With the many advances in cancer treatment, today’s cancer patients have more and more reasons for hope. Portraits of Hope are the incredible stories of our patients and their journeys of hope and survival. Click on a thumbnail and scroll down to view each story.
Cancer Specialist Offer Collective Opinions on Treatment
When faced with a diagnosis of cancer, it is not unusual for a patient to consider a second opinion. Patients want reassurance that they are going to receive the highest level of treatment available. At the McLeod Center for Cancer Treatment and Research, patients receive a second, third, fourth and fifth opinion on their treatment plan from the Tumor Board, whose mission is to provide patients not only with peace of mind but also the best cancer treatment plan possible for each specific diagnosis.
Each week at McLeod, physicians representing Medical Oncology, Pathology, Radiation Oncology, Radiology, and Surgery, discuss every cancer patient’s case presented to one of four McLeod Tumor Boards. Together, they recommend the best treatment plans for patients with breast cancer, lung cancer, brain and spine cancer as well as any other cancer presented to the board. Other specialists who offer expertise in their specialty area may include Cardiothoracic Surgery, Pulmonology, Neurosurgery and Physics.
During each McLeod Tumor Board meeting, these groups of physicians review the pertinent imaging scans and diagnostic studies, as well as the pathology, and receive a presentation of the patient’s case, including their history of physical findings.
The board’s recommendations are then provided to the patient’s physician to support his or her plans for treatment. The patient and the physician make the final decision regarding the plan of care based on the information and suggestions from at least five other physician consults on the case from the McLeod Tumor Board.
Diagnosed with an aggressive breast cancer at 43 years old, Tonya Howell believes in the importance of this team approach to cancer care. “Breast cancer is not a ‘fit in the box’ type of treatment. You can’t treat every woman diagnosed with breast cancer the same way. Each person’s cancer requires a specific plan for treatment based on many factors. Knowing my cancer case has been discussed by many different specialists before starting treatment gave me confidence that I was in the right hands.”
In Tonya’s case, her oncologist, Dr. Rajesh Bajaj, explained that the detection of an enlarged lymph node on an MRI resulted in some back and forth discussion about whether the node was positive. The team reviewed every facet of Tonya’s cancer, taking into consideration her age, the size of the tumor and the aggressiveness of the cancer. Ultimately, the physicians agreed that regardless of whether the node was positive, Tonya’s treatment plan should include chemotherapy, surgery and radiation.
Dr. T. Rhett Spencer, Coordinator of the McLeod Tumor Boards, explains, “I find the communication in this area between the surgeons, medical oncologists and radiation oncologists to be the best of any location I have ever noted. Rarely does a day go by that we are not in contact with medical oncologists and visa versa. This close communication greatly benefits the patient in the management of their disease.”
Lung cancer patients also benefit from the expertise of cardiothoracic surgeons and those physicians in medical and radiation oncology, pulmonary, radiology and pathology who discuss their cases. These physicians evaluate the patient’s diagnosis and determine the safest, most efficient way to treat the lesion whether that encompasses conventional or robotic surgery, the use of chemotherapy, and traditional radiation versus stereotactic body radiotherapy.
“We also have a separate tumor board meeting every other Thursday morning dedicated to our neuro-oncology cases,” said Dr. Spencer. “During this meeting, we work with the neurosurgeons and physicists to come up with the best plan for each patient. This allows us to evaluate a patient’s tumor to see if they are a candidate for stereotactic radiosurgery, if chemotherapy is indicated or whether we need additional pathology before making a decision on exactly how to treat the cancer.
“The McLeod Tumor Board is especially important in the more challenging and unusual cases. Using this approach, we bring together specialists who are experts in their field to collaborate and reach a unified decision on the best plan of care for the patient. Our patients remain at the center of what we do, and this team mindset gives us an opportunity to deliver the most advanced, effective treatment available to patients diagnosed with cancer,” added Dr. Spencer.
Two days after Christmas in 2017, Mike Smalley of Hartsville, South Carolina suddenly felt ill at work. Brushing off his symptoms as a stomach virus or dehydration, Mike continued working but then began sweating and felt pain creeping up his arm. Keenly aware of heart disease because of his family history, Mike quickly realized he may be experiencing a heart attack and asked a co-worker to call 911.
In addition to his family history, 54-year-old Mike smoked for 40 years. In fact, that morning, he purchased a new lighter and a pack of cigarettes. When Mike arrived at McLeod Regional Medical Center, he told the paramedics, “Throw these away for me,” as they transported him inside the Emergency Department (ED).
In the ED, McLeod Cardiologist Dr. Thomas Stoughton confirmed Mike was suffering a heart attack based on the EKG results. They quickly moved him to the Cardiac Catheterization Lab where McLeod Interventional Cardiologist Dr. Fred Krainin performed a heart catheterization. Dr. Krainin located a 100 percent blockage on the left side of Mike’s heart that required two stents in order to keep the narrowed area open and allow blood to flow again.
Following a diagnosis of heart disease, patients like Mike receive blood thinning treatment for at least 12 months to prevent blood clots. Plavix, a blood thinning medication, helps blood flow more easily and reduces the risk of a heart attack or stroke. The medication works by preventing platelets from sticking together and forming clots.
“During my recovery in the hospital after the heart catheterization procedure, Dr. Stoughton ordered a chest scan,” Mike said. “He explained to me that the scan indicated a mass on my lung which could be cancer. I was devastated, knowing I brought it on myself by smoking.”
