Monarch marks milestone, powers cancer fight for Fox Chase Cancer Center

In 2018, doctors at Fox Chase Cancer Center were among the first in the country to use a type of GPS to find lung cancer. The machine has become a mainstay for Fox Chase.

A lung cancer diagnosis is frightening but not necessarily the end of the road.

"I'll go in and tell them that guys it's going to be okay and I think that helps a lot," said Dr. Rohit Kumar, Director, Respiratory and Pulmonary Function Service.

One of the game-changing tools Fox Chase Cancer Center is using in that fight is Monarch, a traditional bronchoscope with a robotic assist.

"It's allowed us to be able to diagnose these nodules at a much earlier stage," said Dr. Kumar.

A nodule is a tiny mass. With a handheld controller similar to other bronchoscopes, Dr. Christopher Manley can navigate the flexible scope, with the help of robotic navigation to get a direct look and a tiny sample of the nodule.

"Which gives turn-by-turn directions and allows you to localize and approach very small lung nodules with improved stability and accuracy," said Dr. Manley. "About half of the procedure is robotic control. That's the half of biopsying the peripheral nodules."

It gives them more precise control in trying to find and biopsy very small growths, even as a patient's breathing and heartbeat move that target. More accurate biopsies translate into more customized treatment.

Fox Chase has already used Monarch more than 500 times in just over two years.

"The stability of it and the dexterity of the robotic tip allows me to do things I wouldn't normally be able to do with a traditional bronchoscope," he said.

Dr. Manley said Monarch isn't limited to diagnosing cancer.

"We've diagnosed with granulomatous disease, meaning something inflammatory or secondary to an infection, we found tuberculosis in patients," he said.

It can also determine what might be a tumor or just fibrous tissue in lungs which have had radiation before.

Fox Chase will also begin trials next year using Monarch to treat lung cancer, possibly by injecting chemo or other medications or using microwave or radiofrequency directly on the nodules.
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