Northwestern Medicine performs first double lung transplant in patient with stage 4 colorectal cancer

On June 10, her 42nd birthday, Amanda Wilk of Minnesota had more than just a day to celebrate. After battling colorectal cancer since 2017, Wilk rang the doorbell at Northwestern Medicine in Chicago to declare he was officially cancer-free.

She was the first known patient to undergo a double lung transplant while diagnosed with stage 4 colorectal cancer in the US.

According to the CDC, colorectal cancer is the fourth most common cancer associated with cancer-related deaths in men and women in the U.S. — with nearly 142,000 people newly diagnosed in 2021 — and is becoming more widespread among patients with less age. 50 years old. entering the bloodstream, cancer usually metastasizes first to the liver, followed by the lungs, bones, brain or spinal cord, according to the nonprofit cancer research center City of Hope. One study found that about 20% of patients already have metastases when they are diagnosed.

Although the first successful double lung transplant occurred in 1986, Northwestern surgeons have pioneered a new surgical technique for cancer patients who have exhausted all other options. The goal? To prevent cancer from spreading during transplant surgery.

Discovering the transplant. The bilateral transplant surgery, performed on June 3, was Wilk’s second major transplant. She had previously had a liver transplant after her brother donated 60% of his liver in 2020, she said during a news conference on Wednesday.

Wilk’s treatment before the liver transplant included colon resection, chemotherapy, liver ablations and radiation beads to the liver, according to a news release.

But the cancer returned to her lungs six months after she received the liver, and her doctor told her she probably only had two and a half years to live, she said, adding that there did not appear to be any other viable treatment options available.

Wilk could not accept this fate. She traveled to different hospitals until she heard about Northwestern’s Double Lung Replacement and Multidisciplinary Care (DREAM) program, which offered the procedure to patients whose cancers had not responded to other treatments. The DREAM program has performed 40 lung transplants on patients with other advanced cancers, but this was the team’s first transplant for a case of colorectal cancer.

“When other hospitals told her there was nothing more they could do, she didn’t really take no for an answer. Instead, it has become part of medical history,” Catherine Myers, a pulmonologist at the Northwestern Medicine Canning Thoracic Institute, said at the news conference.

Facing the transplant. Myers and Ankit Bharat, chief of thoracic surgery at Northwestern Medicine and director of the thoracic institute, said at the conference that the program aims to prove that lung transplantation can be used successfully as a form of cancer treatment.

“By doing this surgery, we hope to be able to create a system where lung transplantation is a treatment for cancers that have spread to the lungs. This is done in the liver transplant world,” Myers said. “We really want to change the paradigm around the use of lung transplantation to treat these types of cancer.”

The procedure was a little more challenging than other double lung transplants, as surgeons had to be careful not to release cancer cells into the bloodstream. “It’s a much more tedious dissection,” Bharat said.

Instead of removing one lung at a time, which is typically done in double lung transplants, Northwestern surgeons remove both lungs at the same time, along with the surrounding lymph nodes, and then flush the airway and chest cavity. before transplanting the new lungs.

For Wilk, it was a success.

“She has been out for over three months and based on all the tests that are available to us, including DNA blood tests, there is no sign of cancer in her body right now,” Bharat said.

Today, Wilk is getting back into running, enjoying her job at an elementary school in Minnesota and hoping to one day run in the Chicago Marathon.

“It’s incredible. I can’t believe it. I still have it increased [feeling] like, ‘What should I worry about? What’s going to happen now?’” Wilk said at the conference. “I hope that, over time, I won’t have that feeling.”