Back to her life after shocking lung cancer diagnosis

The pain in Susan Brim’s chest started in December 2017. An emergency medicine physician at the Kaiser Permanente San Francisco Medical Center, the mother of 3 knew something wasn’t quite right when, no matter what she did, the discomfort persisted.

When a type of imaging called a CT scan showed a large area in her lung that looked abnormal, Dr. Brim and her doctors assumed it was an infection — she was young, after all, and a nonsmoker. But initial tests didn’t show an infection, and her doctors recommended a biopsy, which she quickly scheduled at the Kaiser Permanente Oakland Medical Center, the largest of 3 specialty care centers for thoracic surgery in Northern California.

Dr. Brim’s biopsy revealed lung cancer, which accounts for 22% of all cancer deaths in the United States, according to the National Cancer Institute.

“It was a shock,” she recalled. “But my pulmonologist referred me to see Jeffrey Velotta, a thoracic surgeon, who spearheads the specialty care center for thoracic surgery in Oakland.”

Improved results

Dr. Susan Brim is one of more than 3,000 patients in Northern California who has benefited from Kaiser Permanente’s shift to managing all thoracic cancer surgeries in designated specialty care centers — located in Oakland, South Sacramento, and Santa Clara. Kaiser Permanente is one of the first health care organizations in the country to implement this regionalized approach.

“We picked the places with the highest number of thoracic surgeons and where we were already doing a significant amount of minimally invasive lung cancer operations,” Dr. Velotta explained. “Any patient from around the region can be referred to one of the centers. Our research shows that by regionalizing lung cancer surgery into 3 centers with highly trained, board-certified thoracic surgeons doing these surgeries, we’ve significantly improved 1- and 3-year survival rates for our lung cancer patients.”

‘Pioneering work’

Dr. Velotta removed half of Dr. Brim’s lung using video-assisted thoracoscopic surgery. In this minimally invasive procedure, a tiny camera known as a videoscope and small surgical tools are inserted into the patient’s chest through small cuts made between the ribs. Research by Dr. Velotta has shown that this approach contributes to lower complication rates, less postoperative pain, and higher quality of life than traditional open surgery.

Hours after her surgery, Dr. Brim was encouraged to get up and start walking, as recommended by Kaiser Permanente’s Enhanced Recovery After Surgery program, a proven method to reduce complications after surgery. She also received a long-lasting nerve block instead of intravenous opioids to help manage her pain.

The following evening, Dr. Brim was able to go home to her family. “While the recovery was difficult, being able to be at home made it so much better,” she recalled.

Within a couple of months, she was back at work part-time and slowly resuming her usual activities; within 6 months, Dr. Brim felt close to fully recovered.

And since her doctors caught the mass at an early stage, she is now cancer-free.

“I am so grateful for my experience with Dr. Velotta and the entire Oakland thoracic surgery team. They saved my life. As both a patient and a physician, I have a huge appreciation for the pioneering work they are doing to take care of patients like me.”

Learn more about cancer care at Kaiser Permanente.