By Nina Huang
Northwest Asian Weekly
Born in 1982 in Oklahoma City to Vietnamese immigrants who escaped after the war, Dr. Khanh Pham wasn’t completely sold on becoming a doctor in college.
After graduating from the University of California, Riverside, Pham went onto the Medical College of Wisconsin to train in becoming a urologist. Pham almost became a lawyer, but his father — also a physician — encouraged him to pursue medicine.
After he was a year and a half into school, Pham wasn’t sure it was right for him and wanted to change careers. But as time went on, he found what he was looking for and that was an opportunity to be intellectually challenged and to feel like he was helping people.
Pursuing urology
“Choosing urology was also an accident, I didn’t know what an urologist was during med school,” Pham said.
During a transplant surgery rotation, Pham met someone who told him exactly what urology was, and he was convinced that it was a great field to pursue. It is one of the most competitive specialties and when he was training, there were only 240 training spots in the country. He felt lucky to have made things happen the way they did.
Urology focuses on surgical and medical diseases of the male and female urinary-tract system and the male reproductive organs.
“In residency, the guy that trained me had one of the top five highest volume of bladder removals in the country. I learned most of what I know from him,” Pham said.
After a five-year residency and two years pursuing a fellowship in urology oncology in Seattle, Pham spent a year conducting prostate cancer research at Fred Hutchinson Cancer Research Center, followed by a year at Virginia Mason Hospital. For the past three years, Pham has worked at Overlake Hospital in Bellevue.
Technological advances
According to Pham, robotic surgery is relatively new and has been around for the past decade or so.
“Robotic surgery is essentially laparoscopic surgery. It’s connected to a device that has arms and the device is controlled at a console where you look inside and use your feet to push pedals. You can control the camera and cut and sew things with your hands and feet,” he explained.
Pham said that urologists are pioneers in bringing the robot mainstream. It was originally designed to do a cardiac bypass without cutting up the sternum.
In the past, the only way to remove kidneys was to cut a huge incision, but the robot has made the process less invasive, and it lessens blood loss and pain. Pham said that there are only a handful of people who use the robot to remove bladders in the region.
In his career, he said he has removed up to 20 bladders with the robot.
On the other hand, he said some people say the procedure takes longer to do and there may be higher upfront costs.
Life-saving robotics
Less than three years ago, Pham removed a tumor from David Lo’s kidney.
Lo, 67 at the time, had gone in for an annual checkup with his general practitioner (GP) and complained about some pain in his right side. His doctor thought it might be a hernia and recommended Lo get an MRI.
But Lo went home and thought it was probably nothing, and he forgot about it, until a month later. His doctor called, reminding Lo that he hadn’t gotten his MRI yet and encouraged Lo to do the test.
He thought it was unusual for the GP to call and remind him, so he got the MRI. It found a hernia on his right side and a tumor on his left kidney that was a little over two centimeters in size.
“Luckily, I listened. My GP recommended I see Dr. Pham and he took care of it,” Lo said.
Lo said that Pham explained the two ways to do the surgery — to cut open the stomach or robotic surgery.
Lo opted for the robotic surgery.
When the day of surgery arrived, the doctors prepared Lo for the procedure, but somehow the anesthesiologist said that his windpipe was too narrow, and they also tested his blood, which was low on potassium. They cancelled the surgery and it took another month for Lo to get his potassium levels back up to try the robotic surgery again.
Lo said that it normally takes three to four hours for the surgery, but it took them over six hours because the tumor was hard to remove. He was overweight and the fat in the stomach made the surgery more difficult. Pham enlisted the help of another doctor to finish the surgery, but ultimately, it was completed successfully. Lo healed properly after just a three-day stay in the hospital and a two-week recovery time at home.
The surgery left four small round scars on Lo’s stomach, instead of a long incision scar had he gone with the other surgery option.
Lo explained that he didn’t have to go through chemotherapy afterwards, all thanks to Pham and the good Lord.
“I found out afterwards that the doctors had to use doppler radar to aim precisely. That was mind blowing because I like high tech. I felt very comfortable with robots doing it,” Lo said.
Now at 69 years old, Lo has annual visits with Pham for check-ups.
Heed the signs
Pham advises that if people find something about their body that doesn’t seem right, don’t ignore it. See a doctor. Bladder cancer symptoms would be blood in the urine, even if it’s not painful. Kidney cancer would be detectable during imaging tests.
According to the Mayo Clinic, bladder cancer is one of the most common cancers, affecting approximately 68,000 adults in the United States each year. Bladder cancer occurs in men more frequently than in women and usually affects older adults, though it can happen at any age.
In addition, about seven out of every 10 bladder cancers diagnosed start out at an early stage — when bladder cancer is highly treatable. However, even early-stage bladder cancer may recur in the bladder. For this reason, people with bladder cancer typically need follow-up tests for years after treatment.
Nina can be reached at info@nwasianweekly.com.