Thanks to a minimally invasive surgery technique, one lifelong smoker got back to his new smoke-free lifestyle in a matter of days.
by The Iowa Clinic on Wednesday, December 12, 2018
Quitting smoking is the first step toward reducing your risk of lung cancer. But you don't reap the benefits on day one. The longer you smoke, the higher your risk of developing lung cancer. And that risk can follow you for decades after you quit smoking.
Howard Hugen knows this all too well. After decades of addiction, he was finally able to kick his habit in 2014. But the damage was done. He was diagnosed with lung cancer in 2018.
"My primary care doctor was kind of concerned. I had a little bit of a cough,"; Hugen says. "I was a smoker for quite a while — probably 55 years. He wanted me to do this new low-dose CT scan annually.";
"There's been more widespread lung cancer screening with CT scans, so more tumors are being identified,"; says Dr. Brian Rundall, DO, a cardiothoracic surgeon at The Iowa Clinic. "People that have a long history of smoking — that's the main category of people who may need annual screening. Studies have shown there's a benefit.";
Lung Cancer Despite Breaking the Habit
Hugen had tried to quit smoking many times over the years, but "not with a real good mental determination,"; he says. He developed a bit of a smoker's cough in recent years, but nothing that bothered him much.
Hugen was finally able to escape his addiction by taking gradual steps. He switched to e-cigarettes, getting his nicotine fix without all the smoke. Over the course of 18 months, he slowly weaned himself of his nicotine addiction and became a non-smoker.
"That was tough. I was off and on, off and on, off and on,"; he says. "It was touch-and-go. I finally phased it out because it wasn't good for me and it showed up on these tests.";
His smoker's cough disappeared almost immediately, and he felt good. But Hugen was in his mid-70s and had in excess of five decades of smoking behind him. At that point, the risk of lung cancer doesn't go back to normal after quitting.
Luckily, the full-body CT scan Hugen underwent caught the lung cancer in its early stages. It was still localized to his lungs and small enough to avoid a thoracotomy, a major open-chest surgery to remove lung cancer.
VATS Lobectomy Leads to Speedy Recovery
Dr. Rundall performed Hugen's surgery, using a minimally invasive technique known as video-assisted thoracic surgery (VATS) to remove the entire upper lobe of his right lung.
The VATS procedure uses an endoscope to explore the lungs. Then, with three small incisions — two at the bottom of the chest and one near the armpit — the cancerous lobe and lymph nodes are removed and drainage tubes are inserted. Patients are able to fully recover from surgery in just three to four weeks — almost twice as fast as the six-week recovery time on a thoracotomy.
"With this technique, lobectomies can be performed just through smaller incisions with a camera,"; Dr. Rundall says. "It's really reduced the pain associated with a large incision between the ribs and spreading the ribs. We find it gets them back to work a little bit sooner, and even heavy lifting sooner.";
Hugen underwent surgery on July 26. At his age, he feared he would be laid up for a long time recovering from the procedure and have difficulty getting back to doing the things he enjoyed.
"I was pleasantly surprised. I had no pain — discomfort, yes — but I really can't say pain,"; he says. "By the second day, I was walking already. And quite a bit, too. I would say I really have no side effects at all from the surgery.";
Walking Away After a Cancer Scare
In his postoperative stay at Iowa Methodist Medical Center in Des Moines, Hugen walked circles around the hospital — eventually doing so without a nurse at his side. He's happy that his surgery allowed him to walk out of the hospital and back onto his normal daily route.
"I enjoy walking. That's probably the main thing I do to stay active,"; he says. "In the basement, I do have a treadmill for the winter. But it's a lot nicer to walk outside.";
Now cancer-free and smoke-free, Hugen's goal is to keep on walking in order to stay active and healthy as long as he can. He'll need chest scans every few months for at least the next year to keep an eye on his lungs. But other than that, the lobectomy was the only treatment he needed for his lung cancer.
"I have a real good impression of what they did for me — the invasiveness, my recovery, everything,"; he says. "I talked to people who had lung surgery 15 years ago where the incision was all the way from your back to your front. But this surgery was a piece of cake for me. I feel super good.";