‘Gamer’ technology helps Sarah Cannon detect lung cancer at earlier stages

Closeup of hands in surgical gloves holding a gaming controller

The newest technology in the hands of HCA Healthcare physicians is the same tool in the hands of video gamers across the world: an Xbox controller. Sarah Cannon Cancer Institute at TriStar Health has introduced a device that uses video game schematics to save the lives of patients through early detection.

TriStar Health was one of only 10 systems to introduce robotic bronchoscopy in its first year of FDA approval and has now performed more procedures than any other site in the world. Physicians can use this technology to evaluate the smallest of abnormalities, giving us hope we can diagnose cancers sooner and at the earliest stages. More lives can be saved more often by the ability to confidently reach and visualize lung cancer while it’s still small.

“Lung cancer is the number-one cancer killer in the U.S., killing more than breast, prostate and colon cancers combined,” says Susan Garwood, MD, pulmonologist and advanced bronchoscopist at Sarah Cannon Cancer Institute at TriStar Centennial Medical Center.

Did you know?

In 2020, the American Cancer Society estimates approximately 135,720 deaths are expected to occur as a result of lung cancer. Within one year of being diagnosed, more than half of people with lung cancer die.

Lung cancer: early diagnosis is key

The primary challenge facing both patients and physicians is that lung cancer is usually detected at a late stage. Symptoms of lung cancer typically don’t appear until the disease is at an advanced, non-curable stage. This means the key to beating lung cancer is early stage diagnosis.

“If you can find lung cancer at a centimeter or smaller, the survival rate is 91%,” explains Dr. Garwood. “If you find it at stage four, that survival is virtually zero: 2-5%.”

Treatments for lung cancer include surgery, chemotherapy and radiation therapy with the success of treatment being highly dependent on the size and stage of the disease. “The challenge has not only been detecting the presence of the disease, but having the right tools to access and diagnose cancer when it is still only the size of a pea” adds Dr. Garwood.

In traditional procedures, cancerous nodules are located by a bronchoscope, a small, camera-like device inserted through the nose or mouth that travels through the airways and lungs, identifying and capturing images of any abnormalities. The scope is useful when cancer is in the center of the chest but due to its short length, tiny nodules in the periphery of the lung that are actively moving with routine breathing and not visible on x-ray make for near impossible targets with success rate of biopsy less than 15%. The alternative is a more accurate biopsy through the chest wall by a radiologist with a needle but while accurate this runs the risk of collapsing the lung or causing bleeding and doesn’t allow for same time evaluation of lymph nodes to complete the cancer staging process.

Woman wearing black suit. Headshot of Dr. Susan Garwood.
Susan Garwood, MD, pulmonologist and advanced bronchoscopist at Sarah Cannon Cancer Institute at TriStar Centennial Medical Center

Enter robotic bronchoscopy. And the Xbox.

The robotic bronchoscope uses a modified Xbox controller to guide the scope through the entire length of the lung, all at the touch of a button, or the move of a joystick. The tool uses gaming technology and optical recognition software to locate and biopsy nodules in real time with unprecedented accuracy.

The scope maintains vision throughout the procedure event to the very edges of the lung allowing you to see cancer while you biopsy adding to the accuracy. It gives real time feedback of the position of the scope in the patient using optical pattern recognition and coordinates much like GPS in your car. It also maintains all of the functions of a regular bronchoscope with the ability to clear mucus with suction and irrigation to keep the air passages clear while you drive.

The scope enters and is locked in place, allowing a physician to conduct the procedure either in a seated position or in a different location in the room. They need only to keep their eyes on the console while navigating the procedure from the palms of their hands. The joysticks on the controller allow the user to advance or move side to side, just as you would in a video game. The buttons that might normally let a gamer jump or accelerate are now used to suction or irrigate.

“The Xbox controller is honestly just an ergonomically perfect way for us to manipulate this GPS technology with our hands in a natural gaming position,” Dr. Garwood says. “Robotic bronchoscopy results in shorter anesthetic time and faster results, using the locked scope and agile controller to diagnose, stage and plan all in one setting, under one anesthetic.”

“If you have lungs, you can get lung cancer,” reiterates Dr. Garwood. Smokers, those who’ve stopped smoking and even those who’ve never smoked at all are susceptible to the disease. With this game-changing technology, HCA Healthcare is one step closer to beating lung cancer and giving all patients a healthier tomorrow.

Three members of a surgical team in the operating room using a gaming controller

Being faced with a cancer diagnosis can be overwhelming and often confusing. Innovative tools are just one of the ways HCA Healthcare and Sarah Cannon are working to demystify the diagnosis and extend person-centered care.

With every innovation ahead, whether in the hands of physicians or the hands of patients, HCA Healthcare is advancing knowledge and opening doors to the future of compassionate patient care.

Sarah Cannon, the Cancer Institute of HCA Healthcare, offers integrated cancer services with convenient access to cutting-edge therapies for those facing cancer in communities across the United States and United Kingdom. Sarah Cannon’s cancer programs include individualized patient navigation provided by oncology-trained nurses, more than 1,200 stem cell transplants performed annually throughout the Sarah Cannon Blood Cancer Network, hundreds of clinical trials, and molecular profiling capabilities. Through its services, Sarah Cannon is providing state-of-the-art cancer care close to home for hundreds of thousands of patients, a number unmatched by any single cancer center. To learn more about Sarah Cannon, visit

About HCA Healthcare

HCA Healthcare, one of the nation's leading providers of healthcare services, is comprised of 183 hospitals and more than 2,300 sites of care, in 20 states and the United Kingdom. Our more than 283,000 colleagues are connected by a single purpose — to give patients healthier tomorrows.

As an enterprise, we recognize the significant responsibility we have as a leading healthcare provider within each of the communities we serve, as well as the opportunity we have to improve the lives of the patients for whom we are entrusted to care. Through the compassion, knowledge and skill of our caregivers, and our ability to leverage our scale and innovative capabilities, HCA Healthcare is in a unique position to play a leading role in the transformation of care.

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