David Kidder didn’t have time for lung cancer.
He didn’t even want to slow down for a biopsy.
A fit and active 79-year-old, David had lumber to haul and crops to plant. And while building a 2,000-square-foot addition to his house, he worked shoulder-to-shoulder with the crew.
When an X-ray revealed a suspicious spot on his upper right lung, David worried it could put the brakes on his active life.
With a little research, however, he learned Spectrum Health has pioneered a minimally invasive biopsy technique—requiring no incision.
And even when the biopsy revealed stage 1 cancer, a surgeon removed it with a minimally invasive operation.
“This is a gift from God,” said David, as he took a break from his construction project at home. “I can do anything. Wow, I am blown away. I have no effects—nothing.”
Retired from the lumber business, David lives with his wife, Alvera, on a 480-acre country property in Hesperia, Michigan.
Last winter, he thought he had a bronchial infection, so he went to a local doctor’s office.
“The doctor came back and said, ‘Mr. Kidder, you have a little spot on your lung.’”
David couldn’t believe it.
“I have never smoked a cigarette in my life,” he said.
A minimally invasive approach
The doctor urged him to get a biopsy to see if the spot was cancerous.
The first specialist David consulted said, given the location of the lesion, he would need two incisions to reach the nodule and lymph nodes for a biopsy.
David worried about how long it would take to heal from the procedure. So, he began to research his options.
His search led him to the Spectrum Health’s pulmonology department and the Lung Multispecialty Team clinic at Lemmen Holton. He learned of their procedure that combines three technologies—robotics, electromagnetic navigation and a cone beam CT scanner to provide real-time scans of a patient’s lungs during the biopsy.
Spectrum Health doctors became the first in the nation to perform the advanced technique in 2019.
“The minimally invasive approach used for diagnosing his lung cancer is only being done in a handful of hospitals in the country,” said Gustavo Cumbo-Nacheli, MD, a Spectrum Health interventional pulmonologist.
Early on a February morning, David went into the operating room for the biopsy.
A screen above the operating table showed a map of his airways. In the upper right lung lay a spot less than an inch wide, about the size of a grape.
Dr. Cumbo guided a Monarch Auris bronchoscopy scope, equipped with a camera, into his airway and then into his right lung. An electromagnetic navigation system guided him through the twists and turns of David’s airways to the upper lobe—a difficult area to reach.
“This is a really hard case, really hard, as it is far out there,” he said.
When he reached the lesion, he deployed the needle to take a sample for a biopsy. Before doing so, however, he checked the placement of the needle using a cone beam CT scanner.
The medical team, wearing lead aprons, backed away from the operating table as the scanner moved around the table, creating a 3D image of the lungs.
In the control room, Dr. Cumbo examined the image. It showed the needle sat 2 centimeters away from the lesion.
He returned to the operating table and again navigated toward the lesion. This time, the real-time CT scan showed the needle in the center of the spot.
Fight back against lung cancer
“This is a win for this technology,” Dr. Cumbo said. “The beauty of doing this, even though it took one hour extra, is that we can provide patients with personalized medicine in a safe way.”
Without the CT scan to confirm placement of the biopsy needle, David would have needed a repeat biopsy.
Dr. Cumbo hopes the approach soon will be used not only to biopsy a tumor, but to treat it. Researchers are investigating the use of the procedure to perform an ablation or deliver chemotherapy directly to a tumor.
It would be a welcome development in the treatment of lung cancer, which kills 150,000 Americans each year and accounts for 25% of all cancer deaths.
“With lung cancer being the one of the most aggressive cancers, we need to fight back,” Dr. Cumbo said.
Next step: surgery
After the procedure, David said he felt no discomfort.
“I never had one bit of repercussion from the whole thing,” he said. “It was just awesome.”
The biopsy revealed the lesion was cancerous. But the biopsies of nearby lymph nodes showed no sign of cancer.
David soon learned surgery to remove his tumor also could be performed with a minimally invasive approach.
“When I left the doctor that day, I couldn’t believe it,” he said. “The sun was shinier. The trees were brighter.”
In early March, Geoffrey Lam, MD, a Spectrum Health cardiothoracic surgeon, performed a robotic, minimally invasive surgery to remove the upper lobe of David’s right lung.
The surgery required only four small incisions in his chest, each about the size of a fingertip, to accommodate the tools and camera needed for the operation.
After Dr. Lam removed the lobe, he placed it in a bag and cinched the drawstring, compressing the tissue small enough to be removed through a narrow tube. He also removed 28 lymph nodes for examination.
“Fortunately, his final pathology report showed he had stage 1A lung cancer, and therefore he would not need any chemotherapy or radiation after surgery,” Dr. Lam said. “He will just undergo periodic surveillance CT scans of the chest for monitoring purposes.”
For David, the news brought relief, as well as gratitude for the medical team that brought him through lung cancer.
“Dr. Cumbo and Dr. Lam are so dedicated and professional, and their efforts saved my life,” he said. “Their kindness and caring were so apparent, and it followed through to every person who cared for me at Spectrum Health Meijer Heart Center.
“I believe it is only by the grace of God that I am here, because he led me to Spectrum Health and the wonderful physicians there.”
A second chance
After four days in the hospital, David went home to recover.
“I was on the John Deere tractor one week after I got home,” he said.
By day 10, he walked 2 miles a day and no longer needed prescription pain medication.
After he received the all-clear to resume his activities, David jumped back into the chores around the house and farm. He used a chainsaw to cut down two large cherry trees. He planted 10 acres of corn.
He enjoys quieter pursuits, as well—like watching the deer that wander through his property.
“This morning I was watching mama with her two twins,” he said. “She had her buck fawn with her. The babies were nuzzling the small buck and mama kind of pawed at him.”
After a year of construction, David has nearly finished the addition on his home. Soon, he will open the entry between the house and spacious new room.
“It’s like a brand-new life,” he said. “I’m thankful to God that he gave me another chance.”