World first cancer surgery at Guy's and St Thomas'

A father of four has become the first person in the world to successfully undergo robotic surgery to remove throat and lung cancers at the same time.

Surgeons at Guy’s and St Thomas’ used minimally invasive robotic techniques to significantly speed up the patient’s recovery time, meaning the next stage of his treatment could begin as quickly as possible, and giving him the best chance of cure.

Harvey, 49, was diagnosed with throat cancer in July after going to see his GP when he noticed a lump in his neck. Further tests confirmed he also had cancer in his lung.

Combined surgery to remove both cancers followed by chemotherapy and radiotherapy was seen as the best option to reduce the risk of it coming back.

Until now, this would have meant a gruelling operation, involving opening the patient’s chest and jaw and a long stay in intensive care. It also required the insertion of a breathing tube through the neck, a feeding tube into the stomach and many weeks of subsequent recovery.

Prolonged recovery from open surgery delays the start of chemotherapy and radiotherapy, which will adversely impact upon survival.

Specialists at Guy’s Hospital pushed the boundaries to offer a better option and performed the first ever minimally invasive robotic surgery on 14 August to remove both neck and lung cancers at the same time.

Led by Mr Asit Arora, robotic head and neck surgical lead and Mr Andrea Bille, consultant thoracic surgeon, the two teams used the Da Vinci Xi robot in one anaesthetic sitting. They were supported by Mr Jean-Pierre Jeannon, clinical director for surgical oncology. The thoracic robotic program is led by Mr Tom Routledge.

First, the head and neck team performed trans-oral robotic surgery (TORS) to remove the primary tumour from the throat. The thoracic team then performed robotic surgery to remove two thirds of the right lung along with all the affected lymph nodes.

The combined procedure lasted for six hours in total.

Guy’s and St Thomas’ is a leading centre for robotic surgery and carries out the most robotic operations in the UK with around 800 cases a year.

Harvey said: “It was devastating to be told I had cancer. To be my age and have two cancers, particularly in the lung as well, is a spot of bad luck to say the least.

“When I found out about the neck, I managed to get my head around that. The prognosis was good. And then you get hit and told you have another cancer (lung) which is far worse. That was the most difficult thing to hear.”

Harvey married his partner of over 20 years, Lorraine, the day before the operation.

The psychiatrist said: “In my professional life I’ve had a long standing interest in research. So the idea that even if this does take me down, that the treatment of it has produced a world first and hopefully informed research felt very fitting.

“I’m delighted, both for the opportunity it has given me but also it fits with a lot of my work over the years. To be part of something like that is wonderful and it’s given us hope where we had none.”

Asit Arora, consultant ENT head and neck surgeon at Guy’s and St Thomas, said: “It is testament to Harvey’s courage, his will-power to recover and the minimally invasive robotic approach that he went home six days later without the need for a feeding or breathing tube.

“Above all, he was able to start radiotherapy almost straight away due to the success of this ground breaking operation.”

Andrea Bille, consultant thoracic surgeon at Guy’s and St Thomas’, said: “Seamless working between our teams allowed us to quickly agree and schedule the surgery to get the best possible outcome for the patient.

“This was a real multidisciplinary team effort, not just surgical, without which we simply wouldn't be able to offer this kind of cutting edge cancer treatment.”

Less than two weeks before his pioneering surgery, Harvey had a neck dissection performed by Mr Arora to remove all the lymph nodes including the cancerous lump that was in his neck.

Harvey has since completed radiotherapy for the neck after this was started at the beginning of September. He has now begun radiotherapy for the lung, following chemotherapy.

Harvey’s wife Lorraine, 50, said: “The care and the treatment has been fantastic and I’ve liked the positivity of the surgeons. Given the darkness that we’re in they have always been optimistic about the future which has been fantastic. You can always come out after seeing them and think ‘oh that’s good’.”

Harvey added: “I’m very proud of the medical profession and healthcare. I just want to say thanks to everybody and very much see Guy’s and St Thomas’ as leading the charge. I’m delighted with the care and to be given this opportunity.”