Dr Ben Lancashire

The end of an era!

Professor Chris Pyke performed his final private practice operating list last week.

Chris commenced surgical training in 1984, and trained under my father (Ray Lancashire) at the Mater Hospital! He undertook post-fellowship training at the Mayo Clinic (USA) and the Nottingham Breast Unit (UK). On return to Australia, he set up private practice at the Mater Private Hospital in 1991. Chris took up a position as senior lecturer with The University of Queensland and completed a PhD in breast cancer risk quantification. He also completed a post-graduate diploma in oncoplastic breast surgery.

Chris was the Director of Surgery, and my own Consultant (boss!) at the Mater Hospital when I was a surgical trainee.

Chris’ achievements are immense - to list them all is impossible. He has had roles as the Vice President of the Royal Australasian College of Surgeons, and their Chairman for the Court of Examiners. He spent 4 years as the president of BreastSurgANZ and has been the Chairman of the Board for the Foundation for Breast Cancer Care. Chris chairs the Mater Private Breast Cancer Multidisciplinary Team Meeting, has led studies with Mater Research, and is a passionate fundraiser for the Mater Foundation.

Chris is not only a talented surgeon and great colleague, but also a compassionate and hilarious person (if you love “dad jokes” 🤣).

He looks forward to continuing his role as the Director of Medical Services and hopefully spending more time with his family.

It’s been a pleasure and an honour to work with him over the years. Congratulations Professor Pyke!

My 8th time participating in the Mater Chick’s In Pink International Women’s Day Fun Run! This event raises funds for life-saving breast cancer research, medical equipment and practical services for those affected by breast cancer.

Another sold out event was blessed with spectacular Brisbane weather. Many thanks for all of those who participated and donated. I will see you all there again next year!

My pink sidekicks 💕

Some light training for the upcoming International Women’s Day Fun Run with a family spin around the park. My little pink sidekicks keeping me motivated as only daughters can! 🏃🏻🏃🏼‍♀️🏃🏼‍♀️

Last week Brisbane hosted the Australasian International Breast Congress (AIBC). I was lucky enough to have two of my research posters accepted for presentation.

Again – it was so good to be attending these conferences in person.

The AIBC is a joint congress of the Australasian Society for Breast Disease (ASBD), World Congress on Controversies in Breast Cancer (CoBrCa) and Breast Surgeons of Australia and New Zealand (BreastSurgANZ). We discussed controversial issues in breast conditions and the conference includes presentations, debates, and discussions.

It was also a great opportunity to catch up with old and current colleagues outside of the hospital!

Thyroid nodule biopsy – What if my result is ‘inconclusive’? 🤷🏼‍♂️

Investigation of a thyroid nodule often involves a fine needle aspirate (FNA) biopsy. The purpose of the biopsy is to ascertain whether the nodule is malignant (cancerous), and therefore confirm whether surgery to remove it (thyroidectomy) is required. Occasionally (~20% of cases), a biopsy will return an inconclusive result (the nodule pathology is described as ‘indeterminate’, ‘atypical’ or ‘suspicious’ – Bethesda Category III or IV). In such cases, the need for surgery may be less clear. Some patients will be advised to proceed with surgery, others to simply ‘watch-and-wait’.

A new tool to assist management of thyroid nodules (the ThyroSeq v3 multigene classifier test) has recently become available to Australian patients. The test analyses biopsied thyroid tissue in greater detail, and may assist to:
🔹 Confirm or rule-out malignancy
🔹 Guide the choice of surgery (partial versus total thyroidectomy)
🔹 Inform options for targeted chemotherapy or immunotherapy

Although this test helps to clarify thyroid pathology and help direct treatment decisions, it is still subject to error. It is also still relatively expensive as test processing is done overseas and it is not rebated by Medicare. Dr Lancashire can discuss if this test is suitable for you. 🔬👨‍🔬

Early detection of a breast cancer can reduce the extent of treatment people may need and potentially save a life. Being "breast aware" - examining your breasts regularly and having your routine breast screening - are the simplest things you can do to to help detect a breast cancer early.

