Thoracic Surgeon Focuses on Minimally Invasive Care

General thoracic surgeon Melanie Edwards, MD, honed her skills in minimally invasive surgery with a fellowship at Cedars-Sinai Medical Center but coming back to Saint Louis University was a chance to rejoin her mentors.

Author: Lucy Schultze

For general thoracic surgeon Melanie Edwards, MD, the chance to return to her training grounds at Saint Louis University two years ago was a welcome opportunity.

“I knew this would be a place where I could practice the type of surgery that I think is important to patients,” said Edwards, an assistant professor of surgery and a SLUCare Cardiothoracic Surgeon.

“I have great mentors at SLU, so I was really excited to come back,” she said. “We have a wide range of specialists and are really on the cutting edge in terms of what we’re able to offer patients. This is a great place to work.”

In terms of the type of practice she sought, Edwards was attracted by the way she’d seen physicians in the department work together, both among themselves and with other specialists, to offer patients with lung or esophageal cancer the best possible treatment approach.

Witnessing those kinds of interactions during her general surgery residency at Harvard Medical School in Boston helped draw her to her specialty.

“One of the things I really liked was the multidisciplinary collaboration that the thoracic surgeons had,” she said. “Everyone would sit down and discuss individual patients and their treatment plans. That’s something I’ve since championed throughout my career.”

Edwards completed a fellowship in cardiothoracic surgery at SLU, then took a position in New Orleans at the Louisiana State University Health Sciences Center. That was in 2008, three years after Hurricane Katrina, as the city continued to rebuild. Edwards was among physicians providing care for the city’s underserved population, as she built up a practice as a lone provider of general thoracic surgery and oncology.

“We started a lung nodule clinic and worked to get patients through more quickly,” she said. “We saw a large underserved population, with a lot of late-stage cancers and advanced diseases. The experience was interesting for me —being fresh out of training and seeing all of these advanced cases. It was really a chance to hit the ground running as I was introduced to the complexities of thoracic surgery.”

After four years in New Orleans, Edwards was ready to return to a more advanced environment in terms of standards of care. She also wanted to further develop her skills in minimally invasive surgery. A fellowship at Cedars-Sinai Medical Center in Los Angeles provided the opportunity to hone that aspect of her practice and develop her work in minimally invasive surgery. Today, minimally invasive procedures are central to both her practice and that of her department at SLU.

“When I first came to SLU, we were doing mostly open thoracotomies, whereas today we have transitioned to an almost completely minimally invasive approach,” she said. “It’s very rewarding to be part of that process.”

Pulmonary procedures make up a bulk of Edwards’ practice today. In removing lung tumors, more than 80 percent of cases can be handled through minimally invasive techniques, she said, with very large tumors as a rare exception.

Edwards also operates to treat benign issues of the esophagus, such as acid reflux disease, swallowing problems or other abnormalities, as well as correcting hiatal hernias and providing care for trauma patients. Among younger patients, she operates on collapsed lungs as well as for problems like hyperhydrosis.

“Even though general thoracic surgery may seem to cover only a limited area of the body, there is a great variety in the pathology we see and how it presents,” she said. “I enjoy this practice — especially the way esophageal practice stretches your creativity and demands that you be able to think outside the box. The cases are not always straightforward, which is what I like about surgery in general. Challenges are something I tend to go toward rather than run away from.”

A broad range of experiences and environments over her life and career helped shape the way Edwards approaches her practice today.

Born in Alberta, Canada, to Jamaican parents, she spent most of her youth in Jamaica before heading to the United States for college in 1993. After that, her education and medical training took her to every corner of the country before she settled in the Midwest.

Edwards earned an undergraduate degree from Oakwood College in Huntsville, Ala., then went on to attend Loma Linda School of Medicine in California.

“I had been interested in medicine all my life,” Edwards said. “As a kid, I thought my pediatrician was the greatest person in the world. When I was 11, I wanted to be a pediatrician, but by medical school, I knew I wanted to go into surgery.”

Edwards completed a general surgery residency at Beth Israel Deaconess Medical Center through Harvard, which led her to thoracic surgery and a fellowship at SLU.

Looking back, Edwards considers the approach of individualized medicine and treatment for patients based on their specific cancer profile as having been in its infancy during her training years.

“That approach was probably just emerging but hadn’t fully blossomed during that time,” she said. “It’s been interesting to watch how things have changed in the years since.

“Today is an exciting time to be in oncology. These are challenging diseases, and the outcomes still aren’t what we would like them to be, in terms of long-term survival for lung and esophageal cancer. But we have a lot more tools today, both on the medical side and on the surgical side.

“Some patients who may not tolerate a more radical approach do quite well with minimally invasive procedures like robotic lobectomy. There’s a great benefit to be had in minimally invasive surgery, and that’s something I feel strongly about.”

Edwards also appreciates the chance to move the field forward by taking part in research. While most of her projects involve pulmonary lung cancer, she is also currently involved in a study to judge the effectiveness of a device designed to improve breathing in ALS patients. The a multi-center clinical trial will test the NeuRx Diaphragm Pacing System, which electrically stimulates the diaphragm muscle in an effort to slow muscle loss that can lead to breathing difficulties.

Edwards brings to the study her experience in having surgically implanted the sensors in ALS patients during her fellowship at Cedars-Sinai.

Outside of her work, Edwards stays active with cycling, swimming and yoga. She also enjoys baking.




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