Selected Podcast
Only 5% of Cardiothoracic Surgeons are Female. Meet Dr. Colleen Gaughan: Female Thoracic Surgeon
Colleen Gaughan MD discusses cardiothoracic surgery and The Harron Lung Center at Penn Medicine. She shares the fact that only 5% of cardiothoracic surgeons are female. In this podcast, please meet Dr. Colleen Gaughan: Female Thoracic Surgeon
Featuring:
Colleen Gaughan, MD
Dr. Colleen Bernadette Gaughan is the Chief of Thoracic Surgery at the Philadelphia VA Medical Center. She is also an assistant professor of clinical medicine at Penn medicine. Dr. Gaughan attended medical school at Temple University School of Medicine. She completed residencies at Temple University Hospital and University of Miami Jackson Memorial Medical Center. Her fellowships took place at University of Miami Jackson Memorial Medical Center, University of Miami Hospital and Clinic, and USC Medical Center. Dr. Gaughan is board certified in thoracic and cardiac surgery. Transcription:
Melanie Cole (Host): Welcome to the podcast series from the specialists at Penn Medicine. I'm Melanie Cole, and I invite you to listen as we meet Dr. Colleen Bernadette Gaughan. She's Chief of Thoracic Surgery at the Philadelphia VA Medical Center, as we're discussing cardiothoracic surgery and the Heron Lung Center at Penn Medicine. Dr. Gaughan, it's such a pleasure to have you with us. And as we get into this conversation today, since only 5% of cardiothoracic surgeons are female. Tell us a little bit about yourself and why you picked this field.
Colleen Gaughan, MD (Guest): Thank you for having me, Melanie, it's really a pleasure to be on the podcast today. You know, I have to say that, all of my life I've liked a challenge. When I was a kid, I would often, try to break into things that girls weren't supposed to do. And it really got me interested in math and the sciences. My older sister was a great influence on me and she is a scientist as well. And when I started going to medical school, I was very interested in anatomy and the physiologic, the pathophysiology of surgery and surgical intervention. And so I knew that I wanted to do something that was very technically challenging.
But also one of the reasons that I went to medical school in the first place, was really to treat cancer patients. And so putting those two things together, I was considering either surgical oncology or thoracic surgery and thoracic surgery just really had the technical component, the real technical challenge that I was looking for, and I knew that there were not a lot of women in the profession. And that was something that I kind of enjoyed breaking that barrier. That is part of my personality and my makeup is that I liked to kind of charge at those types of things, and to change those types of things. And then if I can help anybody else, who's also trying to break through those types of barriers and challenges, that's something that I really enjoy.
Host: What have been some of the challenges and I thank you so much for that answer, but what have you seen for other women that are considering this field? What would you like to tell them?
Dr. Gaughan: I would say that being a woman in surgery is better than it used to be. There is not the bias against female surgeons that used to exist. And some patients freely seek out female surgeons more. If you look at studies that have been done on female physicians, they spend more time with patients.
Patients sometimes report higher satisfaction from seeing a female physician due to better communications and again, more time spent with patients. So, I think that women in surgery are much more accepted than they once were
Host: it's great information. So, you've worked with Tumor Glow, Dr. Gaughan a technology developed by Dr. Singhal at Penn thoracic surgery to find tumors that might otherwise escape notice during surgery, we did a podcast on it. It's absolutely fascinating. Has Tumor Glow become a part of standard practice for lung cancer surgery at Penn Medicine? Why is it such a useful adjunct to your surgical capabilities?
Dr. Gaughan: So, Tumor Glow Is a new technique and it's still in clinical trials. Dr. Singhal is the innovator and inventor of the technique. And what it does is that there's an infusion given to the patient preoperatively, that labels the tumor. And a special, near infrared light is shined during the surgery, which reacts with the infusion medication that is given so that the tumor cells light up or glow.
