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New Lung Cancer Procedure Allows Quick Recovery


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http://www.nbcwashington.com/news/healt ... 80797.html


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Brian White runs far. He runs for hours. Sometimes the 59-year-old starts at sunrise and finishes when the sun sets.

"I've been an exerciser in an exercise program for at least 15 years," he said.

But his running came to a halt last spring. After recovering from pneumonia, a chest X-ray revealed a slow-growing tumor in his right lung.

"The news was very bad," White said. "She said I had a growth of 2.5 centimeters and she was pretty sure it was cancer in my lower right lung."

"He was beside himself," said Dr. Sandeep Khandar, a thoracic surgeon with the Inova Thoracic Oncology Program. "He just didn't understand how this could happen to him. He did everything right."

White believed the diagnosis was a death sentence, but Khandar told him there was hope in a new procedure to remove lung tumors that would not only get rid of the cancer, but would allow him to get back to his active lifestyle -- in mere days.

"With the minimally invasive operation, we're able to get people out of the hospital as early as the next day," Khandar said. "They get back to work in a couple of days, back to functioning in a normal capacity generally within a week or so."

Khandar is one of just 40 surgeons in the country who is removing lung tumors through two tiny incisions. Doctors insert a small camera through one of the holes. In the other, they put in special instruments that go between the ribs to remove the tumors.

"The biggest advantage is not spreading the ribs," Khandar said. "If you don't spread the ribs, then patients will have less pain."

In the traditional open surgeries, surgeons make large incisions in the chest and actually spread the ribs to access the lung. That causes damage to the muscles and a lot of pain. It can take weeks for patients to recover.

"A traditional open operation, the patient is typically out of work for several weeks, on narcotic pain medication for several weeks, up to a month, and still having a substantial amount of pain up to four, seven, eight, even 12 weeks."

"After the operation, he said, 'I'll have you walking from the recovery room into your room,' and I said, 'That's pretty much unbelievable,'" White said.

But the doctor was true to his word. White was not only back home the next day, but his running sneakers were back on his feet in less than a week.

"Everything he said, it came true," White said. "And it really was amazing. How he got my lung out of that little hole, I have no idea, but he did."

Most lung tumors can now be removed through this procedure, but some larger tumors or those that are located in the center of the lung may still need to be taken out through the traditional open surgery.

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(Washington News, Health, by Eun Yang, September 4, 2009)


The information contained in these articles may or may not be in agreement with my own opinions. They are not being posted with the intention of being medical advice of any kind.

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That's the procedure the surgeon started with for my exploratory surgery 3 years ago (thoracoscopy). But he found my pleural effusion had shoved the lung against the chest wall and essentially glued it in place, so he had to transition to a full thoracotomy to get access. The 2 little holes became part of a much longer incision which did involve some rib spreading, but it wasn't as painful as I'd been led to believe. I think many or most surgeons today will attempt the scope procedure first, though I imagine some are better at it than others.


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That sounds pretty familiar. My tumor was just a bit bigger than his (2.8 cm), and near the outside of my lung where a VATS procedure would probably have worked. I was also unhappy with how long open surgery would keep me from exercising.

But I didn't find a surgeon near me who did VATS, and traveling somewhere else would have been no guarantee that VATS wouldn't turn into open surgery before the surgeon was finished, so I just had open surgery locally.

Some of the treatment decisions we face can be tough. I was back on my bike in 16 days, but with 20/20 hindsight, I would have traveled for the VATS.

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