Miracle cancer patient gets third lease on life
“I call Nancy our miracle patient,” said oncologist Dr. Armen Asik in the Baystate Regional Cancer Program.
“She’s one of our very amazing success stories,” added Dr. Ziad Kutayli, a colorectal surgeon at Baystate Medical Center.
But for patient Nancy Boistelle, it was all about faith.
“My faith in God has played such an upfront role in my cancer journey,” said Boistelle, noting she also had faith in her doctors to do right by her because of her faith in God.
A more emotional person
Now a more emotional person, Boistelle explained that “chemotherapy rearranged my whole being,” as she broke into tears while beginning to tell her story.
“When something upsets me, my digestive system often gets out of balance. I had an episode at work that upset me, and I ended up having diarrhea, which was normal for me. But, this time over-the-counter medications weren’t doing the trick and I was home sick for a couple of days,” said Boistelle, who decided to call her primary care physician, Dr. Gurpal Kingra, who promptly ordered a colonoscopy to learn what was going on.
“So, on one February day, I found myself having a colonoscopy at Noble Hospital before they became part of Baystate Health. Dr. Heidi Kolek did the procedure and afterwards 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, which came back positive for cancer. I remember having no reaction to what she was telling me, only asking, ‘How long do I have?’” she added.
Dr. Kolek sent Boistelle – formerly of Russell and who now lives in Westfield – to Baystate Medical Center where she would soon meet her “dream team” of doctors beginning with Dr. Kutayli.
The news wasn't good
“Dr. Kutayli ordered a myriad of 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 all the results came back, Dr. Kutayli said to me, ‘Nancy, you have stage 4 metastasized colorectal cancer which has spread to your liver,’” said 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, one of the program’s oncologists, who he said was the ‘best in the business’ when it comes to chemotherapy. I followed each step as recommended. I had no fear….just did as was suggested,” she added.
According to the American Cancer Society (ACS), excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both women and men in the United States. It is estimated that in 2016 there will be some 95,270 new cases of colon cancer. Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States.
Cancer that originates elsewhere in the body and spreads to the liver is referred to as liver metastasis. It most commonly results from other cancers such as Nancy’s colon cancer, but also from lung cancer, renal cancer, ovarian cancer and prostate cancer.
Cancer stage determines treatment
“Treatment for colon cancer, which can include a combination of surgery, chemotherapy, and radiation, depends on many factors, chief of which is the stage of the cancer,” said Dr. Asik.
“Because Nancy’s was stage IV colon cancer, for which surgery is often unlikely to result in a cure, it was decided to first treat her with chemotherapy to shrink the tumor,” he added.
Like many cancer patients, Boistelle had a chemotherapy port implanted under her skin, allowing easy access to her blood stream to infuse the chemotherapy drugs.
She said the chemotherapy regimen she underwent 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, and after the first couple of chemotherapy treatments I got very sick,” said Boistelle. She noted that staff in the infusion suites “were wonderful with me and all the cancer patients there,” where she received anti-nausea drugs to offset the side effects from her chemotherapy.
The results were incredible
After three months of chemotherapy, Dr. Asik ordered another CT scan and the results were more than her doctors could have ever hoped for.
“When I saw Dr. Asik afterwards he told me, ‘Nancy, there will be no more chemotherapy for you now. Your tumors are gone,’” said 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 remaining where the tumor once was, and what was amazing was the fact that Nancy’s cancer responded so well to the chemotherapy with the tumors literally melting away,” he said.
“This was really quite a dramatic response to just three months of chemotherapy,” added Dr. Asik.
"I want others to know that we have our own Dana Farber Cancer Institute right in our own backyard with the best oncologists, surgeons, and other staff – and it’s the Baystate Regional Cancer Program.”
Trust in God
“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,” said Boistelle.
Still she would 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,” said Dr. Kutayli.
“I had prepared myself mentally and emotionally that I would come out of the surgery that September with a (colostomy) bag. But, even though the lengthy surgery resulted in taking out 10 inches of my colon, a bag wasn’t needed. Then when Dr. Cannizzo came in to operate on my liver, he had to stop because he couldn’t find any tumor remaining,” said Boistelle.
