Featuring: Ankit Bharat, MBBS, Young Chae, MD
Six months after surgery, the patient has no signs of cancer in his body, providing new hope for lung cancer patients at Northwestern Medicine.
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For the first time at Northwestern Medicine, surgeons have successfully performed a double-lung transplant on a patient with terminal lung cancer. The patient, 54-year-old Albert Khoury of Chicago, is a non-smoker who was diagnosed with lung cancer at the start of the COVID-19 pandemic. Six months after his transplant, Khoury’s new lungs are working well, and he currently has no signs of cancer left in his body, giving hope to other patients with advanced stages of this deadly disease.
“Lung transplantation for lung cancer is extremely uncommon with few cases reported,” said Ankit Bharat, MD, chief of thoracic surgery at Northwestern Medicine and executive director of the Canning Thoracic Institute, who is also a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “For patients with stage 4 cancer, lung transplantation is considered a complete ‘no-no,’ but because Albert’s cancer was confined only to his chest, we were confident we could clear all the cancer during surgery and save his life.”
In early 2020, Khoury was working as a cement finisher for the Chicago Department of Transportation, framing and dressing up concrete and sidewalks, when he developed back pain, sneezing, chills, and a cough with mucus. Khoury thought it was COVID-19, but then he started coughing up blood and called his primary care doctor.
“They discovered stage 1 lung cancer, but due to the COVID-19 surge, I couldn’t begin treatment right away. By July 2020, my cancer grew to stage 2 and after several chemotherapy treatments, it kept growing to stage 3 and 4. Doctors at other health systems told me there was no chance for survival,” explained Khoury. “But then my sister saw a news story about lung transplants being pioneered for COVID-19 patients at Northwestern Medicine and encouraged me to make an appointment to see if lung transplantation could be an option.”
Khoury met with Young Chae, MD, a medical oncologist with Lurie Cancer Center at Northwestern Medicine, who wanted to try other treatment options before considering lung transplantation. Until this point, no lung transplants had been performed on lung cancer patients at Northwestern Medicine. But, Khoury’s health continued to decline, and he ended up in the intensive care unit on a ventilator with pneumonia and sepsis.
“Both of Albert’s lungs were filled with cancer, and day by day his oxygen saturation was dropping. I left his hospital room and thought to myself, ‘could a lung transplant really be an option?’” questioned Dr. Chae. “Ironically, as I was walking down the hallway, I ran into Dr. Bharat and explained Albert’s situation. The team did a transplant evaluation and found Albert to be eligible. Fortunately, the tumor was only localized to the chest completely encasing both his lungs but hadn’t spread to other parts of his body, which is a rare characteristic for stage 4 lung cancer.”
After spending two weeks on the transplant waitlist, Khoury received his new lungs on September 25, 2021. During the seven-hour operation, surgeons had to be extremely meticulous to not let trillions of cancer cells from the old lungs spill out into Khoury’s chest cavity or into his blood stream.
“One of the biggest fears of performing a transplant on anyone who has cancer is the risk of recurrence after the transplant,” said Dr. Bharat. “All transplant patients require medications to control their immune system, which has an immune-suppressive effect. The concern is that if you suppress someone’s immune system and they have lingering cancer cells in the body, those will flare up very quickly.”
“Six months after transplant, we’re thrilled with Albert’s progress. He doesn’t require oxygen and is leading a normal life,” added Dr. Chae. “The collaboration that happened with this case is one of our strengths at Northwestern Medicine and seeing Albert happy is the greatest reward.”
“My life went from zero to 100 because of Northwestern Medicine,” said Khoury. “You didn’t see this smile on my face for over a year, but now I can’t stop smiling. My medical team never gave up on me.”
Because the outcome was so successful, Drs. Bharat and Chae are developing a new set of protocols for treating lung cancer patients at Northwestern Medicine, and they’re currently in the process of starting a clinical registry to track the progress of such patients over time. Lung cancer is the leading cause of cancer-related deaths in the United States among men and women, making up almost 25 percent of all cancer mortalities. For more information about Northwestern Medicine’s lung cancer and lung transplant programs, visit nm.org.
This article was originally published in the Northwestern Medicine Newsroom on March 24, 2022.
Ankit Bharat, MBBS, is the chief of Thoracic Surgery in the Department of Surgery, Harold L. and Margaret N. Method Research Professor of Surgery and associate professor of Surgery (Thoracic Surgery) and Medicine (Pulmonary and Critical Care). Dr. Bharat specializes in malignant and benign chest and esophageal diseases. His research focuses on lung preservation, transplant immunology and airway biology, achieved through collaboration with the Kovler Comprehensive Transplant Center and the Division of Pulmonary and Critical Care Medicine.
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