John Anderson, 60, a resident of Jefferson City, Mo., had smoked for more than 40 years when he got devastating news last June. His doctors thought he had an inoperable lung cancer, and only about three months to live. Then Jefferson City cardiothoracic surgeon Paul Brown Jr., MD, looked at Anderson''s x-rays, and determined Anderson was a candidate for a "sleeve lobectomy" – a procedure involving removing the right upper lobe and a substantial portion of the bronchi and rebuilding the remaining airway.
"Dr. Brown said if I was game, he thought he could get the cancer," Anderson said. "I told him to go ahead."
Anderson had the procedure and was out of the hospital in less than 30 days.
But that winter, Anderson had some difficulty breathing. Scar tissue had formed at the site of anastomosis, constricting the airway. Dr. Brown referred Anderson to Washington University physician Martin Mayse, MD, at Barnes-Jewish Hospital.
Dr. Mayse specializes in the relatively new field of interventional pulmonology, treating conditions such as pulmonary complications of cancer including malignant airway obstructions and recurrent malignant pleural effusions, with minimally invasive techniques. Barnes-Jewish is one of only a handful of centers across the country offering this service.
Dr. Mayse suggested that Anderson have a pulmonary stenting procedure. The general public has become familiar with cardiac stenting – placing a tiny wire tube to prop open clogged blood vessels. But pulmonary stenting is still relatively unknown.
But Anderson, once again in a difficult medical situation, was ready to have the procedure. Anderson attributed much of his enthusiasm to Dr. Mayse''s thoroughness in explaining the procedure, willingness to answer questions and compassion for his patients.
"For instance, he sat down and went through the various stent sizes and pressure sizes with me," Anderson said. "I''ve never been acquainted with a doctor quite like him."
In the March procedure, Dr. Mayse, using a bronchoscope, first dilated much of the tissue blocking the airway, then placed a removable stent to keep the airway open.
Dr. Mayse has since kept in touch, for an examination and planning for the stent removal. Recently, he was hit once again with bad news. A small cancer had returned to his lung in an area unreachable by surgery. But with chemotherapy at the Siteman Cancer Center at Washington University and Barnes-Jewish Hospital to shrink the tumor, followed by a "cone" radiation, a technique that focuses that radiation on the tumor while sparing surrounding tissues, doctors think they have an excellent chance to eradicate or control the tumor. Anderson, of course, is willing to try it.