For Jennifer Hoppick, smoking was just something that ran in the family. "Everyone in my family always smoked, all their lives, and no one ever got lung cancer." The 61-year smoker thought she was in the clear until doctors heard something abnormal in her chest. She was diagnosed with early stage lung cancer. "Sent me to get a chest x-ray, and that's where it started. I absolutely had no symptoms at all."
Traditionally, life-saving treatment means a ten-inch incision between the ribs. Surgeons spread the rib cage to reach the cancerous lobes. "In this patient, you can see that there's an abnormality along here."
Now, there's a new, less invasive approach for those who catch their cancer early. It's called video-assisted thoracoscopic surgery or "vats." "We're now using multiple, smaller keyhole incisions and telescopes with long instruments to do the work that we used to do with our hands."
Surgeons make two or three-inch-long incisions at the rib cage to insert a tiny camera and tools. Guided by the images on the video screen, doctors find the diseased lobe and pull it out without spreading the ribs. For Jennifer, it meant less time in the hospital and a surprisingly fast recovery. "I went back to work after three weeks." Dr. Michael Smith, thoracic surgeon.
"And the good thing, too, is that the data shows that there's no difference in the long-term outcome after this procedure. So it's still a good cancer operation for early stage lung cancer."
Now, Jennifer's cancer free … and on a mission to stay that way, saying yes to a healthier lifestyle, and no to cigarettes. If caught in its first stage, lung cancer patients have an almost 90-percent chance of surviving for more than ten years. Surgeons are also using the vats procedure for diagnosing certain pneumonia infections and tumors of the chest and in treating collapsing lungs.
BACKGROUND: Lung cancer is the leading cause of cancer death among men and women in the United States. According to the Mayo Clinic, lung cancer is also the most preventable cancer. The primary risk factor of lung cancer is the length of time and number of cigarettes a person smokes. The Centers for Disease Control ranks lung cancer as having more accounted deaths than breast cancer, prostate cancer and colon cancer combined. More specifically, 90,139 men and 69,078 women died from lung cancer.
DIAGNOSIS: Lung cancer is usually undetectable at its earliest stages. Most symptoms of lung cancer occur when the disease is advanced. Some common symptoms include a new cough, shortness of breath, wheezing, coughing up blood, chest pain, fever and weight loss. Diagnosis of the cancer is based on a biopsy report reviewed by a pathologist. Lung cancer is usually categorized as either non-small cell or small cell depending on how the cells look under a microscope during the biopsy.
CURRENT TREATMENTS: Treatment for lung cancer is based on the stage of the tumor and the patient's medical condition. Options for treatment include surgery, radiation, chemotherapy or a combination of all of these treatments. Some of the current surgeries include mediastinoscopy, or sampling lymph nodes along the main airway in order to assess for spread of tumor; thoracoscopy, which involves accessing the chest through small incisions to diagnose and treat the cancer; wedge resection, or removing a small section of one lung; segmentectomy, which involves removing a part of the lobe of one lung; lobectomy, or removing an entire lobe of one lung (the most common type of lung cancer surgery); sleeve resection, or removing a part of the airway; and pneumonectomy, removing a lung. Radiation is given with an external beam and can destroy cancer cells without surgery. Radiation can be given before or after surgery, or before, during or after chemotherapy. Chemotherapy may include a variety of drugs prescribed and monitored by a medical oncologist. Chemotherapy can help radiation be more effective.
NEW APPROACHES: In video-assisted thoracoscopic surgery, or VATS, surgeons use small multiple keyhole incisions to insert a long instrument into the body to do the work doctors hands would do in a lobectomy. The advantages are that patients have less post-operative discomfort because the instrument allows the doctor to avoid spreading the ribs to get to the tumor, and a shorter hospitalization. Experts have observed no significant difference in long-term outcomes between VATS and more traditional surgeries for early-stage lung cancer.
FOR MORE INFORMATION, PLEASE CONTACT:
Carmelle Malkovich
Public Relations
St. Joseph's Hospital and Medical Center
Phoenix, AZ
(602) 406-3319
Carmelle.malkovich@chw.edu
