Posted on Thursday 30 July 2020
Rachel Bailey with baby Phoenix
A pregnant woman whose rare cancer was detected during a scan underwent robotic surgery on her kidney during lockdown.
Rachel Bailey, 28, from Southwark in South London, had a grapefruit-sized tumour and part of a kidney removed during a complex operation in May at Guy’s Cancer Centre just two weeks after she gave birth.
Keen to breastfeed her new-born daughter Phoenix around the surgery, Rachel was able to have the procedure and be back home for cuddles just 25 hours after being admitted to hospital.
Mr Ben Challacombe, the consultant urological surgeon at Guy’s and St Thomas’ NHS Foundation Trust who operated on Rachel, said: “Rachel’s situation is rare. I have done over 1,000 robot kidney operations and only had one other similar case.
“If Rachel hadn’t been pregnant, her tumour may not have been spotted until later when the outcome could have been different. It may be that her baby saved her life.”
While doctors will keep a close eye on Rachel in the coming months and years, they are confident they removed all of the 9cm tumour and she doesn’t need radiotherapy or chemotherapy.
Rachel, who runs a dog walking business, was 21 weeks pregnant in January this year when she started bleeding and went to St Thomas’ Hospital for an emergency check-up. While that showed that her baby was healthy, a scan found that she had a previously undetected 6cm tumour on one of her kidneys.
An MRI and biopsy showed the tumour was malignant, but caught in the early stages and likely to be slow-growing so doctors suggested Rachel complete her pregnancy but be induced early to enable subsequent surgery to remove the tumour.
However, as lockdown was enforced in late March, Rachel’s induction and surgery were cancelled. When Rachel’s baby started measuring small for dates, the midwife team at St Thomas’ decided she needed to be induced at 38 weeks.
Mr Challacombe, clinical robotic surgery lead at Guy’s and St Thomas’, then arranged for Rachel to have her tumour removed as soon as possible after her baby was born, following two weeks of self-isolation.
The procedure was a collaboration with Guy’s and St Thomas’ and HCA’s London Bridge Hospital, which runs private healthcare on the top four floors of the Cancer Centre at Guy’s. During lockdown, the centre was kept as a Covid-free site, to treat around 800 NHS cancer patients in a safe environment.
Rachel said: “Suddenly everything was back on again and it was a rollercoaster of emotions, but I tried not to stress out my baby. I had been doing hypnobirthing and pregnancy yoga so I understood the importance of trying to keep relaxed.
“I was really trying to encourage my baby to come naturally, and I would talk to her all the time. When the time came for my induction, I had to go in by myself because of Covid [restrictions], but the midwives were all lovely.”
It was as midwives were about to induce Rachel they realised she was already in labour and little Phoenix was born naturally, weighing 4lb 4oz.
Rachel said: “After the birth, the worry about the surgery set in. I had to leave Phoenix, and I had always wanted to breastfeed, but she wasn’t allowed to come into the hospital with me. I had just given birth and was trying to recover, and then I was desperately trying to breastfeed and express milk for her. As she was so tiny, she needed to be with me.”
So that Rachel was away from her baby for as short a time as possible, and because she lives close to the hospital, her surgeon arranged for her to have a Covid test the day before her scheduled surgery and to spend the night at home with Phoenix
Rachel had key-hole surgery on HCA’s facilities at Guy’s using the da Vinci Xi robot the following day to remove her tumour, which had grown 3cm since first being spotted.
Mr Challacombe said: “It was a very complicated operation as the tumour had grown much bigger than you would have expected in that time. It was one of the biggest partial removals I have done without removing the whole kidney. We wanted to avoid that, as it would cause a bigger scar, more pain, and mean a slower recovery for Rachel.
“We knew she wanted to be with her baby so we did everything we could to get her home as soon as possible. It’s been a very positive outcome for Rachel and she and Phoenix are doing really well.”
Rachel said: “I’m very lucky I was pregnant, otherwise I wouldn’t have known about the tumour. I have always wanted a family and I waited so long to get pregnant. Phoenix has been a blessing.
“Without Phoenix, the midwives, Ben and the urology team, this experience would have been a lot more stressful. With them fighting my corner, I didn’t feel like I was doing this on my own.”
Janene Madden, CEO of London Bridge Hospital, said: “Uniting across healthcare has never been more important. And the collaboration between Guy’s and St Thomas’ and London Bridge Hospital has meant time-critical cancer treatment for patients like Rachel has continued safely during this extremely challenging time.”
Guy’s and St Thomas’ has three da Vinci robotic surgery systems and carries out around 800 robotic operations a year – more than any other trust in the UK. Robotic procedures are done by key-hole, meaning a quicker recovery time and much shorter length of hospital stay for patients.