When David’s voice got hoarse, he didn’t think too much of it – he coaches softball so a hoarse voice isn’t that unusual.
But when his voice didn’t come back, it led David to the diagnosis of not one but two complex medical issues – and the multidisciplinary team of physicians who could help him with both.
David’s doctor referred him to Bevan Yueh, MD, an ear, nose and throat (ENT) specialist with University of Minnesota Physicians and chair of the Medical School’s Department of Otolaryngology. Dr. Yueh diagnosed throat cancer and ordered a biopsy and PET scan. At the first meeting with David and his wife Susan, Dr. Yueh’s confidence was a comfort.
“He told us, ‘We will cure it,’” said David, who was also impressed with the way Dr. Yueh’s staff coordinated his care. “I never had to call to make an appointment. They handled everything from the first day I walked into the office.”
And there was a lot to handle.
Scan reveals more than expected
During his biopsy, ENT specialist Stephanie Misono, MD, used a laser to reduce the size of the mass along David’s airway that had been obstructing his breathing. This brought him some immediate relief.
“Before that, when I was talking to someone I’d have to suck in a breath after every few words,” David recalled.
Then the PET scan brought both good news and bad news. The cancer hadn’t spread, but the scan revealed an abdominal aortic aneurysm, an enlarged area in the major blood vessel that runs from the heart through the chest and abdomen. A ruptured abdominal aortic aneurysm can cause life-threatening bleeding. These aneurysms often grow slowly and without any symptoms, making them difficult to detect, so it was lucky for David that the scan found it before it ruptured.
The multidisciplinary team involved in David’s care now grew to include vascular surgeon William Payne, MD. The team met to discuss which condition to treat first, the cancer or the aneurysm, and decided that fixing the aneurysm first was the best strategy for addressing both conditions effectively. Dr. Payne performed surgery the next day to repair it.
After a brief recovery period, David began cancer treatment, going in five days a week for seven weeks for radiation and getting chemotherapy every three to four weeks. Oncologist Naomi Fujioka, MD,radiation oncologist Margaret Reynolds, MD, and Tanya Watson, NP, worked together to coordinate David’s care and manage his side effects from treatment.
“I never got sick, never lost my hair,” said David. He’d had a feeding tube implanted in case he was too ill to eat, but was glad he never had to use it.
But shortly after his treatment ended, just when most people are starting to recover, David developed another complication: necrotizing pneumonia. Dr. Fujioka explains that it can be hard to control secretions after chemo and radiation, so David was likely aspirating fluids into his lung, which caused the pneumonia. He was hospitalized for a week with a constant IV drip of antibiotics.
A couple of months later, a routine PET scan raised some new concerns about his throat.
Dr. Misono used the laser again to perform extensive biopsies in the area. Fortunately, the results revealed that it wasn’t a recurrence of the cancer but a fungal infection – which can be an after-effect of radiation – and swelling and inflammation that can also be common after cancer treatment.
Now, that he’s completed treatment, a summer sunrise might find David and Susan at their lake home. During his treatment, his kids had his pontoon boat refurbished as a surprise. David and Susan enjoy spending time with their kids and grandkids and taking the boat out for some fishing.
Full recovery will take time and David still has some pain in his throat; he has to remember to take pain medication before meals to make it possible to swallow. But, as with the life-threatening conditions that brought him to the University of Minnesota, he’s taking this in stride.
“Attitude makes a big difference in recovery,” Dr. Fujioka says, “and David’s is amazing.”