Amid surgery, Chennai Singer, a breast cancer patient remains busy in singing songs

Kochi: Apollo Proton Cancer Centre, the first & only Proton Therapy Centre in South Asia & the Middle East performed a Palliative Mastectomy for a patient with Metastatic breast cancer while the patient was singing.

The surgeon at Apollo Proton Cancer Centre said it was first time worldwide that a patient was awake and singing during breast cancer surgery, despite the extensive lung metastases and overcoming her anxiety.

Seethalakshmi, a classical singer and teacher, from Chennai diagnosed with advanced breast cancer, walked into the Breast Oncology department at Apollo Proton Cancer Centre a few months ago.

At that point of time, she was unable to speak a complete sentence, let alone sing, since the cancer had spread all over her body, and predominantly to her lungs. She improved dramatically following few cycles of chemotherapy and targeted therapy, so-much-so that she not only was able to get back to what she loved doing best, i.e. sing, but even resumed online classes for her students.

While the multidisciplinary team arrived at the consensus of a palliative mastectomy for an ulcerated breast tumour; her treating surgeon and anaesthetist were faced with another challenge. The lung metastasis had caused extensive lung tissue damage, pneumothorax (air locking outside the lung), and fluid collection in both lung bases, rendering her unfit for general anaesthesia, not to forget patient’s anxiety at undergoing a surgery.

Performing the surgical procedure under general anaesthesia for Seethalakshmi was fraught with immense risk, and may have necessitated ventilator and ICU care for many days.

In order to avoid such complications, Dr. Manjula Rao, Consultant Oncoplastic Breast Surgeon, and Dr. D. Indumathi, Consultant, Anaesthesiology decided to consider other alternatives.

The patient was extensively counselled on three separate visits, by the doctors, regarding the various options available to her, and the pros and cons of each technique.

Based on her output, Dr. Manjula Rao & Dr.Indumathi, decided to go ahead with performing the surgery under epidural anaesthesia, which involves delivery of the anaesthetic into a small catheter that is placed just inside the epidural space, which lies outside the spinal cord. At her request, they also decided to give her mild sedation during surgery to mitigate her anxiety.

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