UH Clinical Update - September 2017
For patients suspected of having lung cancer, University Hospitals interventional pulmonologist Benjamin Young, MD, provides access and efficiency. 
“I want to get them in as quickly as possible,” says Dr. Young, who is Director of Bronchoscopy at UH Cleveland Medical Center. “Oftentimes, I’m the entry point into the system when somebody needs a tissue diagnosis, needs a biopsy or needs additional information to be able to appropriately stage the patient. The nice thing about the training I have is that I can do all of that in one setting – the diagnosis and staging to get the ball rolling and not have to wait to schedule multiple procedures with multiple people. It does help to expedite the flow through the system.”
Dr. Young recently returned to UH after a four-year stint at Cleveland Clinic, where he served on the medical staff and did fellowship training in interventional pulmonary medicine. A graduate of Case Western Reserve University School of Medicine, Dr. Young did his internal medicine residency and pulmonary/critical care fellowship training at UH Cleveland Medical Center, followed by a faculty position here from 2010 to 2013.
In his work at UH, Dr. Young says he often finds people amazed at what interventional pulmonology can accomplish.
“I think we surprise people with some of the things we can do,” he says.
One especially valuable procedure, Dr. Young says, is navigational bronchoscopy, which employs an electromagnetic field coupled with a CT scan.
“The computer is able to register the CT scan to the magnetic field so we know where the tip of your catheter is inside the chest in three-dimensional space,” Dr. Young says. “We’re able to use the system to navigate out to our target, kind of like a GPS. Where it’s really useful is in small masses and smaller nodules. In the past, using just fluoroscopy, if you couldn’t see the lesion you could just blindly biopsy, or have to consider another biopsy technique, such as a CT-guided percutaneous needle biopsy or a surgical biopsy. At the same time, the status of lymph nodes in lung cancer is crucial to the staging and ultimate treatment. While we’re doing navigational bronchoscopy, we can also look at the lymph nodes and take care of two steps. There’s a little more testing that needs to happen, but we can help people move people along the care path.”
Other advanced procedures available through Dr. Young include placement of airway stents and placement of indwelling pleural catheters to manage malignant pleural effusion.
“Any time someone has tumor in the airway there are things we can do to help them breathe a little easier and provide some improvement in their quality of life,” he says. “With the indwelling pleural catheter placement, it keeps people out of the hospital, keeps them functional and able to manage it on their own without needing to come in and see us so frequently.”
Although much of his practice is devoted to patients with lung cancer, Dr. Young also helps manage airway complications in patients who’ve had a lung transplant. For certain patients with asthma, he also offers the option of bronchial thermoplasty. The procedure gained attention locally through Cleveland Cavaliers player Richard Jefferson, who credits it with saving his basketball career.
UH purchased a bronchial thermoplasty system in the spring.
“It’s for people with severe refractory asthma that hasn’t responded to medical therapy,” Dr. Young says. “It decreases the amount of smooth muscle in the central airways. It’s that smooth muscle that leads to the bronchoconstriction and wheezing. In the right patient, it can make a big difference in their quality of life. It’s not going to be for everybody, but there are people we can help. Right now, we’re looking for the right patients.”
With all these services, Dr. Young says, the focus is on patient comfort.
“A lot of times what I’m doing is palliative in nature, helping patients feel better. When you can’t breathe, nothing else matters,” he says. “I want to get them in quick and help them to breathe better.”