Hospital first in country to carry out radio-guided lung surgery

Posted on in Research

When Joan Wanless was diagnosed with lung cancer on one side of her lungs and a tiny nodule was found on the other she feared the worst.

Joan and the team

Experts explained that it was an untypical case and that if the 6mm nodule was cancerous as well it would be too dangerous to try to operate.

The grandmother-of-eight was dealt a further blow when she discovered the nodule was so small that it would be extremely hard to find during surgery and too high risk to do a biopsy using normal surgical methods.

Luckily for Joan her cardiothoracic consultant Joel Dunning at The James Cook University Hospital had heard of an advanced technique, never before used in this country, that could help them locate the nodule using a small amount of radioactive tracer.

In order to carry out the radio-guided technique special permission had to be obtained from the Administration of Radioactive Substances Advisory Committee and Mr Dunning had to call on the expertise of a number of colleagues including the hospital’s head of nuclear medicine Mark Richardson, radiologist Dr Arivalagan Bapusamy and theatre sister Caroline Baldwin.

“If the nodule was cancer then going through a major operation on the other side of the lungs would have been too high risk so we absolutely had to know what the nodule was,” said Mr Dunning.

“The nodule was 1cm deep into the lung so we were not going to be able to get to it safely using normal methods.Joan and Gordon

“In a presentation I had seen in America someone had talked about injecting a radioactive solution near to the nodule and then using a Geiger counter (instrument for detecting emitted radiation) to find its exact location. So I made enquiries as to whether we could do something similar.”

It was a team effort with radiologist Dr Bapusamy injecting the radioactive solution guided by images from a CT scanner and Mr Richardson working closely with Mr Dunning in theatres to accurately locate and remove the nodule.

Mr Richardson said: “It was a great success. The gamma ray emissions enabled us to find the nodule very quickly using a radiation detector-probe designed for use in surgery.”

Pathology tests revealed the nodule was benign and a week later Joan, 72, was able to have her tumour removed using a form of keyhole surgery known as a VATS (video-assisted thoracoscopic surgery) lobectomy which is much less invasive than traditional surgery.

Five days later Joan was back at her Middlesbrough home with husband Gordon and she is now looking forward to her grandson’s wedding in 2015.

“When they told me I had lung cancer I thought that was it,” said Joan. “When they say cancer that’s the first thing you think of, it’s an awful feeling.

“But when Mr Dunning told me I could have the operation that was the best Christmas present ever.

“All the family had been really down and this news just lifted us up. He gave me a chance and I will never forget that. Everyone at the hospital has just been marvellous.”