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Thirteen years ago, Irene Duy was told her lung tumour was inoperable.
She was then referred to University Health Network's (UHN) Thoracic Surgeon, Dr. Shaf Keshavjee.
Since then, Irene has celebrated the births of all five of her grandchildren, and in 2015, celebrated her 50th wedding anniversary.
"It was easy to say she's inoperable, because by the textbooks, she had poor lung function and did not fit the standard criteria for lung resection, so she was deemed inoperable," explains Dr. Keshavjee, also Director of the Toronto Lung Transplant Program and Surgeon-in-Chief at UHN.
"It's the question then of: can you figure out anything special to get this patient through curative surgery for her cancer surgery?"
Out of options
Irene showed no signs of trouble 13 years ago. She discovered the cancerous tumour on her lung in an annual x-ray with her general practitioner.
"I was quite surprised when I received the diagnosis," explains Irene.
Initially, her physician told her the tumour was inoperable and her best course of action would be radiation and chemotherapy.
Her son-in-law, who had done a rotation on thoracic surgery at Toronto General Hospital during his training, disagreed.
He referred her to Dr. Shaf Keshavjee.
Beating the odds at UHN
Dr. Keshavjee explains that Irene's tumour was in its early stages. The course of treatment advised by her physician wasn't because of the advancement of her cancer, but rather because her lung function was significantly compromised from emphysema, Irene's underlying lung condition.
"There are more ways to treat lung cancer than just surgery, but if the tumour is in a central location of the lung, the radiation can damage functioning lung tissue too, and someone like Irene can't afford that," explains Dr. Keshavjee.
"Because of our experience in lung volume reduction surgery and lung transplant surgery, we have learned to safely operate on people with pretty marginal lung function and remove lung cancers."
Irene came to see Dr. Keshavjee who referred her to West Park Healthcare Centre for some pre-operative rehabilitation. He called her that same day to confirm he would be performing her tumour-removal surgery.
"We've been referring patients to West Park for many years to make patients who are borderline or technically inoperable, operable – essentially to get them in the best possible shape for the surgery," explains Dr. Keshavjee.
"It was a frightening diagnosis but once I met Dr. Keshavjee at Toronto General, it became very manageable," says Irene.
"The team made it so that I understood everything that was happening. They were great."
Thirteen years and five grandchildren later
This past July, Irene and her husband gathered their family to celebrate their 50th wedding anniversary.
"All five grandchildren were born in the last 13 years. My oldest grandchild is 12. I may have not seen that otherwise," says Irene.
"A lot of what we do at UHN is going that extra mile for a patient. It is both a risk and a responsibility that we take," says Dr. Keshavjee.
"If she did not make it through the surgery that day thirteen years ago, we would have in effect shortened her life, not prolonged it. It's really important and special for us as an institution, and even for me personally, to see a person who is alive 13 years later because of what we did."
"If I received the radiation, which is what was first recommended, I'm sure the outcome wouldn't have lasted 13 years. It's really impacted my life," says Irene.