A Grand Rounds presentation on oncoplastic breast surgery for my colleagues, doctors-in-training and medical students at Greenslopes Private Hospital this week. Thank you to those who attended in person (and online!). It was a pleasure to update the group on advances in breast surgical techniques.

Today is Crazysocks4docs Day – An opportunity to raise awareness of mental health challenges faced by health care professionals, and support tangible action on this front.

It is well established that doctors experience substantially higher rates of psychological distress and suicidal thoughts compared to the general population and other professionals.

Positive change in this space is critically important. Discussion around the demands of our profession, and the immense toll this can take on practitioners’ personal lives, has grown considerably since my time as a junior doctor. Asking for help isn’t considered a sign of weakness. Self-care is encouraged. Work-life balance inches closer to being within reach.

Despite progress, we still have a way to go. Today is a reminder for every ‘health care hero’ to take pause for themselves, reach out to their colleagues, and turn talk into action.

Even a wonky, heart-shaped pancake is perfect in its own way. This one was burnt on the outside and doughy in the middle - but it was made with love 😆🥰🥞

Happy Mother's Day to all the mums out there. You are all perfect and we wouldn't see it any other way 💐❤️

An inspiring week of surgical education, research and professional networking at the RACS ASC 2022 draws to a close today.

A great opportunity to present some of my research and hear from colleagues about theirs.

Looking forward to next year’s event!

Great to be back to “in-person” events! The RACS Annual Scientific Congress 2022 begins!

Every year the Royal Australasian College of Surgeons holds the ASC - their largest multi-disciplinary surgical meeting held in Australia and New Zealand. Held over 4 days, it provides surgeons the opportunity to learn the latest advances in their surgical specialties.

I’m honoured to be both an invited speaker and a session chair at this year’s congress.

More to come!

That’s a wrap!

The ‘Breast Friends & Family’ fundraising team did the 2022 RACQ International Women’s Day ‘Fun Run, Your Way’ this morning!

We caught up at New Farm Park for some sunshine, fresh air, exercise and (most importantly) an ice block to finish!

It’s not too late to donate to support women with breast cancer – jump online to see our team fundraising page (see comments for link).

MINI car, MIGHTY cause! The RACQ International Women’s Day Fun Run is less than 2 weeks away now (Sunday 6th March 2022), and the Mater Chicks in Pink hope to raise $2M to support women with breast cancer. What’s more, participants who fundraise $50 will have a chance to win a MINI Cooper Hatch thanks to MINI Garage!

*Please note: Breast Surgeon and Breast Care Nurse not included 😉

Thyroid cancer diagnosis in a pandemic – should I worry?

I have had discussions with several concerned patients who have had their thyroid surgery delayed due to COVID-19 pandemic. This may be due to a reduction in the surgical services in their health district, or because they have had a recent COVID-19 infection themselves, delaying their surgery from an anaesthetic safety point of view.

There are four main types of thyroid cancer:
🔹 Papillary (70-80%)
🔹 Follicular/Hürthle (10-15%)
🔹 Medullary (5%)
🔹 Anaplastic (2%)

The prognosis for the most common types of thyroid cancer (papillary and follicular) is generally excellent. Medullary thyroid cancer is often associated with genetic endocrine disorders, and it tends to spread earlier than papillary cancers. Anaplastic thyroid cancer is extremely rare and carries a very poor prognosis despite surgery.

Most thyroid cancers are treated with a hemithyroidectomy (partial removal of the thyroid) or total thyroidectomy (complete removal of the thyroid gland). Some thyroid cancers require additional neck lymph node surgery and/or treatment with radioiodine.

For low-risk thyroid cancer, an ‘active surveillance’ approach is being taken in a selective group of patients, mostly being small, confined to the thyroid without any lymph node involvement. This involves regular examinations and neck ultrasound. It is important to realise that this decision needs made by an experienced thyroid surgeon within a multidisciplinary team setting.

