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

Endo Battery

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Endo Battery

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

June 24, 2025 • Alanna • Episode 155

0:00 | 5:28

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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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Introduction to Quick Connect

Speaker 1 0:00

Life moves fast and so should the answers to your biggest questions . Welcome to EndoBattery's Quick Connect , your direct line to expert insights . Short , powerful and right to the point . You send in the questions , I bring in the experts and in just five minutes you get the knowledge you need . No long episodes , no extra time needed , and just remember expert opinions shared here are for general information and not for personalized medical advice . Always consult your provider for your case-specific guidance . Got a question ? Send it in and let's quickly get you the answers . I'm your host , alana , and it's time to connect .

Dr. Di Chiara: Thoracic Surgery Expert

Speaker 1 0:51

Today I am joined by my guest , dr Francesco Di Chiara , a leading consultant thoracic surgeon at the John Radcliffe Hospital in Oxford and a true pioneer in minimally invasive chest surgery . Renowned internationally for developing and refining cutting edge techniques , including groundbreaking single incision procedure for thoracic outlet syndrome , dr D Chiara is transforming the way we approach complex thoracic conditions , with deep expertise in lung cancer , chest wall trauma and rare disorders like thoracic endometriosis . He's not only a gifted surgeon , but also a passionate educator and an innovator . I am thrilled to be diving into this conversation with someone who is shaping the future for thoracic endometriosis . Please help me in welcoming Dr Francesco

How Common Is Thoracic Endometriosis?

Speaker 1 1:31

Di Chiara . How rare or how common is thoracic endometriosis ?

Speaker 2 1:37

That's the bit I want to find out because I really don't believe it's rare . I think we're just seeing the tip of the iceberg . We are seeing the patient that not only managed to go seven , eight years to be diagnosed with endometriosis but then also another few , several years to get to see a thrust , especially that can be the diagnosis . So you're seeing a fraction of the fraction . For example , all my patients now come before through the gynecologist with already diagnosis of endometriosis . I think the future will be I see adolescents that has a death first symptoms and the first especially they see somebody with thoracic endometriosis . Now I'm seeing patients that are 30 plus symptoms and the first especially they see somebody for thoracic endometriosis . Now I see in patients they are 30 plus and they already have diagnosis of endometriosis .

Surgical Risks for Young Patients

Speaker 1 2:32

Is there risk in doing thoracic surgery for endometriosis on teens ?

Speaker 2 2:44

And is there more risk of it coming back because they are so young ? No-transcript for the pelvis seems to have good results and increased quality of life , and although we don't have the numbers and the data to support this claim on drastic endometriosis , it seems intuitive that the same logic you apply to the pelvis you should apply to the chest . So actually you should improve the quality of life .

Speaker 1 3:08

Is there more risk associated because they are so young , with more adverse outcomes ?

Speaker 2 3:16

I would say actually it's safer because the main risk of thoracic surgery is related to aging heart disease and lung diseases , which are basically non-prevalent

Healthcare Coverage and Access Issues

Speaker 2 3:30

at all in teens and young adults . So it's generally considered safe for operating younger individuals .

Speaker 1 3:39

Have you seen a shift in the way that and of course this is going to be different from country to country because with the US insurance may or may not cover it if they see it on the heart . Are you noticing over in the UK that they're taking that more seriously in that healthcare system for those in the public health system to get better help ?

Speaker 2 4:01

So when it comes to provision of a complex endometriosis care in the UK , I think it's a work in progress in the NHS , in the public health system , and we are debating as we speak with NHS England to create a network , but the provision is quite patchy across the country . There's not a definite unified program .

Speaker 1 4:31

It's probably worldwide yeah .

Speaker 2 4:33

Yeah , it's tricky to ?

Speaker 1 4:34

Yeah , yeah , it's tricky to get surgery good surgeries covered , but does the severity dictate how it can be covered across the board ? And I don't think that that's an easy answer for anyone

Episode Closing and Contact Information

Speaker 1 4:47

to answer . So that's a wrap for this quick connect . I hope today's insights helped you move forward with more clarity and confidence . Do you have more questions ? Keep them coming , send them in and I'll bring you the expert answers . You can send them in by using the link in the top of the description of this podcast episode or by emailing contact at endobatterycom or visiting the endobatterycom contact page . Until next time , keep feeling empowered through knowledge .