November 4, 2019

Back to her life after shocking lung cancer diagnosis

Doctor and mother of 3 received top-notch care at Kaiser Permanente specialty care center for thoracic surgery.

The pain in Susan Brim’s chest started in December 2017. An emergency medicine physician at the Kaiser Permanente San Francisco Medical Center, the 38-year-old mother of 3 knew something wasn’t quite right when, no matter what she did, the discomfort persisted.

When a CT scan showed a large lesion in her lung, Dr. Brim and her doctors assumed it was an infection — she was young, after all, and a nonsmoker. But when initial tests didn’t show an infection, her doctors recommended a navigational biopsy, which she quickly scheduled with Melissa Tukey, MD, an interventional pulmonologist 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.

“It was a shock,” she recalled. “But my pulmonologist was able to immediately schedule a PET scan, and then referred me to see Dr. Jeffrey Velotta, a thoracic surgeon, who spearheads the specialty care center for thoracic surgery in Oakland.”

Improved results

Lung cancer has a high mortality rate, accounting for 25.3% of all cancer deaths in the United States, according to the National Cancer Institute.

Dr. Brim is one of 1,600 patients who has benefited from Kaiser Permanente Northern California’s shift in 2014 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.

Recent research led by Dr. Velotta showed that regionalizing thoracic surgery resulted in shorter hospitals stays and fewer complications. The study also found an increase in the use of minimally invasive, video-assisted thoracoscopic surgery — from 57% to 86% — contributing to lower complication rates, less postoperative pain, and higher quality of life compared to patients who had open surgery.

“We wanted to pick the places with the highest number of thoracic surgeon specialists and where we were already doing a significant amount of lung cancer operations,” Dr. Velotta said. “Any patient from around the region can be referred to one of the centers. And our research shows that by regionalizing lung cancer surgery into 3 centers with highly trained, board-certified thoracic surgeons doing these surgeries, we were able to improve outcomes for our patients.”

‘Pioneering work’

Hours after her surgery, which removed nearly half of her left lung, 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.