Duke Surgeons Perform Minimally Invasive Surgery for Lung Cancer

Durham, N.C. — Smoking has health consequences even after quitting, especially with the threat of lung cancer. Early detection through screening increases the chance of survival and a new procedure makes those chances even better.

Alan Clever kicked the smoking habit 25 years ago. However, late in 2005, chest imaging revealed a possible tumor that was later found to be early-stage lung cancer.

“I thought I had escaped that, but your sins catch up with you,” Clever said.

Dr. Thomas D'Amico at Duke Comprehensive Cancer Center said Clever needed the lower third of his right lung removed. Standard lobectomy surgery would mean a large incision, cutting through muscle and cracking open the ribs. But in a newer minimally invasive procedure, surgeons work laproscopically through two small incisions.

“All I've got is two little holes and slit about that long, so it healed up rather quickly,” Clever said

There is faster healing and less pain with the surgery, so patients need fewer narcotics after surgery. There are also fewer complications. The hospital stay is shorter and patients return to normal activity much faster.

“The list really goes on and on,” D'Amico said. “The advantages of minimally invasive surgery compared to conventional surgery are numerous.”

A study in the Annals of Thoracic surgery points to another major benefit. After conventional surgery, patients are often too weak take the desired dose of chemotherapy drugs.

“After the minimally invasive procedure, patients are better able to tolerate the full dose of chemotherapy,” D'Amico said.

Patients begin chemo sooner and they're less likely to miss or delay doses. That greatly improves their chances of long-term survival.

Clever said he is still a little short of breath at times, but he's still active.

“I pretty much do everything I want to do,” he said.

Most patients with early-stage lung cancer still have the conventional surgery, but Duke is a national leader in training other surgeons for the new procedure.