Nurse’s Trust in City of Hope Doctors Pays Off After Complex Thyroid Cancer Surgery

January 24, 2018 | by Robin Heffler

As a postoperative surgical nurse for 15 years, Southern California resident Marietta M., 52, was used to seeing and treating a wide range of medical conditions. But that experience didn’t make it any easier when she discovered a lump and swelling on the right side of her neck in December 2016, which her ear, nose and throat doctor biopsied and said was papillary thyroid cancer.

With more tests needed and her doctor about to leave for vacation, Marietta followed the advice of nursing friends who recommended she go to City of Hope. She made an appointment with Ellie Maghami, M.D., chief of head and neck surgery and the Norman and Sadie Lee Foundation Endowed Professor in Head and Neck Cancer, who ordered an MRI. It revealed that the cancer had spread to the lymph nodes on the right side of Marietta's neck and her trachea, or windpipe, making surgery more complicated.

“I have a friend with Stage 4 breast cancer, and I was used to comforting sick friends,” said Marietta, “and I thought ‘Now me, too?’ I felt healthy and took no medications, only vitamins. The diagnosis was devastating, and made me very sad and upset.”

Maghami explained that there were several different surgical options, depending on what the surgeons saw when they went in. One was a sternotomy, in which the chest bone is sawed down to be able to access and safely remove cancerous lymph nodes, a scenario that frightened Marietta.

Maghami-Ellie Ellie Maghami, M.D.
When surgery day arrived on September 13, the surgical team consisted of Maghami, Thomas Gernon, M.D., a head and neck cancer surgeon who assisted with the neck procedure, and Dan Raz, M.D., M.A.S. a thoracic surgeon, who helped to repair the tracheal wall.

“We took out the thyroid gland and lymph nodes that had metastasized, and created a space at the base of the neck where we were able to expose the abnormal nodes under the collar bone and the sternal bone, so we didn’t need to do a sternotomy,” Maghami said of the 11-hour procedure. “Afterward, she didn’t lose function of either of her vocal chords, she could breathe without effort and swallow without trouble, and her voice was good. The cherry on top of all of this was that the pathologist’s report showed all cancer was removed from the windpipe.”

Maghami, The Norman and Sadie Lee Foundation Endowed Professor in Head and Neck Cancer, noted that this type of invasive disease occurs in only 1 to 2 percent of thyroid cancers, and many medical centers don’t have the expertise to treat it. City of Hope, however, can draw on the multidisciplinary knowledge and experience of its medical staff in such cases.
 
"After the surgery, I was relieved and happy with the outcome,” Marietta said. In a letter to Maghami, she wrote: “No amount of words can express my gratitude to you as the best surgeon handling my case. Indeed, you are instrumental in my healing and successful surgery. I really can’t thank you enough for transforming people’s lives and continuously going the extra mile to keep me healthy and healed.”

Eight weeks after surgery, Marietta was given radiation to destroy any potentially remaining cancer cells. She also is receiving daily doses of thyroid hormone replacement, since her thyroid had been removed.

Marietta will continue to have body scans, bloodwork and visits with Maghami and endocrinologists to monitor her health. Equally important are daily walks and twice-weekly physical therapy sessions, which are helping her to resume her regular activities.

“Right after the surgery I was slouching and afraid to stretch my tight neck,” she said. “But with physical therapy, my neck feels much looser, I can drive a few blocks to the market or church, and I’m doing a little light housework. I’ve made significant progress. For the holidays I had a small get-together with family and I even cooked!”
 
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