Florida Lung Cancer Specialist

A diagnosis of lung cancer, lung nodule, or a collapsed lung can be scary—especially when surgery is discussed as a treatment option.  Dr. Tishko is a proven lung cancer specialist who has pioneered a new surgical approach for lung cancer treatment and works with a larger cancer care team.

To ease your concerns and help you prepare for any surgical procedure that your thoracic team recommends, your surgeon should walk you through the procedural steps, preparation, and recovery needs. Knowing that you are in the hands of a skilled, experienced surgeon can also put your mind at ease as your surgery approaches.

Dr. Dennis Tishko has performed thousands of lung surgeries, primarily to treat lung cancer, so he can instill a sense of confidence about your treatment. Specializing in both open and minimally-invasive surgical procedures, Dr. Tishko can make informed recommendations for your future health and pave the way toward a positive outcome.

How Surgery Plays a Role in Lung Cancer Care

This is an old fashioned extensive thoracotomy incision. It is no longer the standard of care. Minimally invasive surgery has allowed for dramatically improved results with much less trauma.

There are different types of lung cancer, which will progress differently in various stages, so surgery is not always an appropriate treatment option. Often, small cell lung cancer is not treated surgically unless it is diagnosed at very early stages, because this type of cancer can spread quickly to nearby structures that will make surgery too risky. In some cases, surgery may simply be exploratory, intended to diagnose the presence of cancer and assess the staging of the disease for more accurate treatment planning later on. If you do require surgery, Dr. Tishko will carefully explain the nature of the procedure and ensure that you know what to expect in the outcome.

Types of Lung Surgeries

Dr. Tishko specializes in various surgeries of the lungs and chest, including the following procedures:

  • Lung Biopsy – A lung biopsy will be recommended if nodules are found in the lung tissue via CT scan or chest X-ray. These nodules may be benign or cancerous, so it is necessary to take a tissue sample and view it under a microscope to confirm that cancer is present.
  • Thoracotomy – This surgery is a conventional open operation, in which the thoracic cavity is accessed through an incision on the side of the body for full examination and exposure. Because of the risky nature of this procedure, it is often avoided in favor of less invasive exploratory surgeries.
  • Mediastinoscopy – In a mediastonoscopy, an opening is made just above the breastbone and below the neck to access the lymph nodes. It is essential in staging lung cancer and diagnosing other serious respiratory diseases.
  • Bronchoscopy – During a bronchoscopy, the doctor will get a look inside the airways as a thin, flexible tube is inserted through the windpipe and into the lungs.
  • Esophagectomy – Cancer of the esophagus is often treated first through surgery, followed by chemotherapy or radiation. The esophagectomy surgery involves the removal of the affected area of the esophagus.
  • Chemotherapy Port Placement – Chemotherapy drugs can be administered in many ways, including intravenously through a surgically placed port in the chest. This can make the introduction of chemo drugs into the body easier and provide more direct access to the cancerous cells.
Dr. Tishko works as part of a larger cancer care team, lending unique surgical expertise to lung and esophageal cancer patients. To learn more about his track record of surgical success or schedule a surgical consultation, contact our office to request an appointment.

