Robotic-Assisted Surgery for Lung Cancer Treatment Brings Faster Recovery, Less Pain

The past efforts of many made it possible for Deborah Miller to have a healthier future. The Kentucky resident recently underwent robotic-assisted surgery to treat her early-stage lung cancer.

“It was a success because of the doctors and scientists researching the field of early-stage lung cancer treatment. And because funding to hospitals helps support the purchase of new technology. And the academic experience the doctors, nurses, and medical staff have. Each of them took care of me,” says Deborah.

In early May 2020, Deborah was receiving care for another health issue when a computed tomography (CT) scan revealed a shadowy area on her right lung. Her doctor ordered a second CT scan the following day and a positron emission tomography (PET) scan just ten days later to further uncover what was going on. Less than a month after the initial testing began, Dr. Valerie Williams, Associate Medical Director of Thoracic Surgery at St. Elizabeth Healthcare in Edgewood, used a da Vinci surgical robot to diagnose Deborah’s lung cancer and remove a portion of her right lung and 23 lymph nodes.

From diagnosis to treatment, everything went fast. St. Elizabeth and
Dr. Williams takes a cancer diagnosis seriously. They wanted to make sure my needs were met as fast as possible – it was as fast as lightning,” she says.

The speed at which things happened also made the process easier, Deborah says. “It helped with my ‘scanxiety.’ When you get that Big C diagnosis or think you might have cancer, you want answers right away and you want the tumor out of your body immediately,” she says.

“When lung cancer is caught at an early stage, surgery can be curative,”  Dr. Williams says. “During surgery, I remove the section of the lung in which the cancer exists and all the draining lymph nodes on that side of the patient’s chest.  When surgery can be done in the beginning stages of lung cancer, the five-year survival rate can be as high as 90%.”

Deborah’s procedure, called a lobectomy, was done with robotic-assisted thoracic surgery. The advanced technique is less invasive than traditional open surgery and provides multiple benefits to both the patient and the surgeon.

Many facilities offer minimally-invasive video assisted thoracic surgery, but St. Elizabeth Healthcare is one of few health systems in the region that offers robotic-assisted thoracic surgery. Both types are less invasive than open surgery, but robotic-assisted surgery offers several advantages not possible with other methods.

In robotic-assisted surgery, the surgeon makes small incisions and passes a tiny camera and flexible surgical instruments into the patient’s chest. The robotic camera views the surgical area up close through a magnified system that shows the area in three dimensions and provides improved visibility. A robotic arm holds the surgical tools and moves with the surgeon’s commands. The da Vinci robot does not perform the surgery. It assists the surgeon, who remains in control at all times.

“Using the da Vinci robotic system allows me to perform intricate surgery using a minimally invasive approach. It provides significantly better visibility of the vital structures like the pulmonary arteries and allows me to make precise movements and dissection more easily,” Dr. Williams says.

“The flexibility of the robotic arm mimics the movement of a human wrist—without any tremor or unwanted movement. This feature improves dexterity, precision and control and allows me to operate more easily in tight spaces,” she adds.

Robotic-assisted thoracic surgery offers numerous benefits to the patient as well. The nationwide average hospital stay after lung cancer surgery is five days. At St. Elizabeth, patients who undergo robotic-assisted lobectomies typically go home two days earlier with an average post-surgery stay of about 2 ½ days.

Other benefits include:

• Faster recovery time overall
• Fewer complications during and after surgery
• Less post-surgical pain
• Reduced blood loss and muscle damage
• Quicker return to daily activities

Deborah left the hospital three days after her surgery. Now, she says her recovery has been relatively uneventful. “There were times I had pain, but it was very manageable,” she explains.

Her prognosis is good. Regular follow-up care and monitoring for the next five years will help ensure Deborah’s continued good health. She credits  Dr. Williams’s expertise for her positive outcome.

Deborah says that Dr. Williams takes cancer very seriously. Her skill and compassion were the perfect combinations for what she needed. “She’s very encouraging – all around, she’s top-notch. I was so thankful, and I feel blessed and grateful that she was my doctor.”

Know Your Risk

While Ginny’s lung cancer has no known cause, tobacco smoke remains the largest risk factor for developing lung cancer. The disease is a serious health concern across our state. Kentucky leads the nation in smoking and has more deaths from lung cancer than the next eight cancers combined, including breast, prostate and colon cancer.

Lung cancer can be a serious, deadly disease. However, the implementation of lung cancer screening is changing the outcomes for many people that are found to have lung cancer by detecting it early, when it is very curable.

“The most exciting advancement in lung cancer is screening,” Dr. Calhoun says. “We can target people who are at most risk for lung cancer and offer them a low-dose CT scan. It’s a safe, effective way to detect and diagnose lung cancer in its early stages, which ultimately leads to better treatment and outcomes. We are moving lung cancer screening to match the screening that occurs with mammography for breast cancer.”

The low-dose CT scan can detect lung cancer early. According to the NCCN Guidelines for Patients Lung Cancer Screening Version 1.2017, individuals may be a good candidate for a low-dose CT scan if they are:

• Between 55 and 77 years old
• A current smoker or have quit within the past 15 years
• Have a 30-pack year history. Pack years are calculated by multiplying the number of years smoked. For example, if you smoked one pack a day for 30 years (1×30), that would equal a 30-pack year history. Smoking two packs a day for 15 years (2×15) would also equal a 30-pack year history.

A Team Approach to Care

Since coming to St. Elizabeth, Dr. Calhoun has been working to help advance the care and treatment available to individuals with lung cancer. At the heart of that is a multi-disciplinary approach where radiologists, pathologists, pulmonologists, thoracic surgeons and medical and radiation oncologists work together to discuss the patient’s case, review the films, pathology and identify the best treatment plan for each individual, including clinical trials.

“Detecting, diagnosing and treating lung cancer is evolutionary,” he says. “When we work across disciplines, we get different perspectives, experience and knowledge that are all relevant to the same problem. We’re positioned to do what’s best for the patient at any stage of their treatment.”

Expert Care, Right Here

Ginny is thankful for not only the care she received but that the guidance, support and expertise she needed was so close to home. Dr. Calhoun’s approach is one that resonated with her, and with many of his other patients.

“It’s clear that Dr. Calhoun cares about his patients,” Ginny says. “He took the time to sit down and talk with me – to understand what I wanted from treatment, my history and interests. He used all that information, along with his own experience and knowledge, to make a recommendation that would be best for me.”

“I try to see everyone as an individual,” Dr. Calhoun says. “I recognize that what they are going through is scary. But, I’m also an expert in what I do with a lot of experience, so I’m well positioned to help them figure out their lung cancer situation and get the treatment that’s best for them.”