It's analogous to, in some ways the real-time PET CT scan, which is certainly an innovation that has revolutionized cancer care. Where this is really very, very helpful to the surgeon is that because of lung cancer screening and early detection of lung cancer, we are operating on smaller and smaller lung nodules. Tumor Glow can help us to find those nodules. A lot of them are not solid in nature. And so you can't necessarily feel them very well, but also with minimally invasive techniques, the ability to feel individual lung nodules is even less. So, Tumor Glow gives us the added advantage of being able to see the area of the tumor from the tumor cells lighting up, which allows us to resect less lung tissue in order to make a diagnosis for these very small lung nodules. The other thing where it's very useful is after removal of the lung nodules, we can examine the lung again with the special light, and see if the margins are clear. Meaning where we've disconnected the tumor from the rest of the lung we can ensure that there's no lingering tumor cells along our line of resection.
And in some cases, Tumor Glow has allowed us to see other nodules within the lung that we did not suspect from the CT scan or would have missed without the addition of Tumor Glow. So, it really can add to the surgical procedure itself and also help the surgeon to do a better surgery and making sure that our margins are clear.
Host: Fascinating. So, Dr. Gaughan, according to the American Lung Association, the rate of new lung cancer cases over the past 42 years or so has dropped, but it's risen for women. Tell us a little bit about what you've noticed in your field as far as women and lung cancer.
Dr. Gaughan: So first we'll talk about women smokers and lung cancer. And it's an interesting history in that the Surgeon General's report of 1964, declared that smoking was associated with lung cancer. And shortly after that, there was a precipitous drop in the rate of male smoking. However at that time, women were just starting to smoke more and the tobacco companies really shifted their marketing, to women and marketed it to them as a sign of independence.
At the time, of course, the women's liberation movement was really, taking speed and going forward. More women were entering the workforce. Remember the you've come a long way, baby, marketing campaigns, from when we were kids. So, the rate of women smoking rose up exponentially. Because of that shift in marketing to women and smoking and the exponential rise in the rates of women smoking in the late sixties to early seventies, 30 to 40 years later, we're seeing an increase in the rate of women getting lung cancer. That will eventually crest the rate of women smoking has gone down in the eighties to the nineties.
However, there are new and different types of lung cancers that we're seeing now, in women non-smokers and those are on the rise. The theory is that they could be related to a hormonal factor such as some of them have estrogen receptor positivity, similar to cancers that we see in breast cancer. So, the rate of lung cancer in smokers overall is decreasing as the rate of smokers decreased 20 to 30 years ago. Now we're seeing an incidence rise in these other lung cancers.
The good news about those though, is that they tend to be slower growing and so offer more opportunities for discovery and treatment. And that's why we encourage If they're a smoker to go for a lung cancer screening, or if you develop any new symptoms, unexpected symptoms such as coughs, that be investigated first by your primary care. But if appropriate, referring on for a CT scan.
Host: So, before we wrap up are outcomes different for women compared to men when diagnosed with lung cancer? Do they respond better to certain treatments? Tell us just a little bit about what you've noticed.
Dr. Gaughan: So in general, women tend to visit their doctors more and tend to pay attention to early symptoms, as a general rule, more, than men. And so what we notice in our women lung cancer patients is that we often see them at an earlier stage than our male lung cancer patients. And we do have an opportunity for earlier intervention. In particular, in the case of we call them adenocarcinoma in situ spectrum lesions. They're seen on CT scans as a ground glass opacity, or a sub solid lesion. We know that our compliance with women for followup and monitoring of those nodules is better than our male CT scan followups.
So, women tend to present earlier and have more opportunities for treatment because of that. In our lung cancer screening program, fortunately some of those statistics are changing in that our male population who is at high risk is hearing from their primary care doctors, earlier to go and seek treatment before they even know that they would have a lump or a tumor. And so it is more favorable. But there are types of lung cancers that affect women, especially women nonsmokers more and fortunately it has a slower course than other types of lung cancer. And so there is an earlier opportunity for treatment in those women.
Host: Isn't it fascinating. And what an exciting time to be in your field. As we wrap up, do you have any insight for physicians looking to refer to a female thoracic surgeon?
Dr. Gaughan: I would say that probably the most important thing in seeking out your surgeon is, having a good rapport and making sure that they have important and good communication skills that will allow the patient and doctor to interact in a way that's very positive.