The COVID-19 pandemic has seen delayed non-urgent elective surgery, which has impacted many patients with thyroid cancer. A recently published study in the ANZ Journal of Surgery(1) found that 90% of thyroid cancer clinicians reported delaying treatments for their patients during the pandemic, and that 88% of clinicians were worried by such delays. Importantly however, clinicians’ concerns usually related to patient anxiety about the delay rather than risk of disease progression in the meantime.

For the majority of patients, a minor delay in their surgery will not result in poorer outcomes from a cancer point of view.

You can read more about thyroid cancer and endocrine procedures on my website.

1. Nickel, B et al (2021). Thyroid cancer clinicians' views and experiences of delayed treatment during the COVID-19 pandemic: An international cross-sectional survey. ANZ journal of surgery, 91(12), 2562–2564.

Today is World Cancer Day and this year’s theme is “Close the Care Gap”.

Barriers to health care access and patient disengagement during the COVID-19 pandemic has seen many Australians postpone cancer screening over the last 2 years. For those living in rural and remote Australia, particularly Aboriginal and Torres Strait Islander communities, this phenomenon was amplified.

In the breast cancer setting for example, many women in smaller communities are less likely to participate in breast screening and are inclined to feel culturally isolated in hospitals and clinics (Breast Cancer Network Australia 2018). Aboriginal and Torres Strait Islander women are 1.2 times more likely to die from breast cancer than non-Indigenous females (AIHW 2018), and early detection is critical in closing the gap in breast cancer mortality rates.

Finding cancer early means there are more treatment options. Let’s get the message out loud and clear, across every corner of Australia!

It’s done! 🎉 🥳 I’ve submitted my thesis manuscript!

This was the final piece of assessment towards my degree of ‘Master of Advanced Surgery (Breast Surgery)’. 🎓

It’s been quite a slog doing this degree over the last 2 years while working full-time. I could not have done it without the patience and support of my wife.

While I had hoped 2022 might get a bit easier, we’re not off to a very good start. 🦠

Please stay safe everybody. 🙏🏻

What is a general surgeon?🧑‍⚕️ 👨‍⚕️ 🤔

Occasionally patients are initially confused when they are referred to me for a hernia or a gallbladder problem. Yes – I am a specialist breast and endocrine surgeon – but I am also a specialist general surgeon.

General surgeons are a highly skilled and broadly trained surgeons that deal with a wide range of surgical conditions. These days, most general surgeons have special interest and extra training in more focused areas, but keep up their general surgery skills and interests.

General surgeons often take years of extra training (after general surgery training) in areas like:
🔸 Breast & Endocrine Surgery
🔸 Colorectal Surgery
🔸 Upper Gastrointestinal Surgery
🔸 Hepatobiliary Surgery
🔸 Soft Tissue Surgical Oncology
🔸 Trauma Surgery
🔸 Transplant Surgery

I love being a specialist breast, thyroid and parathyroid surgeon. But as they say – “variety is the spice of life!” and general surgeons are trained to tackle whatever comes through the door. It certainly keeps you on your toes and is mostly very rewarding.

In the last year I have managed thousands of surgical cases – from breast cancers, huge thyroids, horrific stabbings, bowel perforations, appendicitis, hernias, gallbladders…. right through to small skin lesions I have excised in the office.

Here is a spleen we removed last year – this case got the heart rate up!

CrazySocks4Docs Day! This day is held every year on the first Friday of June.

It aims to raise awareness of the mental health of doctors and health practitioners, in effort to reduce the stigma for those experiencing mental illness.

The team at QEII Jubilee Hospital in Brisbane were keen to show their support for this important cause.

There is meaning behind the cleverly-designed Crazysocks4docs logo. The odd and brightly coloured socks reflect the ‘zone’ someone may be in with mental health: being well (green) or unwell (red). The socks form faces (both front on) but also two faces looking to each other to reflect the asking for help (red) and giving of help (green). The stethoscope helps form the eyes and the face. The little cartoon in the bell of the stethoscope contains a dog - a reminder that pets provide unconditional support. The feet remind us to “walk the talk” and no one should walk alone with a mental health issue.