Landscaper Blooms After Surprise Lung Cancer Diagnosis, Robotic-Assisted Surgery

An ordinary day and a routine physical turned into much more for Tom Hoffner, 66, a Quakertown resident and landscaper by trade. His electrocardiogram came out abnormal, so his primary care clinician referred him to a cardiologist. His heart tested healthy, so he was sent to the pulmonology department. At first, nothing stood out. 

Baffled but determined, nurse practitioner Andrea Dally, CRNP, with Lehigh Valley Health Network (LVHN), insisted on a computed tomography (CT) scan of Hoffner’s lungs. He fit the criteria of having been a heavy smoker for more than 20 years. The CT scan picked up a suspicious nodule, so Dally ordered a biopsy. Sure enough, the biopsy results showed stage 1 lung cancer.

“I had no symptoms, nothing,” says Hoffner, who credits Dally for her perseverance. “They couldn’t find anything, but they kept looking. I had no idea I had cancer.”

For treatment, Hoffner was referred to cardiothoracic surgeon Richard Chang, MD, Chief, Section of Thoracic Surgery, with Lehigh Valley Institute for Surgical Excellence. Dr. Chang recommended a robotic-assisted lobectomy, an operation where a portion of the lung is removed. 

“Tom was lucky because he was diagnosed very early, when the cells were just becoming cancer,” Dr. Chang says. “If the cancer had been more advanced, it would have been treated with surgery, radiation, chemotherapy, maybe immunotherapy, depending on the surgery. Because we found it at stage 1, the surgery is curative.” 

Dr. Chang performed the lobectomy and removed Hoffner’s lymph nodes at the same time using one of LVHN’s da Vinci Xi robots. Fortunately, all his lymph nodes tested negative for cancer, and Hoffner was able to return home after three days in the hospital. He was highly appreciative of the care he received.

“LVHN nurses and doctors are the best in the world. I wouldn’t go anywhere else,” Hoffner says. “I asked Dr. Chang when I needed to come back and see him and he said, ‘never.’”

Because robotic-assisted lung surgery uses very small incisions in the chest, pain is minimal, and recovery is fast. The more invasive alternative involves making a large incision and spreading the ribs apart to reach the lung. Hoffner’s surgery was his third robotic procedure (one for prostate cancer and one for gall bladder surgery) and, he says, the least invasive.

“I came home on a Thursday, ordered 10 yards of mulch and put it down on Saturday,” he says. “My mother used to say, ‘A body in motion isn’t going to stop.’ So, I don’t.”

Hoffner’s drive certainly contributed to his recovery with “no complications,” but it was the CT scan that probably saved his life.

“Our multidisciplinary program involves primary care clinicians, pulmonologists, thoracic surgeons and nurse navigators who all work together to fast-track patients from early diagnosis and screening to treatment,” Dr. Chang says. “Of vital importance is that LVHN made the investment to improve access to early detection. Because the cure rate for lung cancer goes up based on the screening program.”