Monday, August 24, 2009

Minimally invasive surgery lessens pain of esophageal cancer

New option has many advantages over traditional surgery

Since retiring as chief of the Boston Police Department in 2007, Albert E. Goslin has enjoyed spending New England’s bone-chilling winter months in sunny Florida. However, esophageal cancer nearly grounded that journey until a team at the Mass General Cancer Center and Division of Thoracic Surgery lead him down a quick road to recovery.

Using an innovative minimally invasive procedure, Goslin’s thoracic surgeon, Christopher Morse, MD, was able to remove the tumor with less postoperative pain and a shorter recovery time, allowing Goslin to start a second round of chemotherapy more quickly.

“Minimally invasive esophageal surgery provides patients with an option that has many advantages over traditional surgery, including a faster recovery time and less postoperative discomfort” said Morse.

A new surgical optionGoslin’s doctors first saw indications of a problem after routine blood tests turned up some troubling results. Following a CT scan that showed thickening of his esophagus, Goslin made and appointment with Dr. Panagiotis M. Fidias at the MGH Cancer Center where he was diagnosed with esophageal cancer.

“I discussed the treatment options with Dr. Fidias and my family and decided on a combination of chemotherapy and surgery,” said Goslin. “I went through a cycle of chemotherapy and was referred to Dr. Morse for the surgery.”

Because Goslin’s tumor was confined to the distal esophagus, Dr. Morse decided he was an excellent candidate for a minimally invasive approach to his esophageal resection.

An esophagectomy involves the removal of the cancerous part of the esophagus and is the primary treatment for these cancers if they have not spread. In traditional open surgery, large abdominal as well as chest incisions are used to resect and reconstruct the esophagus. In contrast, the laparoscopic procedure involves several small abdominal and chest incisions to allow access for the camera and instruments.

“Minimally invasive esophagectomy has been demonstrated to have similar oncologic results as traditional surgery, but with this option we can alleviate some of the pain and in the case of Mr. Goslin, get him to his second round of chemotherapy part of a clinical trial) feeling strong,” said Dr. Morse.

While the conventional surgical approach remains the standard at many hospitals, Dr. Morse introduced the alternative surgical approach at Mass General in 2008. This was after completing an eight month fellowship with the University of Pittsburgh Medical Center doctors who pioneered the technically-demanding procedure. Goslin was thankful for the option.

“Dr. Morse felt I was a good candidate for the surgery, and I was more than happy to have it done that way,” he said. “The recovery was remarkably quick. I was back on my feet within a day and was able to be active and get to the gym within weeks.”

The road to recovery

After the surgery, which removed one-third of his esophagus and 31 lymph nodes, Goslin had to go through another cycle of chemotherapy. With his wife and daughter by his side, he finished his last treatment on December 15 and days later was on a flight to Florida.

A scan done at a Florida hospital in April found that he was free of cancer.

“It was a little bump in the road, but I’m feeling great. I am very fortunate,” said Goslin.

Learn more about the Division of Thoracic Surgery and the Cancer Center.

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