Commonly Asked Questions

What is a Mediastinoscopy?
Mediastinoscopy is a surgical operation designed to obtain tissue from the lymph nodes in the center of the chest. The center of the chest is called the mediastinum.
Why do I need a Mediastinoscopy?
A Mediastinoscopy is used to obtain tissue from the lymph nodes in the mediastinum.
Lymph nodes in the mediastinum may be suspicious because of cancer or infection or immune problems or other diseases that may have caused them to become abnormal. The most reliable way to make a definitive diagnosis is to obtain tissue directly from the lymph node itself.
Will I need to stay in the hospital for a Mediastinoscopy?
No. Mediastinoscopy is almost always done as an outpatient- this means the surgery is done and the patient goes home the same day. In rare instances only will a patient need to be admitted after Mediastinoscopy.
Is Mediastinoscopy painful?
Mediastinoscopy is generally not a very painful operation. Almost everyone has a sore throat, like a bad cold; however, the incision itself is generally not especially painful. A pain medication prescription will be given to you. Tylenol may be used if your pain is only moderate. It is common to have some discomfort in the neck and areas around the incision, but this should diminish in the first several days after surgery.
Do I need to take time off from work after surgery?
You may return to work the day after surgery as long as you do not drive while taking narcotic pain medication. Many people prefer to take one (1) day off after surgery to allow themselves time to determine how well they have recovered from the anesthetic and the operation. Medically, there is no reason why you cannot return to work after the Mediastinoscopy.
I have swelling by the incision. Is this normal?
Yes! Almost everyone has a swollen area at the incision site after surgery. The area looks like you have swallowed a walnut, and is swollen for several weeks. This is entirely normal and is not a complication or problem. If the incision is not draining or hot, the swelling is normal and will resolve in time.
When can I resume smoking?
NEVER! It is never appropriate to resume smoking! You may never resume smoking. There are no circumstances under which it is appropriate for you to resume smoking of any kind.
Will I need another operation?
Mediastinoscopy is very often used in conjunction with other operations for lung abnormalities. If a lung mass has been noted and discussed with you, surgery for this may be planned after your Mediastinoscopy. Please discuss this with your doctor if you have further questions.
What should I do about the medication I was taking before surgery?
You should resume taking all medications that you were taking before surgery, EXCEPT BLOOD THINNERS. If you were taking blood thinners before surgery and you stopped the blood thinners, please discuss this with your doctor before resuming any blood thinner medication.
Will my family doctor get a copy of the operation report?
Yes, your family doctor should get a copy of the operation report and the pathology report. Please make sure we have the correct name and address for your family doctor to make sure records are properly sent.
When can I shower?
You may shower as soon as the original bandage is removed 48 hrs after surgery. If the incision is draining at all contact your doctor.
When can I bathe in the bathtub?
You may bathe in a tub after one week.
Should I put any ointment or salve or cream on the incision?
No. Keep the incision clean and dry. Do not put any ointment, salve, cream, or other preparation on your skin. Keep it clean and dry.
When can I drive?
You may not drive if you are taking narcotic pain medicine. When you are no longer taking the pain medicine and you feel that you are strong enough to drive and operate heavy machinery, you may resume driving. Do not drive while taking narcotics or while unable to move your head safely for driving.
When can I take the bandage off?
Take the bandage off 48 hrs after surgery. Do not leave the bandage on for more than 2 days. You may change the bandage if it becomes soiled or stained.
When do I remove the strips of tape over the incision?
If tape strips are used instead of surgical glue, the tape strips over the incision should be removed on the 5th day after surgery. Do not leave the tape strips on for more than 5 days, regardless of what anyone may tell you. Sometimes patients hear that the strips “will fall off by themselves”- this is not the case. The tape strips should be removed just like a Band Aid on the 5th day after surgery.
Is it common to cough up blood after surgery?
Yes. You may cough up blood for several days after surgery. This is entirely normal after the scope passes through the wind pipe. Irritation is common and small amounts of blood in your sputum are common. This should clear up after several days.
It hurts when I turn my head. Is this common?
Patients occasionally note that they have some discomfort when turning their head from side to side or back and forth. Although this does not happen very often, it is certainly something that can be seen withMediastinoscopy and should resolve in the first several days after surgery. If the pain is significant, remember to use your pain medication.
Will the doctor come out and talk with my family after surgery?
Yes. Your doctor will discuss the surgery with your family afterwards. Please make sure they are in the waiting room. Whoever is waiting must not leave the waiting room at all until the operation is complete. Make sure your family does not leave the waiting room.
Can I resume my normal activity after surgery?
Yes. You may begin your normal activities; however, if you are taking narcotic pain medication, you may not drive or operate heavy machinery or use alcohol.
Are there any special precautions to take with the incision?
Keep the incision clean and dry. Do not use any ointment, salve, or creams on the incision site at all. You may shower 48 hors after surgery. There are no activity restrictions at all.
Is a sore throat normal?
Yes. Many patients have a sore throat after this operation, similar to having a bad cold. This is likely to resolve within the first week of surgery.
When will I find out the results of my surgery?
Pathology results may take up to one week to be confirmed. Your doctor will contact you when the results are available, or you may discuss results at your office visit with your doctor if an appointment has been set up soon after surgery. Please do not call the office to check on pathology results; you will be notified as soon as they are available.
What if I have other questions?
If you have other questions not covered which cannot wait until your office visit, please call our office during regular businesshours. Otherwise, your doctor will be happy to talk with you at your next office visit about any questions you may have.

Dr. Dennis J. Tishko, MD, FACS

Tel: 321-268-6868
Fax: 321-268-6895

250 Harrison St, 2nd Floor

Titusville, FL 32780

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