“I call Nancy our miracle patient,” says oncologist Dr. Armen Asik in the Baystate Regional Cancer Program.
“She’s one of our very amazing success stories,” adds Dr. Ziad Kutayli, a colorectal surgeon at Baystate Medical Center.
For Nancy Boistelle, it was all about faith. “My faith in God has played such an upfront role in my cancer journey,” she explains, noting she also had faith in her doctors to do right by her because of her faith in God.
TROUBLING SYMPTOMS LEAD TO COLONOSCOPY
“I was home sick with diarrhea for a couple of days, and over-the-counter medications weren’t doing the trick,” shares Boistelle.
She decided to speak with her primary care physician, Dr. Gurpal Kingra, who recommended she get a colonoscopy.
“I found myself having a colonoscopy at Noble Hospital before they became part of Baystate Health. Dr. Heidi Kolek did the procedure. Afterward, I wondered why it was taking her so long to come in to talk to me. It was because she had sent a biopsy out to the laboratory and was waiting for the results. When she told me they had come back positive for cancer, I remember having no reaction to what she was telling me, only asking, ‘How long do I have?’”
HER BAYSTATE CANCER DREAM TEAM
Dr. Kolek sent Boistelle—who lives in Westfield—to Baystate Medical Center where she would soon meet her “dream team” of doctors, starting with Dr. Kutayli.
“Dr. Kutayli ordered many medical tests for me. I had X-rays, blood tests, a CT scan and a PET scan, which can detect cancer in other parts of your body. When the results came back, Dr. Kutayli said to me, ‘Nancy, you have stage 4 metastasized colorectal cancer which has spread to your liver,’” explains Boistelle.
“He told me that he wanted me to see Dr. Francis Cannizzo, a surgical oncologist who was part of the Baystate Regional Cancer Program at the time, along with Dr. Armen Asik,” she says.
“I followed each step as recommended. I had no fear; I just did as was suggested,” she says.
TREATING COLON CANCER
According to the American Cancer Society (ACS), roughly 97,000 new cases of colon cancer are diagnosed each year. Apart from skin cancer, it’s the third most common cancer diagnosed in adults in the United States.
Because Boistelle’s colon cancer had spread to another part of her body, hers was called “metastasized” colorectal cancer.
“Treatment for colon cancer, which can include a combination of surgery, chemotherapy, and radiation, depends on many factors. One main factor is the stage of the cancer,” explains Dr. Asik.
“Nancy’s was stage 4 colon cancer, so surgery alone is not often effective as a cure. Together, we decided to first treat her with chemotherapy to help shrink the tumor,” he says.
Like many cancer patients, Boistelle had a chemotherapy port implanted under her skin, allowing easier access to her blood stream to infuse the chemotherapy drugs.
CHEMOTHERAPY DELIVERS DRAMATIC RESULTS
For Boistelle, chemotherapy was the worst part of her illness. “I was going to the D’Amour Center for Cancer Care every other Friday morning to be infused. The staff in the infusion suites were wonderful with me and all the cancer patients there. But after the first couple of chemotherapy treatments I got very sick,” she says.
After three months of chemo, Dr. Asik ordered another CT scan and the results were more than Boistelle’s doctors could have ever hoped for.
“When I saw Dr. Asik after the test he told me, ‘Nancy, there will be no more chemotherapy for you now. Your tumors are gone,’” says Boistelle about the astonishing results.
A second colonoscopy performed by Dr. Kutayli confirmed the promising results. “What I saw in her colon was only scar tissue where the tumor once was. Nancy’s cancer responded so well to the chemotherapy that the tumors literally melted away,” he says.
“This was really a quite dramatic response to just three months of chemotherapy,” adds Dr. Asik.
Still, she would eventually need surgery. “If just one cancer cell survives in the scar tissue, it could metastasize to other areas of the body. So, we usually prefer to go in and remove the area of the scar tissue to make sure no cancer cells are left behind,” explains Dr. Kutayli.
“I had prepared myself mentally and emotionally that I would come out of the surgery with a colostomy bag. But, even though the lengthy surgery removed 10 inches of my colon, a bag wasn’t needed. Then, when Dr. Cannizzo went to operate on my liver, he stopped because he couldn’t find any tumor remaining,” shares Boistelle.
THE BENEFITS OF COORDINATED CARE
Part of the “amazing” factor of her story is the true multidisciplinary approach to treating her cancer. Experts from two different surgical teams—one for her colon and the other for her liver—an oncologist and pathologist worked together to treat Boistelle.
“Both surgeries were minimally-invasive procedures and, as a result, she was able to leave the hospital within a week. If the two surgeries had been performed open at different times, Nancy would have spent an extra week in the hospital,” explains Dr. Kutayli.
After being discharged from the hospital, Boistelle continued to see Dr. Asik once a month. Follow-up care for cancer patients is especially important. It can help track any changes in a person’s health from a recurrence or spread of the cancer.
“Dr. Asik suggested additional chemotherapy after the surgery. I decided not to, and he was uncomfortable with my decision, which I respect. Part of my hesitation was that due to my slow metabolism, the chemo lingered in my system and made me feel very ill. On the good side, though, it also destroyed my cancer,” says Boistelle.
Her regular follow-up appointments with Dr. Asik resulted in news she didn’t want to hear: The results of a CT scan followed by another PET scan, showed that cancer had returned in her liver.
She started chemotherapy again and exactly one year after her first surgery, she had a second surgery to remove any remaining cancer.
Her team wanted to make sure to kill any tumor cells that couldn’t be found with imaging, and recommended more chemotherapy. This time, Boistelle took the advice of her doctor and followed through with treatment.
PREPARING FOR THE SIDE EFFECTS
“My third round of chemotherapy lasted for six months. Once again, I was very sick. Dr. Asik lowered the dose of chemotherapy from 100 percent to 85 percent to make it more tolerable for me. But he told me, ‘Nancy, I can’t go any lower or it won’t be effective, please try to get through it,’” explains Boistelle. “I was unhappy, but I did it. It was like having an extremely severe case of the flu for months.”
She credits nurse practitioner Helen James in the Baystate Regional Cancer Program for preparing her for what could lie ahead during her chemotherapy regimen.
“Nurse James sat down with me to go over the entire scope of possible side effects, and she gave me a notebook to take home to review. Helen reassured me that she wasn’t doing any of this to scare me, that many of the side effects were rare, but just to let me know that they might happen. And all that could happen did.”
In addition to the nausea, vomiting, and hair loss, Boistelle had sores in her mouth, diarrhea, and painful hands from her wrists to finger tips, which were bright red, blistered and peeling.
“As these different side effects would emerge, I would call nurse James or one of Dr. Asik’s assistants would help me, by sharing how to get some relief from the symptoms. Thank God for these special people who do special work for all in need,” Boistelle says.
WORLD-CLASS CARE IN YOUR BACKYARD
“My faith in God strengthened me to continue on without fear or worry, knowing my doctors were in good hands as well. There was never a time that I doubted anything they said or any treatment prescribed. It was as though all of the questions and worry had been removed. I thank God for all of this and the doctors and caregivers he sent my way.”
Now, five and a half years after her second cancer, Boistelle remains cancer free. She’s keeping busy and thanking God for a second, no third, lease on life.
She says that she wants, "others to know that we have our own world-class cancer institute right in our own backyard with the best oncologists, surgeons, and other staff—and it’s the Baystate Regional Cancer Program.”
“I’ll tell you, ‘there but for the Grace of God go I’ has a whole new meaning today.”