QC:How Common is Thoracic Endo and Is It Different in Teens?

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Thoracic endometriosis is likely more common than we think, and we're only seeing "the tip of the iceberg" according to thoracic surgeon Dr. Francesco Di Chiara, who specializes in minimally invasive chest surgery at Oxford's John Radcliffe Hospital.

• Most patients wait 7-8 years for endometriosis diagnosis, then additional years before seeing a thoracic specialist
• Current patients typically arrive in their 30s with pre-existing endometriosis diagnosis from gynecologists
• Dr. Di Chiara envisions a future where adolescents with chest symptoms would see thoracic specialists first
• Surgery for thoracic endometriosis in younger patients may actually be safer than in older adults
• The main surgical risks relate to age-related heart and lung diseases, not present in teens and young adults
• Healthcare coverage for thoracic endometriosis remains "patchy" across countries including the UK's NHS
• Work is ongoing with NHS England to create a unified network for complex endometriosis care

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Episode Transcript

Speaker 1 (00:00):
Life moves fast and so should the answers to your
biggest questions.
Welcome to EndoBattery's QuickConnect, your direct line to
expert insights.
Short, powerful and right tothe point.
You send in the questions, Ibring in the experts and in just
five minutes you get theknowledge you need.
No long episodes, no extra timeneeded, and just remember

(00:20):
expert opinions shared here arefor general information and not
for personalized medical advice.
Always consult your providerfor your case-specific guidance.
Got a question?
Send it in and let's quicklyget you the answers.
I'm your host, alana, and it'stime to connect.

(00:51):
Today I am joined by my guest,dr Francesco Di Chiara, a
leading consultant thoracicsurgeon at the John Radcliffe
Hospital in Oxford and a truepioneer in minimally invasive
chest surgery.
Renowned internationally fordeveloping and refining cutting
edge techniques, includinggroundbreaking single incision
procedure for thoracic outletsyndrome, dr D Chiara is
transforming the way we approachcomplex thoracic conditions,

(01:11):
with deep expertise in lungcancer, chest wall trauma and
rare disorders like thoracicendometriosis.
He's not only a gifted surgeon,but also a passionate educator
and an innovator.
I am thrilled to be diving intothis conversation with someone
who is shaping the future forthoracic endometriosis.
Please help me in welcoming DrFrancesco Di Chiara.
How rare or how common isthoracic endometriosis?

Speaker 2 (01:37):
That's the bit I want to find out because I really
don't believe it's rare.
I think we're just seeing thetip of the iceberg.
We are seeing the patient thatnot only managed to go seven,
eight years to be diagnosed withendometriosis but then also
another few, several years toget to see a thrust, especially

(02:00):
that can be the diagnosis.
So you're seeing a fraction ofthe fraction.
For example, all my patientsnow come before through the
gynecologist with alreadydiagnosis of endometriosis.
I think the future will be Isee adolescents that has a death
first symptoms and the firstespecially they see somebody

(02:23):
with thoracic endometriosis.
Now I'm seeing patients thatare 30 plus symptoms and the
first especially they seesomebody for thoracic
endometriosis.
Now I see in patients they are30 plus and they already have
diagnosis of endometriosis.

Speaker 1 (02:32):
Is there risk in doing thoracic surgery for
endometriosis on teens?

Speaker 2 (02:44):
And is there more risk of it coming back because
they are so young?
No-transcript for the pelvisseems to have good results and
increased quality of life, andalthough we don't have the
numbers and the data to supportthis claim on drastic
endometriosis, it seemsintuitive that the same logic
you apply to the pelvis youshould apply to the chest.
So actually you should improvethe quality of life.

Speaker 1 (03:08):
Is there more risk associated because they are so
young, with more adverseoutcomes?

Speaker 2 (03:16):
I would say actually it's safer because the main risk
of thoracic surgery is relatedto aging heart disease and lung
diseases, which are basicallynon-prevalent at all in teens
and young adults.
So it's generally consideredsafe for operating younger

(03:36):
individuals.

Speaker 1 (03:39):
Have you seen a shift in the way that and of course
this is going to be differentfrom country to country because
with the US insurance may or maynot cover it if they see it on
the heart.
Are you noticing over in the UKthat they're taking that more
seriously in that healthcaresystem for those in the public
health system to get better help?

Speaker 2 (04:01):
So when it comes to provision of a complex
endometriosis care in the UK, Ithink it's a work in progress in
the NHS, in the public healthsystem, and we are debating as
we speak with NHS England tocreate a network, but the

(04:24):
provision is quite patchy acrossthe country.
There's not a definite unifiedprogram.

Speaker 1 (04:31):
It's probably worldwide yeah.

Speaker 2 (04:33):
Yeah, it's tricky to?

Speaker 1 (04:34):
Yeah, yeah, it's tricky to get surgery good
surgeries covered, but does theseverity dictate how it can be
covered across the board?
And I don't think that that'san easy answer for anyone to
answer.
So that's a wrap for this quickconnect.
I hope today's insights helpedyou move forward with more
clarity and confidence.

(04:54):
Do you have more questions?
Keep them coming, send them inand I'll bring you the expert
answers.
You can send them in by usingthe link in the top of the
description of this podcastepisode or by emailing contact
at endobatterycom or visitingthe endobatterycom contact page.
Until next time, keep feelingempowered through knowledge.