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Truck driver James Gary is no stranger to sitting for long stretches on the road. When he started experiencing abdominal pain and noticed abnormal bowel movements, including blood in his stool, the 44-year-old Auburn, Pa., resident chalked it up to hemorrhoids or irritable bowel syndrome related to his extended time at the wheel.
By August 2017, the pain was so bad his fiancée urged him to see a doctor, who immediately scheduled a colonoscopy. “My fiancée looked terrified when they wheeled me out after only five minutes, and no one would look at her,” Gary says. “Turns out I had a colon tumor so big they couldn’t get the scope by it.”
The couple was devastated, and not just by Gary’s bad health news – they were in the middle of planning their wedding just six months away. In a flash, they’d gone from dreaming about their future together to wondering how much future they actually had. Even in the face of an intensive treatment plan, they bravely vowed to push on.
Team action
In October 2017, Gary was referred to colon and rectal surgeon Mikhail Rakhmanine, MD, with Lehigh Valley Topper Cancer Institute, to remove his colon tumor. But bad news got worse: during his pre-surgical workup, an MRI showed multiple metastatic tumors in both lobes of his liver. Gary’s cancer was officially stage 4.
Rakhmanine put surgery on hold and contacted his Cancer Institute colleagues, hematologist oncologist Maged Khalil, MD, and surgical oncologist Jeffrey Brodsky, MD, to devise a coordinated care plan. “Cancer treatment these days is a group approach,” Rakhmanine says. “We have an excellent tumor board where all the doctors work together to come up with the best plan for each patient.”
Gary’s plan began with three months of chemotherapy (six cycles) at Lehigh Valley Topper Cancer Institute in hopes of shrinking the tumors enough for surgery. “He tolerated chemotherapy exceptionally well,” Khalil says. “When we repeated his scans in January 2018, they showed the tumors had responded, particularly his liver tumors – only three remained on the right side. At that point, surgery became a real option.”
Surgical success
Gary underwent surgery with Brodsky the following month to remove the entire right lobe of his liver. “Some patients are candidates to do both liver and colon surgery at the same time,” Brodsky says. “But because of the amount of liver we needed to remove, the team didn’t think it was a good idea. We decided to get the metastatic disease out first.”
By March, Gary had regained enough strength to say “I do” as planned. However, the couple reluctantly agreed to skip their honeymoon so he could undergo six more rounds of chemotherapy. In June, Rakhmanine removed his colon tumor.
Culture of caring
Today, nearly two years since his first surgery, Gary’s scans continue to show no evidence of cancer. He’s back on the road again for work and is beyond grateful for his medical team’s skill, as well as the compassion shown by oncology nurse Mary Cay Altmiller, RN, and nurse practitioner Kristen Wismer, CRNP.
“Everyone at Lehigh Valley Health Network was wonderful,” he says. “My nurse practitioners continued to check in to see how I was feeling. We felt like friends – always welcome. It was an amazing experience.”
Best of all, the couple finally got to enjoy the honeymoon of their dreams in early 2019 – a weeklong whirlwind adventure in Florida, courtesy of an organization called For Pete’s Sake that provides free vacations for cancer patients.