Host: Thank you so much, Dr. Gaughan. Really, really interesting episode. Thank you again for joining us. That concludes this episode from the specialists said Penn Medicine. To refer your patient to Dr. Gaughan at Penn Medicine, please visit our website at pennmedicine.org/refer. Or you can call 877-937-PENN for more information. Please also remember to subscribe, rate and review this podcast and all the other Penn Medicine podcasts. I'm Melanie Cole.
Melanie Cole (Host): Welcome to the podcast series from the specialists at Penn Medicine. I'm Melanie Cole, and I invite you to listen as we meet Dr. Colleen Bernadette Gaughan. She's Chief of Thoracic Surgery at the Philadelphia VA Medical Center, as we're discussing cardiothoracic surgery and the Heron Lung Center at Penn Medicine. Dr. Gaughan, it's such a pleasure to have you with us. And as we get into this conversation today, since only 5% of cardiothoracic surgeons are female. Tell us a little bit about yourself and why you picked this field.
Colleen Gaughan, MD (Guest): Thank you for having me, Melanie, it's really a pleasure to be on the podcast today. You know, I have to say that, all of my life I've liked a challenge. When I was a kid, I would often, try to break into things that girls weren't supposed to do. And it really got me interested in math and the sciences. My older sister was a great influence on me and she is a scientist as well. And when I started going to medical school, I was very interested in anatomy and the physiologic, the pathophysiology of surgery and surgical intervention. And so I knew that I wanted to do something that was very technically challenging.
But also one of the reasons that I went to medical school in the first place, was really to treat cancer patients. And so putting those two things together, I was considering either surgical oncology or thoracic surgery and thoracic surgery just really had the technical component, the real technical challenge that I was looking for, and I knew that there were not a lot of women in the profession. And that was something that I kind of enjoyed breaking that barrier. That is part of my personality and my makeup is that I liked to kind of charge at those types of things, and to change those types of things. And then if I can help anybody else, who's also trying to break through those types of barriers and challenges, that's something that I really enjoy.
Host: What have been some of the challenges and I thank you so much for that answer, but what have you seen for other women that are considering this field? What would you like to tell them?
Dr. Gaughan: I would say that being a woman in surgery is better than it used to be. There is not the bias against female surgeons that used to exist. And some patients freely seek out female surgeons more. If you look at studies that have been done on female physicians, they spend more time with patients.
Patients sometimes report higher satisfaction from seeing a female physician due to better communications and again, more time spent with patients. So, I think that women in surgery are much more accepted than they once were
Host: it's great information. So, you've worked with Tumor Glow, Dr. Gaughan a technology developed by Dr. Singhal at Penn thoracic surgery to find tumors that might otherwise escape notice during surgery, we did a podcast on it. It's absolutely fascinating. Has Tumor Glow become a part of standard practice for lung cancer surgery at Penn Medicine? Why is it such a useful adjunct to your surgical capabilities?
Dr. Gaughan: So, Tumor Glow Is a new technique and it's still in clinical trials. Dr. Singhal is the innovator and inventor of the technique. And what it does is that there's an infusion given to the patient preoperatively, that labels the tumor. And a special, near infrared light is shined during the surgery, which reacts with the infusion medication that is given so that the tumor cells light up or glow.
It's analogous to, in some ways the real-time PET CT scan, which is certainly an innovation that has revolutionized cancer care. Where this is really very, very helpful to the surgeon is that because of lung cancer screening and early detection of lung cancer, we are operating on smaller and smaller lung nodules. Tumor Glow can help us to find those nodules. A lot of them are not solid in nature. And so you can't necessarily feel them very well, but also with minimally invasive techniques, the ability to feel individual lung nodules is even less. So, Tumor Glow gives us the added advantage of being able to see the area of the tumor from the tumor cells lighting up, which allows us to resect less lung tissue in order to make a diagnosis for these very small lung nodules. The other thing where it's very useful is after removal of the lung nodules, we can examine the lung again with the special light, and see if the margins are clear. Meaning where we've disconnected the tumor from the rest of the lung we can ensure that there's no lingering tumor cells along our line of resection.
