When a chest X-ray reveals something suspicious on a lung, patients can experience a great deal of concern. The time between biopsy, diagnosis and treatment can drag on for weeks. Physicians at UMass Memorial Health found a better way, a way that reduces that wait – and the accompanying worry – to mere hours.
LUNG CANCER? REMOVING THE WAIT
A tale of two very different lung cancer experiences
lmagine there are two patients. Each has undergone a routine lung screening, and each has been told they have a suspicious area, a spot, or nodule on a lung that needs to be biopsied to determine if it’s cancer.
PATIENT 1
Patient 1 opts to go the traditional way that lung biopsies are performed, which means:
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The patient undergoes anesthesia.
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A procedure is performed to biopsy the nodule.
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The patient goes home and waits as long as two weeks to hear whether it is cancer.
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Then, if cancer is present, Patient 1 is scheduled for surgery, which could be four weeks later.
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More anesthesia is administered, and finally, a surgery is performed to remove the tumor.
The emotional wear and tear that comes from waiting and worrying can be significant. So can the risks associated with undergoing multiple anesthetic events.
Patient 2
Patient 2 chooses a different route, a novel procedure available at UMass Memorial Health that looks like this:
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The patient undergoes anesthesia, and a biopsy is performed.
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The biopsy is evaluated in the operating room. If the result is cancer, surgery is performed to remove it.
One anesthetic event, immediate results, immediate treatment. Diagnosis and treatment without waiting.

An innovation that makes everyone breathe easier
The procedure is called Robotic One Anesthetic Diagnosis and Treatment, or ROADAT. UMass Memorial Health is one of only two medical centers in the country that perform it.
The benefits of ROADAT can include:
- Reduced waiting to diagnose and treat cancer
- Less anxiety
- One trip to the hospital
- One anesthetic event
- Improved post-operative recovery

How do we do it?
Dr. Mark Maxfield is a thoracic surgeon at UMass Memorial Health and a member of the team that has helped pioneer the ROADAT procedure. He explains it this way:
“The idea was to provide the best patient experience possible for the person with a suspicious lung nodule,” says Dr. Maxfield. “In order to do that we had to do two things. The first innovation was to rethink the entire process from the patient perspective and to stop looking at the biopsy and the surgery as separate events. We had to reinvent our protocols and find ways to achieve accurate, timely and clinically effective results, and a better experience for the patient.
"Next, we employed the right technology to make the procedure as minimally invasive as possible so that the patient doesn’t have to endure unnecessary, large incisions. To accomplish this, we chose specially designed robotic technology that can produce a 3D map of the patient’s lung, which helps us be even more precise and accurate, and allows us to do the entire procedure with very small incisions.
"The second innovation was to have a cytopathologist, the physician who determines whether the biopsy is cancer, in the operating room ready to render a diagnosis in minutes.
“If the cytopathologist tells us it’s cancer,” says Dr. Maxfield, “we call the patient’s family, keep the patient asleep, and perform the surgery to remove it then and there. If it’s not cancer, we wake them up and give them the good news.”
A faster response, a better way
The conventional way of performing a lung biopsy, waiting for results, and then, when necessary, performing surgery, can take as long as six weeks. That’s six weeks of worry and waiting to remove cancer from a patient’s body.
By streamlining the process and approaching two procedures as one, the entire effort can be done in a morning. Should the cancer need to be removed, the patient can be home within a few days.
More to Explore
Lung cancer, early detection and taking care of yourself
UMass Memorial Health can help you understand your risks of lung cancer and uncover it early, when it’s at its most treatable. To learn more, visit: Lung Cancer Screening program, or call 855-UMASS-MD.
Relentless Innovation at UMass Memorial Health
As one of the leading academic medical centers in the country, we take our mission of research, education and outstanding patient care seriously. And because we’re also charged with the health and health care of all people throughout Central Massachusetts, we maintain an intense focus on creating new and better ways to make health care available for all. A better experience. Better outcomes. Healthier lives. It’s what we live for.