Surgeons at North-western Medicine in Chicago recently successfully performed double lung transplantations in two patients suffering from stage 4 cancer.
When cancer spreads from one lung to the other and doesn't respond to standard treatments, patients are left with no options. However, Dr. Ankit Bharat, the chief of thoracic surgery and the director of the North-western Medicine Canning Thoracic Institute, said, "We are going to consider this only when all the options have been exhausted."
Transplanting one lung at a time has historically been the standard procedure for cancer patients. However, it has some risks, such as the remaining cancerous lung can infect the new lung with cancer, and the incisions can infiltrate the cancer cells into the bloodstream.
Bharat and his team at North-western thus opted for a different approach.
They replaced both cancerous lungs at the same time with two healthy transplanted lungs to significantly lower the risk of cancer cells penetrating the new organs or other regions of the body.
This approach, however, is not feasible for all stage 4 lung cancer patients but is only for those in whom cancer is limited to the lungs but not beyond that.
Highlighting the challenges, Dr. William Dahut, the chief scientific officer of the American Cancer Society, said, "Determining the right patient is s huge task. The person undergoing the treatment must be able to tolerate both the surgery as well as the immunosuppressive therapies prescribed after the transplant."
North-western's program, termed North-western Medicine's Double Lung Replacement and Multidisciplinary Care, or DREAM, intends to identify the first 75 cancer patients to get a double-lung transplant. What they learn from these patients will also help other surgery centres perform the procedure.
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