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Chest surgeon with a heart

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Posted: Tuesday, July 22, 2014 3:20 pm

Perhaps thoracic surgeon Melanie A. Edwards, MD developed her medical interest very early in life from strong male and female figures to emulate. Her Jamaican-born father was an optometrist who put himself through school, and her mother did the same and earned a master’s degree. Edwards, who was born in Alberta, Canada to immigrant parents, also loved her pediatrician, who was female.

“So I think somewhere in between the two, that’s how that interest started,” Edwards said. “And I never lost it.”

Her interest in medicine turned into an educational pursuit for excellence, through Oakwood College in Huntsville, Alabama; medical school at Loma Linda University in California; and residencies at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston. Then Edwards’ fellowship in cardiothoracic surgery brought her to Saint Louis University School of Medicine in 2006.

“When I was here as a resident, I came, operated and left,” Edwards said. “I thought SLU was great because all the guys I worked with were all fine and really nice to me, so I thought it was a great place.”

Notice that she said “guys.” The Society of Thoracic Surgeons reports that women make up only about 5 or 6 percent of all such surgeons. However, she said it never appeared to be an issue.

“It’s not been something I’ve paid particular attention to,” Edwards said.

She trained for a year in minimally invasive surgery at Cedars Sinai in Los Angeles, and worked in New Orleans for a time before returning to Saint Louis in 2013 as an assistant professor of surgery and thoracic surgeon at Saint Louis University. 

“Keith Naunheim MD is a great mentor and one of the best people you could work with in the specialty, in terms of just being someone who clinically I share a similar mindset in that he trained me,” Edwards said. “And, I would say he is one of the people I would consider most influential at this phase.”

Thoracic surgeons, Edwards said, primarily conduct operations on the lungs, esophageal tract, chest wall, rib cage, and everything in between, with the exception of the heart.

“I did plenty of hearts and valves when I was a resident – the whole nine,” she said. “I liked it. It’s just that I think thoracic surgery offers a little more of an intellectual challenge for me personally.”

For example, when doctors we look at treating stage 3 lung cancer, Edwards said, the recommendations change to some degree.

“The role of surgery is still controversial and hotly debated at meetings, and eventually you have to make sense of the available evidence and make a decision as to how you are going to proceed,” Edwards said.

“Esophageal cancer is less controversial. The evaluation of a patient usually requires a strategic plan in terms of their diagnosis and staging and management, and those three things intersect to some degree. And it does require some degree of thoughtfulness to think through that in an efficient manner.”

Edwards said she always knew surgery would be her area of work, and trying things out as she went along brought her to thoracic surgery because it combined a lot of things she likes to do, like minimally invasive surgery.

“I like a diversity of patients, although it seems I only operate on two organs of the body,” she said. “There is enough diversity to keep it interesting, both the nature of the problems and the acuity of the patients.”

She performs the majority of her surgeries with small incisions, using a telescope. “Either laparoscopic surgery, if it’s on the esophagus, or video-assisted orthoscopic surgery, if it’s in the chest,” she said.

Edwards said minimally invasive surgeries are better for the patient.

“They recover better with smaller incisions and they have less of an adverse immune response, in terms of the inflammatory response,” Edwards said. “So, basically, the patients get on their feet faster; I think they recover better.”

Looking ahead, Edwards said she wants to stay busy, increasing clinical volume, teaching and developing more programs with the medical school, and eventually doing outreach for lung cancer by starting a lung cancer screening program.

She said making long cancer screening more accessible underserved communities, in particular African Americans, would save lives

“African-American rates and mortality for lung cancer are higher; the number of African Americans who undergo surgery for stage 1 lung cancer is lower. Yet when they’ve looked at tumor markers, they are not really that different,” she said.

“I don’t think we are getting different cancers. I think we are just not getting appropriate treatment or a much earlier diagnosis.”

In addition to the gratifying work, there are qualities Edwards likes about St. Louis as well.

“I think it provides a nice mix of big city and small city,” she said. “It gives the advantages of a major city, in terms of conveniences and accessibility to services, without that big overwhelming feeling. It has more of a small town feeling to it, which is nice.”

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