Surgeon practised on cadaver before ground-breaking cancer operation

A Norfolk surgeon has told how he had to practise on a cadaver before removing a Lowestoft man's cancerous tumour because the operation needed was so rare.

Dean Lawson developed a lump above his collar bone but thought nothing of it until scans revealed a tumour the size of an apple. The 36-year-old from Lowestoft was at first thought to be suffering from lung cancer and given just one year to live.

Further biopsies showed he had a Ewing's sarcoma of the first rib (a C-shaped bone that sits behind the collarbone), a condition which his Norfolk and Norwich University Hospital surgeon Wyn Parry believes is almost certainly unique in that location.

He said: 'Ewing's sarcoma most commonly occurs in the bones of the leg, arm or pelvis. Disease in a rib is less common and I have never seen it in the first rib in my 20 years of experience as a chest surgeon.

'It is difficult from a surgeon's point of view because access to remove a tumour in this rib is highly complex and carries significant risks to the patient.'

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After a course of radiotherapy, Mr Lawson's surgery involved making incisions into the neck and chest, splitting part of the breast bone and then peeling back the collarbone and muscles (called the Grunenwald approach) to eventually remove the first rib and tumour completely, together with part of the top of the right lung.

'I'd encountered the Grunenwald approach in a medical journal but never seen it carried out or performed it myself,' said Mr Parry.

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'The anatomy around the first rib is extremely complex so I enlisted the help of Dr David Heylings, a senior lecturer in anatomy at the University of East Anglia, who allowed me to practise the procedure thoroughly on a cadaver in the medical school before tackling Dean's operation.

'Removing the first rib is particularly challenging because the nerves to the entire arm, forearm and hand pass across the rib, in addition to major blood vessels to and from the arm. Damage to any of these structures could have resulted in major complications for Dean. In fact, he made a spectacular recovery and was chomping at the bit to go home after a couple of days.'

Mr Lawson, who is originally from Middlesborough, is now undergoing chemotherapy. With help from his friends Shaun Underdown and Gemma Searby, who run the Mariner's Rest in Rotterdam Road, Lowestoft, he is on the road to recovery but taking each day as it comes.

He said: 'I was living under a death sentence but the operation gave me a life-line.

'I'm so grateful to Mr Parry and also to my friends, Shaun and Gemma, who have taken me under their wing and given me so much support over the last 14 months.'

He added: 'This last course of chemotherapy has really knocked me back – I've been in bed for two weeks. But I'm trying to make every day count. I am spending time with my friends and trying to keep busy. I am not sure if I'd be here without Shaun and Gemma. Shaun is like a brother to me. He has been with me every step of the way.'

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