the patient or his/her representative, unless a medical emergency exists and the patient is not competent to give consent.
  • Absence of an experienced bronchoscopist to perform or closely and directly supervise the procedure.
  • Lack of adequate facilities and personnel to care for emergencies such as cardiopulmonary arrest, pneumothorax, or bleeding.
  • Inability to adequately oxygenate the patient during the procedure.
  • Pediatric patients.
  • The safety of use of the superDimension navigation system in patients with electrically or magnetically activated implanted medical devices has not been evaluated.

The danger of a serious complication from bronchoscopy is especially high in patients with the disorders listed below. These conditions are usually considered absolute contraindications, unless risk-benefit assessment warrants the procedure:

  • Coagulopathy or bleeding diathesis that cannot be corrected.
  • Severe obstructive airways disease.
  • Severe refractory hypoxemia.
  • Unstable hemodynamic status including dysrhythmias.

Relative contraindications or conditions involving increased risk, according to the American Association for Respiratory Care (AARC) (Respir Care. 2007 Jan;52(1): 74-80) for Fiber-optic Bronchoscopy in adults, include:

  • Lack of patient cooperation.
  • Recent myocardial infarction or unstable angina.
  • Partial tracheal obstruction.
  • Moderate-to-severe hypoxemia or any degree of hypercarbia.
  • Uremia and pulmonary hypertension (possibility of serious hemorrhage after biopsy).
  • Lung abscess (danger of flooding the airway with purulent material).
  • Obstruction of the superior vena cava (possibility of bleeding and laryngeal edema).
  • Debility, advanced age, and malnutrition.
  • Respiratory failure requiring mechanical ventilation.
  • Disorders requiring laser therapy, biopsy of lesions obstructing large airways, or multiple transbronchial lung biopsies.
  • Known or suspected pregnancy (because of radiation exposure). 

The safety of bronchoscopic procedures in asthmatic patients is a concern, but the presence of asthma in most cases does not preclude the use of these procedures.