At Royal Papworth Hospital NHS Foundation Trust we treat patients for both common and rare conditions, often taking on some of the most complex and challenging cases in cardiothoracic surgery.
When Ilanikovaiy Puvanakaumar (56), known as Shanti, first came to clinic at the end of 2024, she had metastatic breast cancer. Also known as stage 4 or advanced breast cancer, this is when the cancer spreads to other parts of the body.
A huge tumour had grown, was looking increasingly difficult to manage and was badly affecting her sternum, ribs and upper abdominal wall. It was painful and infected, oozing pus and blood and smelling bad.
Shanti, whose first language was not English, was suffering both physically and mentally. Her family sadly expected the worst.
Shanti's going home - Shanti (standing, fourth from left) with her sons and Mr Coonar (standing third left) and the multidisciplinary team on 5 South
Mr Aman Coonar is Consultant Thoracic Surgeon at Royal Papworth Hospital:
“Recognising the urgency, we acted immediately, coordinating a complex, multi-disciplinary surgery within days. The tumour itself was enormous, approximately the size of a large grapefruit.
“The surgery required the resection of most of her sternum, some of the surrounding ribs and part of her upper abdominal wall.
“Once the tumour was removed, we, in collaboration with the plastic surgery team from Addenbrooke’s, reconstructed her chest wall using a special mesh polymer to form a firm base and covered it using a flap of muscle and skin from her back."
The tumour in clinic - the tumour of the day surgery - the site of the tumour immediately post-op
After surgery Shanti spent time in critical care, but her recovery was complicated, including several return trips to the operating theatre, reactions to drugs and numerous scans. She was very sick and her wounds started to break down.
Mr Coonar continued: “Throughout all of this, the entire Royal Papworth and Addenbrooke's team was unwavering in their support for Shanti and her family.
“Her treatment required the expertise of multiple teams ranging from tissue viability, microbiology, physiotherapy and occupational therapy, to the surgical nursing staff on 5 South, critical care and theatres.
“Everyone was extraordinary, providing constant care and reassurance to the patient—not just the doctors and nurses but also the healthcare assistants, porters, cleaning staff, phlebotomists and everyone involved in her care.”
“It was a true team effort, and without that collective dedication, she might not have survived.”
Mr Coonar with Shanti and her two sons
After two months Shanti really started to turn the corner. Finally, after three difficult months she was discharged home. As she left she there were hugs and cheers and even some tears from those who cared for her.
She continues to recover well - a testament to both her resilience and the tireless work of our amazing NHS staff at Royal Papworth Hospital and our neighbours at Addenbrookes.