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Edwin Palasek was sanding the hardwood floors of his Weymouth home when he began to experience pain in his sides.
“I figured I’d pulled a muscle,” the active 64-year-old man recalled. But to his astonishment, an X-ray showed a large mass on his kidney, and further scans showed cancer in his back and lungs. “The news hit me like a sledge hammer.”
Hopelessness waned when Palasek became a patient of the Dana-Farber/Brigham and Women’s Cancer Center’s new kidney cancer clinic, which opened in May to provide multidisciplinary care for a cancer that, until recently, had very few effective treatments once it spread beyond the kidney.
Clinic co-directors Jerome Richie, MD, chief of Urology at BWH, and Toni Choueiri, MD, who joined the DF/BWCC from the Cleveland Clinic this spring, see new patients together for the first visit to provide both a surgical and medical perspective.
Both doctors say the multidisciplinary nature of the clinic—surgeons, radiologists, medical oncologists and other specialists working together—offers patients the best possible care for a difficult cancer that in many cases is not diagnosed until it has spread.
“You often find it when you’re looking for something else,” said Richie, one of few surgeons with the expertise to extract a tumor from the kidney, sparing a good portion of this small organ.
In addition to kidney-sparing surgeries and research studies, the new clinic, which is part of the DF/BWCC Genitourinary Cancer Treatment Center, features precise diagnosis of the many sub-types of kidney cancer in order to find the most effective approach for each patient and innovative radiotherapy to freeze cancer cells under CT/MRI guidance.
The care Palasek received at the clinic has set him on the road to recovery. He met with Richie and Choueiri, who decided to treat his back tumor first in order to preserve his active lifestyle. BWH orthopedic surgeon Mitchel Harris, MD, removed the thoracic vertebrae where the tumor rested, replacing it with a titanium implant and fusing it to the adjoining bones. “I felt better right away,” Palasek said.
Then, he qualified for a clinical trial testing a combination of Sutent and a standard chemotherapy drug, Gemcitabine. Palasek and other patients receive guidance on safety and managing side effects from Laurie Appleby, NP, APRN.
After nine weeks of this experimental treatment, Palasek and his family are pleased with the results. The tumors in his lungs are almost gone, and the kidney tumor is about 40 percent smaller.