Sep. 2—A robotic tool named Monarch has performed nearly 200 bronchoscopy procedures in roughly 15 months.

By peeking into the hard-to-see, branchlike airways of the lungs, it allows Dr. Grant Pierson, a pulmonologist with Freeman Health System, to detect cancerous tumors in their early stages, which is key in treating and fending off the disease.

As revolutionary as Monarch has been in the fight against lung cancer in the Joplin area, its capabilities have barely been tapped, Pierson said.

"We're trying to push the envelope," he said. "In the future, we will actually be able to treat lung cancer inside the lung, which could happen as soon as two years from now. That's pretty darn awesome when you think about it."

While early detection from technological tools such as Monarch has driven a sizable wedge into lung cancer's overall numbers in the U.S. in recent years, treatment options haven't changed much. Options are primarily chemotherapy and radiation therapy to shrink the size of the tumor, followed by surgery.

"If you can imagine ... we have somebody with a small (cancerous) nodule that can't undergo surgery to cure it, we can either inject chemotherapy or immunotherapy drugs directly into the tumor without having the full-body side effects" from chemotherapy or radiation, Pierson said.

Using robotics and telescoping, which allows the bronchoscope to reach deep into the lung, maintaining a full visual at all times through the camera, Pierson will eventually be able to directly expose the diseased portion of the lung to various treatments without exposing nearby healthy organ or skin tissue to harmful blasts of radiation.

"Imagine me sitting there, trying to hold a scope and injecting it into the lung" while trying to keep both hands steady, he said. Without the stabilizing features of Monarch aiding him, doing so would likely be impossible — at least when it comes to accuracy. Backed up by Monarch, however, "I'll be able to say, 'Yes, we're in the right spot — we can now inject it.' It would be incredible."

Pierson's highest priority is to be able to treat area lung cancer patients with this pinpoint accuracy as soon as it becomes available.

"I know other places are working on it here in the United States, and I'm trying to be able to place us in a position in our area to be able to jump on this early when they are ready to launch it out into more community-based facilities" like Freeman, he said.

Once that occurs, "we'll be able to take it to that next level. This technology is needed in our community, and we're making good strides to get there and achieve that," he said.

Lung cancer is the leading cause of cancer death in the U.S., making up almost 25% of all cancer deaths, according to the American Cancer Society. Each year, more people die of lung cancer than colon, breast and prostate cancers combined. By year's end, American Cancer Society officials estimate 236,740 Americans will be diagnosed with lung cancer, and more than 130,000 will die from it. Lung cancer mainly occurs in older people; the average age of people when diagnosed is about 70.

"Lung cancer is also a major problem in our area," Pierson said, "and it is by far one of the most underdiagnosed cancers right now, which is why we are trying to make strides to change that."

Freeman celebrated Monarch's 100th successful procedure earlier this year. Pierson said the hospital now is rapidly approaching its 200th procedure.

Those numbers, he said, are "incredible" for the area.

"If you look at other major metropolitan areas, such as Nashville or even Indianapolis, they have done 300 (Monarch) cases in a 17- to 18-month period. So for us, pulling from a service area of 450,000 people here, compared to those service areas of 1.5 million people, our 200 cases in 15 months is just pretty darn incredible," he said.

One thing that has come from the COVID-19 pandemic is that people are much more aware of what's going on inside their lungs, given that the coronavirus primarily attacked people via the respiratory system, Pierson said.

"It's a huge benefit in the sense of recognition," Pierson said. "It's really important for people to stay up on evaluating respiratory symptoms to make sure there are no bad underlying diseases in there. It may be nothing — it may be bronchitis or maybe sinus drainage. But you won't know unless you get it evaluated."

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