Duke Method for Lung-Cancer Surgery Speeds Recovery

Durham, N.C. — Smoking has health consequences, even after you quit. Screening to detect lung cancer early increases the chances of survival, and a new surgical procedure being pioneered at Duke University Medical Center makes those chances even better.

Alan Clever kicked the smoking habit 25 years ago.

Still, late in 2005, chest imaging revealed a possible tumor. It proved 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 of Duke’s Comprehensive Cancer Center said Clever needed the lower third of his right lung removed.

Standard lobectomy surgery requires a large incision, cutting through muscle and cracking open the ribs. In a newer, minimally invasive procedure, though, surgeons work with a laparoscope through two small incisions.

“All I've got is two little holes and a slit … so it healed up rather quickly,” Clever said.

Faster healing and less pain means patients need fewer narcotics after surgery. They also mean fewer complications, shorter hospital stays and faster returns to normal activity.

“The list (of benefits) really goes on and on. The advantages of minimally invasive surgery compared with conventional surgery are numerous,” D’Amico said.

A Duke study in the Annals of Thoracic Surgery points to another major benefit.

After conventional surgery, patients often are too weak take the recommended dose of chemotherapy drugs.

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

That means they begin chemo sooner and are less likely to miss or delay doses. That, in turn, greatly improves long-term survival.

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

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

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