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Two tumors, two cancers, and two surgeries – all at once

Complex surgery at Baystate Medical Center saved Albert Pignatelli's life.

Category: Surgery , Cancer

Albert Pignatelli was enjoying his active lifestyle in Lenox, Massachusetts. The 66-year-old was busy with his painting contracting business, and played tennis every day.

Albert PignatelliThe change in his health was sudden. He told his wife Maryellen that he was feeling extremely ill, and they went to Berkshire Medical Center in Pittsfield. Tests showed that Albert had two large tumors, one in his small intestine and the other in his colon. He was bleeding in his gastrointestinal (digestive) tract. His doctors sent him immediately to receive life-saving care at Baystate Medical Center in Springfield.

Exceptional Surgical Care

“When Albert was admitted he needed immediate surgery,” recalls Dr. Nicolas Jabbour, chair of the department of surgery at Baystate Medical Center. “His case was complex because there were two tumors representing two separate cancers, in two different areas, and they were bleeding.”

Doctors needed a plan to surgically treat both tumors. Dr. Jabbour would do a Whipple procedure (a complex procedure to remove the tumor from the small intestine and reconnect organs to allow Albert to digest food normally) and Dr. Ziad Kutayli, colorectal surgeon, would perform bowel surgery to remove the tumor from the colon and complete a colon resection with a temporary ileostomy (a surgical opening in the abdominal wall to release stool). “We did both of these major surgeries, at the same time,” says Dr. Kutayli.

Specialized Teamwork

Due to the bleeding Albert was experiencing prior to surgery and the complexity of the operation, caregivers needed to prepare for every contingency and critical team members needed to be mobilized.

“We are one of the few local hospitals who have the specialists in-house to orchestrate this complex care,” says Dr. Jabbour. Albert’s care team included specialists in cancer surgery, colon and rectal surgery, gastroenterology, pathology to study the tumors, radiology to provide a map of all the major blood vessels around the tumors, and anesthesia to safely manage Albert’s breathing and heart rate during his nine hour surgery.

Recovering after surgery

After surgery, Albert relied on specialized nurses to care for his ileostomy. Dedicated enterostomal therapy nurses (an RN with specialized training in treating patients with ostomies) were there to teach him how to care for it. Albert was able to start his chemotherapy quickly after the operation, allowing for the best outcome. He received chemotherapy and care under the direction of medical oncologist Dr. Armen Asik from the Baystate Regional Cancer Program at the D’Amour Center for Cancer Care, in order to increase his chances of a cure. After his course of treatment, he returned to Baystate Medical Center for his final procedure to close the ileostomy.

Lynch Syndrome

 

“Because of the number of tumors and where they were located, we asked Albert about his family history of cancer,” says Dr. Kutayli.

Genetic tests conducted in the Pathology department at Baystate Medical Center confirmed that Albert has Lynch syndrome, a genetic predisposition causing a higher risk of certain types of cancer.

“With this identified, his family can now have genetic testing so they would know if they had Lynch syndrome and needed proactive, preventive testing to catch and treat cancers at their earliest stage,” says Dr. Kutayli. Albert will continue to follow-up with his doctors for screening of Lynch related cancers.

"They saved my life"

Albert Pignatelli

Albert’s surgery was successful. Doctors determined that there were no cancer cells in the margins, which meant no cancer cells at the outer edge of the tissue removed. They expect him to return to his quality of life after recovery, and he will continue to receive preventative testing.

As for the care he received at Baystate Medical Center, Albert says “I couldn’t have gotten better care. They saved my life. Dr. Jabbour, Dr. Kutayli, Dr. Asik, the nurses, everyone – they are true experts and they showed such compassion.”

Albert says of Dr. Jabbour, “I think he is a genius. When I came to Baystate for treatment with another provider, he would make sure he saw me when I was here. He calmed me with his demeanor. He told me step by step what was going to happen and how I was going to feel and that was reassuring.”

“Our care of Albert highlights our expertise in handling complex medical cases,” says Dr. Kutayli. “One of our strengths at Baystate is the comprehensive multidisciplinary care we provide. We have a whole system in place for communication among surgeons, pathologists, oncologists, and radiologists, and we are able to deliver this high level of care every day to people who need it in our community.”