Sweat. Can’t live with it, can’t live without it. Don’t sweat it. Bad advice if taken literally. Sweat plays an important role in preventing hyperthermia, when the body overheats. Hyperthermia can be fatal as internal organs over heat and eventually fail. The beads of salty water we call sweat evaporate Read More
Author: alexlittle@att.net
Can you experiment on patients? The answer is yes. As an academic thoracic surgeon many of lung and esophageal cancer patients were in clinical studies. If you are considering participation in a study or are simply curious, this blog should be helpful. There is supervision of and tight controls on Read More
Seed or soil? When and why cancers spread (metastasize) are subjects of intense investigation. We know cells frequently escape from most cancers, including lung cancer, resulting in the dissemination of malignant cells into the blood stream on a regular basis. However, a cancer can be present for variable lengths of Read More
What two surgeons did not do dramatically changed the course of American Surgery. I have discussed the contributions of two influential pioneer surgeons Macewen and Graham. They also changed the course of Surgery in the USA by something they did not do. Both men were offered the position of Chairman Read More
It has been said that the only excuse for smoking…is being on fire. I want to discuss and emphasize the carcinogenic (cancer causing) effects of cigarette smoke. Then we can review the role of thoracic surgery and thoracic surgeons in the care of patients with lung cancer, the subject of Read More
Be prepared. The lung cancer in most patients on whom we thoracic surgeons operate is situated entirely within a lobe of the lung and a lobectomy is a sufficient operation. Occasionally, as previously discussed, it is too large or is positioned such that an entire lung must be removed; a Read More
How to get inside? This was not a meaningful question until the 1990s. Up till then the only route in was by an open thoracotomy. (from thorax, chest, and -otomy, to open) The figure illustrates. A cut in the skin and muscles is parallel to the ribs which are spread Read More
Homogeneity does not describe the surgical community. This can confuse someone looking for the right lung cancer surgeon. There are general surgeons and thoracic surgeons (who have confusingly self-divided themselves into cardiac, cardiothoracic and general thoracic subspecialties). Within all these surgical groups can be found surgeons who operate for lung Read More
Goldilocks…the principle, not the character. The thoracic surgeon must get the operation “just right.” Take out too much lung and the patient is forever short of breath; not enough and the cancer is not cured. As I discussed in a previous blog, Evarts Graham, a surgeon in St. Louis, performed Read More
Staging cancer…it has nothing to do with the theater. In short, staging is determining the extent of the lung cancer. Is the tumor invading into structures outside the lung such as the rib cage or the heart? Has the cancer spread through the lymphatic system to lymph nodes near but Read More