And in some cases, Tumor Glow has allowed us to see other nodules within the lung that we did not suspect from the CT scan or would have missed without the addition of Tumor Glow. So, it really can add to the surgical procedure itself and also help the surgeon to do a better surgery and making sure that our margins are clear.
Host: Fascinating. So, Dr. Gaughan, according to the American Lung Association, the rate of new lung cancer cases over the past 42 years or so has dropped, but it's risen for women. Tell us a little bit about what you've noticed in your field as far as women and lung cancer.
Dr. Gaughan: So first we'll talk about women smokers and lung cancer. And it's an interesting history in that the Surgeon General's report of 1964, declared that smoking was associated with lung cancer. And shortly after that, there was a precipitous drop in the rate of male smoking. However at that time, women were just starting to smoke more and the tobacco companies really shifted their marketing, to women and marketed it to them as a sign of independence.
At the time, of course, the women's liberation movement was really, taking speed and going forward. More women were entering the workforce. Remember the you've come a long way, baby, marketing campaigns, from when we were kids. So, the rate of women smoking rose up exponentially. Because of that shift in marketing to women and smoking and the exponential rise in the rates of women smoking in the late sixties to early seventies, 30 to 40 years later, we're seeing an increase in the rate of women getting lung cancer. That will eventually crest the rate of women smoking has gone down in the eighties to the nineties.
However, there are new and different types of lung cancers that we're seeing now, in women non-smokers and those are on the rise. The theory is that they could be related to a hormonal factor such as some of them have estrogen receptor positivity, similar to cancers that we see in breast cancer. So, the rate of lung cancer in smokers overall is decreasing as the rate of smokers decreased 20 to 30 years ago. Now we're seeing an incidence rise in these other lung cancers.
The good news about those though, is that they tend to be slower growing and so offer more opportunities for discovery and treatment. And that's why we encourage If they're a smoker to go for a lung cancer screening, or if you develop any new symptoms, unexpected symptoms such as coughs, that be investigated first by your primary care. But if appropriate, referring on for a CT scan.
Host: So, before we wrap up are outcomes different for women compared to men when diagnosed with lung cancer? Do they respond better to certain treatments? Tell us just a little bit about what you've noticed.
Dr. Gaughan: So in general, women tend to visit their doctors more and tend to pay attention to early symptoms, as a general rule, more, than men. And so what we notice in our women lung cancer patients is that we often see them at an earlier stage than our male lung cancer patients. And we do have an opportunity for earlier intervention. In particular, in the case of we call them adenocarcinoma in situ spectrum lesions. They're seen on CT scans as a ground glass opacity, or a sub solid lesion. We know that our compliance with women for followup and monitoring of those nodules is better than our male CT scan followups.
So, women tend to present earlier and have more opportunities for treatment because of that. In our lung cancer screening program, fortunately some of those statistics are changing in that our male population who is at high risk is hearing from their primary care doctors, earlier to go and seek treatment before they even know that they would have a lump or a tumor. And so it is more favorable. But there are types of lung cancers that affect women, especially women nonsmokers more and fortunately it has a slower course than other types of lung cancer. And so there is an earlier opportunity for treatment in those women.
Host: Isn't it fascinating. And what an exciting time to be in your field. As we wrap up, do you have any insight for physicians looking to refer to a female thoracic surgeon?
Dr. Gaughan: I would say that probably the most important thing in seeking out your surgeon is, having a good rapport and making sure that they have important and good communication skills that will allow the patient and doctor to interact in a way that's very positive.
Host: Thank you so much, Dr. Gaughan. Really, really interesting episode. Thank you again for joining us. That concludes this episode from the specialists said Penn Medicine. To refer your patient to Dr. Gaughan at Penn Medicine, please visit our website at pennmedicine.org/refer. Or you can call 877-937-PENN for more information. Please also remember to subscribe, rate and review this podcast and all the other Penn Medicine podcasts. I'm Melanie Cole.