Thoracic

Here at BASS, our thoracic surgeons specialize in:

Esophageal Cancer

Unfortunately, the symptoms of esophageal cancer can be difficult to detect, particularly in the early stages where there might be no symptoms. Later stage symptoms may include:

• Difficulty or pain swallowing
• Chest pain or pressure
• Heartburn or a burning sensation
• Weight loss
• Persistent coughing or hoarseness of the voice

Emphysema

As the disease develops slowly, the patient will also develop symptoms over time, which may include:

• Shortness of breath
• Coughing
• Wheezing
• Decreased tolerance for exercise or excretion

Hiatal Hernia

• Heartburn
• Gastroesophageal Reflux Disease (GERD)
• Bitter or sour taste at the back of your throat
• Chest or abdominal pain
• Difficulty swallowing
• Belching
• Coughing

Hyperhidrosis

Typically, symptoms include excessive sweating of the:

• Palms of the hands
• Soles of the feet
• Armpits
• Face

Lung Cancer

• A cough that won’t go away or gets worse
• Chest pain when breathing , coughing or laughing
• Hoarseness
• Unintended Weight loss and loss of appetite
• Coughing up blood
• Shortness of breath
• Feeling weak and tired
• Bronchitis and pneumonia that keep coming back
• Wheezing

Mesothelioma

• Pain under the rib cage
• Difficulty breathing
• Painful coughing
• Pain, swelling or lumps in the abdomen or chest
• Unusual weight loss

Our practice has three board-certified thoracic surgeons available to patients who are in need of surgical intervention for their condition.

Esophageal Cancer

There are various types of treatments available to patients with esophageal cancer. The physician will discuss these options with the patient and will vary depending on the type of cancer and the stage. Typically, treatment involves one or more of the following:

• Surgery (minimally invasive procedure)
• Chemotherapy
• Radiation therapy
• Laser therapy
• Electrocoagulation

Emphysema

The first thing the doctor will recommend to a patient is to stop smoking. Other treatments include:

• Medications that allow the lungs to expand more fully (i.e. bronchodilating medications)
• Steroids, which decrease inflammation
• Antibiotics
• Oxygen – there are home based tanks and portable systems

In more advanced cases:

• Lung Volume Reduction Surgery (LVRS) – a reduction of the both upper lobes of the lungs by 20 to 30% allowing the lower and healthier portions of the lung to work more efficiently
• Lung Transplant – this is a last resort procedure when there is lung failure. This happens when the lungs are damaged to such an extent they no longer transfer oxygen into the body and carbon dioxide out. Unfortunately, the number of people needing transplants far exceeds the number of available donors.

Hiatal Hernia‍

Treatment options will depend on the type of hiatal hernia and the severity. Treatments may include:

• Loss of weight
• Medications to control stomach acid. This is a temporary option that will reduce the pain and discomfort associated with heartburn, reflux or gastroesophageal reflux disease (GERD)
• Surgery to repair the hiatal hernia and restore the anatomy to its correct anatomical structure. This procedure is typically done minimally invasively or laparoscopically.

Hyperhidrosis

There are several treatment options for patients. The results do vary from patient to patient.

Medications

• Prescription antiperspirant
• Nerve-blocking medications, taken orally, block certain chemicals that prevent nerve cells from communicating to each other, including sweat glands.
• Botulinum toxin (i.e. Botox) injected at the source of the excessive sweating, block the nerves that are causing the excessive sweating. The effect lasts for 6 to 12 months and then has to be repeated.

Surgery

• Video assisted thoracoscopic surgery (VATS) – This procedure is most effective with excessive palm and face sweat. A nerve is cut during the procedure, which stops the signal to that instructs the sweat glands to sweat excessively. Other, less invasive procedures should be attempted first.
• Sweat gland removal. As with VATS, this should be a last resort procedure. The surgery removes the sweat glands from the affected area.

Lung Cancer

Surgery to remove the cancerous lung tissue is an option for early stage NSCLC and offers the best chance for a cure.

When considering surgery for SCLC, the first step is to determine whether it has spread. Biopsies will be performed. If cancer cells are found in the lymph, surgery may not bean option for SCLC.

Types of Surgery:

• Wedge Resection is the surgical removal of a small part of a lobe of the lung.
• Lobectomy/ Bilobectomy. Lobectomy is the surgical removal of an entire lobe of the affected lung. This is the most common surgery performed for lung cancer. Bilobectomy is removal of two lobes of the same lung. The right lung has 3 lobes, the left lung has two lobes.
• Pneumonectomy is the surgical removal of the entire affected lung. This surgery is done where the cancer cannot be removed entirely with a lobectomy, if there is concern the cancer has spread through the entire left or right lung or the tumor is centrally located.

Two surgical procedures that are used to remove lung tumors for diagnosis, and to treat lung cancer.

• Thoracotomy is a surgical procedure where an incision is made across the side of the chest, the ribs are spread, and the surgeon can access the affected lung. It can be using a  lobectomy or pneumonectomy, especially when very long tumors are present.
• VATS is video assisted thoracoscopy. It is a minimally invasive technique to diagnose and treat lung cancer. VATS uses a small video camera to guide the surgeon. It allows the surgeon to view the inside of the chest cavity and remove tumors. It requires a smaller incision than a thoracotomy which makes recovery faster.
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Mesothelioma

Once mesothelioma is diagnosed, the physician will need to stage or determine the extent of the cancer. This is done through imaging tests and scans.

Like other cancer treatments, patients are typically recommended to do two or more of the following treatments:

• Surgery to remove part or all of the cancerous tissue along with some surrounding healthy tissue.
• Radiation therapy to destroy the cancer cells using x-rays or other types of high-energy rays.
• Chemotherapy, which uses various drugs to combat the cancer.

The recommended course of treatment will depend on staging and the extent of the cancer.

Here at BASS our thoracic surgeons specialize in:

• Esophageal Cancer
• Emphysema
• Hiatal Hernia
• Hyperhidrosis
• Lung Cancer
• Mesothelioma

Thoracic surgery has made many strides over the past decade. The surgeons here at BASS have been at the leading edge of minimally invasive thoracic surgical procedures. Some thoracic “keyhole” operations are now being performed on patients who would have had open surgery in the past. Our thoracic surgeons work at some of the most advanced medical facilities:

• John Muir Medical Center in Concord
• Eden Medical Center
• Sutter Delta Medical Center
• San Ramon Medical Center

To learn more about thoracic surgery at BASS, we encourage you to contact us and schedule a consultation. During your consultation and subsequent pre-operative workup, your thoracic surgeon may order relevant tests to understand your condition. These tests may include:

• X-rays
• CT scans
• Manometry
• Endoscopy
• Echocardiogram
• And more

For patients that have had these test performed in the past, we ask that you bring the results of your tests with you to your consultation.