Diagnosis of lung cancer in University Hospital Saarland Homburg

About the department

The Department of Pulmonology and Infectology at the University Hospital Saarland Homburg provides all modern diagnostic and therapeutic options for patients with respiratory diseases. Of particular interest is the treatment of lung cancer (in collaboration with cardiothoracic surgeons and oncologists), respiratory failure, chronic obstructive pulmonary disease, and pneumonia. The department offers the services of specialized sections for coronavirus infection, cystic fibrosis, alpha-1 antitrypsin deficiency, interstitial lung disease, and pulmonary hypertension. The department's patients can also receive highly effective intensive care, including extracorporeal membrane oxygenation (ECMO), MARS therapy, and long-term venovenous hemodialysis. The department has the necessary resources for endoscopic diagnostics and treatment, as well as pulmonary function tests in a specialized laboratory. With 78 beds, the department is one of the largest medical facilities of this kind in Germany, including 18 beds with mechanical ventilation. The therapeutic options of the medical facility are complemented by the treatment of infectious diseases, including tropical infections. The department is headed by Prof. Dr. med. Robert Bals.

Lung cancer is one of the most common types of cancer and has a high mortality rate. Lung cancer treatment is a priority for doctors at the medical facility. A modern, specialized Lung Cancer Center, which is part of the department, was founded at the University Hospital in 2017. At this center, pulmonologists, cardiothoracic surgeons, oncologists, radiation therapists, and specialists providing palliative care and psychological support collaborate. Each clinical case is considered at regular interdisciplinary tumor boards, during which doctors study the patient's clinical data and determine which treatment methods will be most effective in his case. In most cases, the treatment is based on the surgical resection of the tumor, a lung lobe, or the whole lung. Chemotherapy and/or radiation therapy are almost always carried out as well. The Lung Cancer Center is certified according to the standards of the German Cancer Society (DKG), which indicates the highest quality of treatment in compliance with current clinical protocols.

The department is one of the few in Germany where patients with rare respiratory pathologies are treated. The department's pulmonologists are rightly proud of their high success rates in the treatment of cystic fibrosis, pulmonary hypertension, idiopathic interstitial pneumonia, interstitial lung disease, alpha-1 antitrypsin deficiency, bronchiectasis, and other pathologies. The above-mentioned diseases are treated using individually developed drug therapy regimens, inhalation therapy, physiotherapy procedures, and other therapeutic methods.

Particular importance in the department is given to endoscopic diagnostic and treatment methods. The specialists at the medical facility have state-of-the-art equipment for endoscopic examinations, which are of particular value for assessing the condition of the respiratory system. Flexible and rigid bronchoscopy, transbronchial lung biopsy, lung cryobiopsy, and endobronchial ultrasound examinations are available here. Endoscopic techniques are also widely used for therapeutic purposes. For example, endobronchial cryotherapy is performed to destroy small lung neoplasms, eliminate respiratory failure due to tumor stenoses in the trachea and bronchi, or remove foreign bodies from the bronchi. The department's doctors also perform electrocoagulation to stop internal bleeding, and endoscopic lung volume reduction is often prescribed for chronic obstructive pulmonary disease, etc.

The department's range of services is complemented by the diagnostics and treatment of sleep-related breathing disorders. For this purpose, the department has a state-of-the-art sleep laboratory, which allows doctors to carry out sleep screening on an outpatient basis. During the examination, doctors can detect sleep apnea, snoring, and other breathing problems during sleep. These examinations can be carried out at home using the Apnoescreen system. After comprehensive diagnostics, patients are prescribed the optimal treatment to get rid of sleep-related problems and improve their quality of life.

The department specializes in the diagnostics and treatment of the following diseases:

• Lung cancer
• Pulmonary fibrosis
• Tuberculosis
• Pneumonia
• Rare lung diseases
  • Idiopathic interstitial pneumonia
  • Interstitial lung disease: pulmonary langerhans cell granulomatosis, pulmonary sarcoidosis, and pulmonary alveolar proteinosis
  • Exogenous allergic alveolitis
  • Alpha-1 antitrypsin deficiency
  • Bronchiectasis caused by immunoglobulin deficiency
• Bronchial asthma
• Chronic obstructive pulmonary disease
• Sleep-related breathing disorders
• Infectious diseases, including coronavirus infection, tropical infections, and other diseases of this spectrum
• Other pathologies

The department's main clinical activities are as follows:

• Diagnostics
  • Pulmonary function tests
    • Body plethysmography
    • Lung diffusion capacity measurement
    • Blood gas analysis
    • Fractional exhaled nitric oxide (FeNO) test
    • Measurement of respiratory muscle strength
    • Spiroergometry 
    • 6-minute walk test
  • Ultrasound scans
  • X-ray scans
  • Endoscopic examinations
    • Endobronchial ultrasound
    • Transbronchial lung biopsy and transbronchial cryobiopsy
• Treatment
  • Drug therapy: intake of pills, injections, and infusions
  • Inhalation therapy
  • Oxygen therapy
  • Physiotherapy procedures
  • CPAP and BiPAP therapy for sleep-related disorders
  • Intensive care for pulmonary diseases: invasive and non-invasive ventilation, ECMO, MARS therapy, etc.
  • Endoscopic procedures
    • Endobronchial cryotherapy for the destruction of small lung neoplasms, the elimination of respiratory failure due to tumor stenoses in the trachea and bronchi, or the removal of foreign bodies from the bronchi
    • Electrocoagulation for internal bleeding
    • Endoscopic lung volume reduction for chronic obstructive pulmonary disease
    • Bronchoalveolar lavage
  • Medical care for patients after lung transplant surgery
• Other diagnostic and therapeutic services