The amazing factor
Part of the “amazing” factor of Nancy’s story is the true multidisciplinary approach to addressing her cancer – two different surgical teams, one for her colon and the other for her liver, an oncologist and pathologist.
“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,” said Dr. Kutayli.
After being discharged from the hospital, Boistelle continued to see Dr. Asik once a month. Follow-up care is important to identify any changes in a cancer patient’s health from a recurrence or spread of the cancer to early detection of other types of cancer.
“Dr. Asik wanted me to undergo additional chemotherapy after the surgery. I decided not to, and he was uncomfortable with my decision, but respected it. Part of the problem was that the chemo, because of my slow metabolism, should have worked its way through my body faster, but lingered and caused me so much nausea, although on the good side it did obliterate my cancer,” said Boistelle.
The cancer returns
Unfortunately, or fortunately as some might say, her constant 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 her cancer had returned in her liver.
“I didn’t feel any pain or discomfort and was surprised to hear of the recurrence. I just did what I was told, again, strengthened by my faith. I wasn’t afraid. So, back to chemotherapy I went for about 4-5 treatments before another CT scan showed that the tumor had once again disappeared,” said Boistelle, who, like before, would still need surgery.
“It was quite a coincidence that exactly one year later in September of 2011 that I found myself having the second surgery. When I came out of surgery, Dr. Cannizzo, who has a great sense of humor that I appreciated, told me he had good news and bad news. ‘Nancy, the cancer is gone, there is nothing I can find except dead scar tissue, which I removed. The bad news is that we just can’t leave it like that, so you will need to have another round of chemotherapy,” she added.
According to Dr. Asik, they did not find any tumor during the surgery, but “wanted to make sure to kill all the tumor cells which were not detectable by imaging.”
Not wanting her cancer to return again, this time Boistelle took the advice of her doctor and followed through with the chemotherapy.
A return to chemotherapy
“So, my third round of chemotherapy, which lasted for six months, began and once again I was very sick. Dr. Asik agreed to lower 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,’” said Boistelle.
“I was unhappy, but did it. And, on Dec. 23, I got the best Christmas present I could have ever asked for – I finished my chemotherapy. I couldn’t eat, but I could sit up and take nourishment as the old saying goes. I had the chemotherapy given to me every other week, and it was like having an extremely severe case of the flu for months,” she added.
Boistelle said she still suffers the lingering effects of the chemotherapy from partial loss of taste, 90% of which has returned, and partial hair loss which has grown back, “but not as coarse and thick as it once was.”
She credits nurse practitioner Helen James in the Baystate Regional Cancer Program for preparing her for what could lie ahead during her chemotherapy regimen.
Chemotherapy side effects
“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,” said Boistelle.
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 all of the time.
“As these different side effects would emerge, I would call Nurse James or one of Dr. Asik’s assistants would help me, by telling me what to do and how to get some relief from the symptoms. Thank God for these special people who do special work for all in need without regard for themselves or the long hours they work,” said Boistelle.
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.
New lease on life
Boistelle, now 68, single, happily retired and living in a condo where she has many friends, attends Sunday Mass at St. Mary’s Church in Westfield and volunteers one day a week at the Parish Center during the school year. While there she does some clerical work, belongs to the Reaching Hands Club and sends out cards for bereavement, baptisms, birthdays, and more, and is a member of the Confraternity of the Most Holy Rosary, which meets monthly.
“I used to be a lector at my church when I lived in Russell. But, I can’t do it today at St. Mary’s because I have stage fright now. It’s just another unpleasant effect that I attribute to the chemotherapy, I can’t face crowds,” said Boistelle.
Reflecting on her two health scares, Boistelle said her faith in God, combined with the support and assistance of friends and family, helped her through the long ordeal.
“I was never afraid, never had any doubts or fear of what lay ahead for me. I thank God for all of this and the doctors and caregivers he sent my way. I’ll tell you, ‘there but for the Grace of God go I’ has a whole new meaning. I want others to know that we have our own Dana Farber Cancer Institute right in our own backyard with the best oncologists, surgeons, and other staff – and it’s the Baystate Regional Cancer Program,” she said.