A Hamil­ton first puts David back on his game

The Hamilton Spectator - - FRONT PAGE - JEFF MA­HONEY

Long­time Spec­ta­tor reader David Hec­tor was get­ting in the car the other day in his ten­nis whites, rac­quet tucked un­der his arm, go­ing off to play as he loves to do.

It was an en­cour­ag­ing sight. The 83year-old had un­der­gone ma­jor surgery two years ago to ad­dress a di­ag­no­sis of lung can­cer.

They took out two of the lungs’ five lobes, one from each lung, try­ing to get at it all. They thought maybe they had. But when he went for his all-clear, they found a few more “spots.”

Even more than the can­cer, the thought of an­other surgery — the painful re­cov­ery, the fol­lowup — had him un­der­stand­ably chap­fallen.

He never wanted to go through that again. Then some­thing hap­pened. Can­cer Care On­tario ap­proved fund­ing for fo­cal tu­mour ab­la­tion in cases of lung can­cer.

And as fate would have it (mov­ing hith­erto un­re­lated lives into dock­ing po­si­tion), the bril­liant Dr. Sri­har­sha Athreya, a marks­man with an im­age-guided RFA probe, found David’s name on his list of pa­tients.

In due course, an­other op­er­a­tion was sched­uled. This one, in June, was be­ing done in the new an­gio IR suite in the Boris Fam­ily Cen­tre for In­ter­ven­tional Ra­di­ol­ogy and On­col­ogy at St. Joseph’s Hos­pi­tal.

David, hav­ing been through lung surgery once be­fore, went in eyes wide open. You’d think he’d be ter­ri­fied. Uh uh. This was dif­fer­ent.

He lit­er­ally had his eyes wide open, un­der con­scious se­da­tion, awake the en­tire time.

It lasted un­der two hours. David, a re­tired Hamil­ton ac­coun­tant who worked for Ernst & Young, went home the same day. No pain. No real re­cov­ery reg­i­men. He went about his life. He’s play­ing ten­nis. Trav­el­ling to Europe. Noth­ing like the first surgery.

“I think they said it’s the first one ever done,” David says of the op­er­a­tion, as I pass him on the side­walk, ask­ing: “Didn’t you just go through surgery?” (See, he’s not just a reader; he’s my neigh­bour.) “You should do a story on it. More peo­ple should know,” David says to me.

It was a “first-ever” in Hamil­ton. On a lung. And is he ever glad it was him.

Here’s what hap­pened. Athreya ma­nip­u­lated a ra­dio-fre­quency ab­la­tion probe (RFA), ba­si­cally a su­perfine nee­dle, into David’s lung, un­der “im­age guid­ance” (X-ray screen­ing, CT scan and such).

When he got the nee­dle at the tu­mour sites, he pressed the plunger to ac­ti­vate the ra­di­at­ing tips; they came out the end like hair-width grap­pling hooks or spi­der legs. A ra­dio-fre­quency cur­rent then heated those tips, en­abling them to “burn” the tu­mour away.

Im­age-guided fo­cal tu­mour ab­la­tion is an ex­am­ple of many in­ter­ven­tional ra­di­ol­ogy pro­ce­dures. Some­times it’s re­ferred to as pin­hole surgery.

“Tech­ni­cally, it’s not surgery,” says Sri­har­sha, who is nonethe­less a trained sur­geon, “but the re­sults are sim­i­lar.”

Cheaper, less trau­matic and doable with­out the pa­tient be­ing put un­der. It is a day-case pro­ce­dure, he says. The lim­i­ta­tion is that it can’t be used on tu­mours over three or four cen­time­tres.

“We’ve been do­ing this at St. Joe’s for 10 years on kid­ney can­cer,” but only this year did Can­cer Care On­tario ap­prove fund­ing for lung can­cer.

Orig­i­nally from Ban­ga­lore, in the In­dian state of Kar­nataka, Sri­har­sha is the son of a sur­geon. And when he was study­ing in Glas­gow, Scot­land, he be­came fas­ci­nated by in­ter­ven­tional ra­di­ol­ogy.

He had thought about work­ing in Scot­land but a friend men­tioned Canada, one thing led to an­other, and now he’s been here eight years.

“We are so for­tu­nate to have such a great team, all of them,” he says of St. Joe’s. “Tho­racic sur­geons, urol­o­gists, on­col­o­gists who sup­port the ab­la­tion pro­gram, the med­i­cal ra­di­a­tion tech­nol­o­gists and nurses. And we are so in­debted to the Boris fam­ily.”

The Boris fam­ily’s do­na­tions have made pos­si­ble the ac­qui­si­tion of the most ad­vanced 3-D imag­ing and ra­di­ol­ogy equip­ment, housed in the newly opened Boris Fam­ily Cen­tre for In­ter­ven­tional Ra­di­ol­ogy.

The rooms in the cen­tre, where Athreya, Dr. Mau­rice Voss, Dr. Oleg Mironov and their col­leagues do their IR pro­ce­dures, fea­ture enor­mous mov­able scan­ning gantries and over­head flat-screen mon­i­tors on piv­ot­ing arms, which show the op­er­a­tors the in­side of the body they’re work­ing on.

On the ceil­ing are flu­o­res­cent pan­els with clouds and other calm­ing im­ages the pa­tient can look at while this is go­ing on.

I don’t know what David saw. Maybe Wim­ble­don high­lights.

He’s prob­a­bly serv­ing an ace some­where as you read this.

Ad­van­tage, us. Our Hamil­ton, city of wa­ter­falls ... and hos­pi­tals.

GARY YOKOYAMA, THE HAMIL­TON SPEC­TA­TOR

Dr.Sri­har­sha Athreya used a ra­diofre­quency ab­la­tion probe to re­move tu­mours from David Hec­tor’s lungs.

David Hec­tor is play­ing ten­nis.

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