Lung, esophageal surgical expert joins faculty
by Toni Baker
Dr. Albert Shou-Yen Chang, a cardiothoracic surgeon specializing in benign and cancerous disease of the lungs and esophagus, has joined the Department of Cardiothoracic and Vascular Surgery. He recently completed his thoracic and cardiovascular surgery residency at the Cleveland Clinic.
Dr.
Chang is a 1996 graduate of Duke University School of Medicine. He completed
a Stanley J. Sarnoff Cardiovascular Research Fellowship at Stanford
University and the Palo Alto Medical Foundation, a surgical research
fellowship at Baylor College of Medicine in Houston and a general surgery
residency at Baylor’s Michael E. DeBakey Department of Surgery.
Dr. Chang specializes in procedures in the chest wall, diaphragm, thyroid, lungs and esophagus. He is researching better ways to screen for lung and esophageal cancers, to stage the diseases and to improve outcomes.
“The most common cancers are breast for women and prostate for men,” says Dr. Chang. “Lung cancer is generally number two in terms of incidence and always number one in terms of death, meaning lung cancer kills more people than breast, prostate and colon cancer combined.” Even early diagnosis carries no more than an 80 percent five-year survival rate.
Inadequate screening for this aggressive cancer, its tendency to be asymptomatic until fairly late and difficulty in staging the disease contribute to high mortality rates, says Dr. Chang. While the disease is more common in men, lung cancer incidence rates for men are flat but climbing for women. Patients are also getting younger. Dr. Chang is part of a multidisciplinary thoracic tumor board at MCG Health System working to optimize lung cancer treatment.
Lung cancer often is detected by a chest X-ray taken for another reason. But for routine screening, the relatively inexpensive test lacks accuracy in detecting small cancers, Dr. Chang says. Computerized tomography scanning holds promise, but has not proven to decrease cancer-specific deaths or be cost-effective.
Benign and cancerous esophageal disease is another growing problem. Reflux, in which stomach acid regularly invades the esophagus, is a major risk factor. Some reflux patients develop Barrett’s esophagus, changes in cells lining the esophagus that can lead to cancer. “You can cure patients of esophageal cancer if you catch them at a very early stage, if we screen carefully for Barrett’s,” Dr. Chang says. Cellular changes can often be corrected with medicine, but surgery may ultimately be needed to remove that part of the intestines.
Dr. Chang performs re-dos for failed reflux surgeries, where the junction between the stomach and esophagus is tightened to help block stomach acids. He also is developing minimally invasive surgical programs for esophageal and lung disease and treats a rare problem, achalasia, or abnormal rigidity of muscles in the lower esophagus. This autoimmune disease can be successfully treated surgically by dividing the muscles.
With hyperhidrosis, another rare problem characterized by excessive perspiration, Dr. Chang cuts out a small section of the sympathetic nervous system which is hyperactive.
Dr. Chang also performs lung transplants, often needed because of chronic obstructive pulmonary disease, which causes swollen, dysfunctional lungs. He plans to help develop a lung transplant program at MCG Health System after the heart transplant program currently under development is well established.