Dr. Stoughton referred Mike to McLeod Pulmonologist Dr. Vinod Jona. After completing a bronchoscopy to biopsy the mass in Mike’s lung, Dr. Jona shared the pathology results with Mike: lung cancer.
Mike required surgery to remove the mass; however, he hesitated stopping the Plavix to undergo surgery because the medicine increases the risk of bleeding during and after surgery. He also understood that continuing the medication decreased his risk of having another heart attack or even death. Studies have shown that patients benefit most from Plavix during the first three to six months.
Mike waited a few months and then returned to Dr. Jona to discuss a treatment plan for the lung cancer. Dr. Jona suggested that Mike meet with Dr. Wayne Holley, McLeod Thoracic Surgeon, and review his surgical options. Dr. Holley joined McLeod Regional Medical Center in December 2017, sharing his expertise in the specialty of robotic thoracic surgery.
After reviewing Mike’s scans and conducting a physical exam, Dr. Holley conferred with Dr. Stoughton who agreed to allow Mike to come off the Plavix for five days for Dr. Holley to operate. In June 2018, Dr. Holley performed a robotic video-assisted thoracoscopic surgery removing the right lower lobe of Mike’s lung and dissecting three lymph nodes.
Thoracic robotic-assisted surgery, a form of minimally invasive surgery, allows the surgeon to reach the lungs without spreading the ribs. “This form of surgery offers better visualization and more precision with smaller incisions,” explained Dr. Holley.
Minimally invasive thoracic surgery also produces better outcomes, results in less pain, better staging of lung cancer, fewer post-operative complications and a two-day hospitalization as opposed to eight to ten days, according to Dr. Holley.
Following surgery, Mike resumed taking Plavix and waited anxiously for Dr. Holley to clear him to return to work. When Mike returned for his follow-up appointment, Dr. Holley explained to him the lung cancer had spread to two lymph nodes. The metastasis of the cancer to the lymph nodes would require Mike to undergo chemotherapy and radiation treatment. As the appointment ended, Mike recalls that Dr. Holley turned to leave, then suddenly came back and gave him a hug. “He said to me, ‘Everything is going to be alright.’
“Words cannot express my deep appreciation for Dr. Holley. He is not only the best doctor, but also a great man.”
With no health insurance, Mike worried how he would afford cancer treatment. Fortunately, Dr. Holley recommended the McLeod Cancer Clinic for Mike’s care.
“When needed I refer patients to the McLeod Cancer Clinic,” explained Dr. Holley. “I feel that McLeod is simply fulfilling its mission in the region to serve patients, regardless of their ability to pay. This commitment distinguishes our hospital from other facilities.”
The McLeod Cancer Clinic provides cancer services, including chemotherapy and radiation therapy, on an outpatient basis to cancer patients from Florence, Darlington, Dillon, Marion, Marlboro and Chesterfield Counties who have no insurance coverage.
In order to receive care in the McLeod Cancer Clinic, a physician must refer the patient with documentation of a cancer diagnosis confirmed by a biopsy. Patients should meet certain income criteria. The six medical oncologists affiliated with McLeod Regional Medical Center care for patients in the clinic on a monthly basis.
Nearly a year after his heart attack, Mike completed his final chemotherapy treatment on December 3, 2018. Continuing his journey from heart disease to cancer, Mike reports he has made some positive lifestyle changes.
“Fear serves as a good motivator when you want to get well,” explained Mike. “I have not touched a cigarette in a year. Because of the time and effort the McLeod teams gave to heal me, I would never do anything to jeopardize what they have done.”
During Mike’s cancer treatment, he bonded with McLeod Oncologist Dr. Sreenivas Rao; Tara Pierce, McLeod Cancer Clinic Coordinator; McLeod Radiation Oncologist Dr. Virginia Clyburn-Ipock; Dr. Jona and Dr. Holley.
“They supported me through all of it,” said Mike. “The Cancer Center staff are a testament as to why McLeod is a top notch hospital. The doctors and nurses have gone above and beyond to make sure I receive the best care; they truly saved my life.”
Duane Adams of Sumter, South Carolina says he travels to McLeod Regional Medical Center in Florence because “it is the only place I will go for care.” He also tells family and friends “if you want to live, you better go to McLeod.”
Extremely familiar with the excellent care delivered by the teams at McLeod, Duane’s medical services have included the specialties of spine surgery, pulmonology, thoracic surgery, oncology, neurosurgery and stereotactic radiosurgery.
A smoker all his life, 63-year-old Duane said he suffered for months with colds, sinus infections and a nagging cough that would not go away. In early 2016, Duane’s primary care physician referred him to McLeod Pulmonologist Dr. Vinod Jona for the cough.
After reviewing Duane’s CT scan which indicated a mass in his lung, Dr. Jona performed a fiber-optic bronchoscopy to biopsy cells from the mass. The bronchoscopy procedure allows Dr. Jona to visually exam the breathing passages of the lungs and obtain samples of tissue.
The analysis of the biopsy revealed lung cancer. Dr. Jona shared the diagnosis with Duane and explained that he was a candidate for surgery.
Dr. Jona followed up with an appointment for Duane with McLeod Cardiothoracic Surgeon Dr. Car y Huber.
Dr. Huber conducted a lobectomy, removing a lobe of Duane’s lung. Once he recovered from surgery, Duane met with McLeod Oncologist Dr. Rajesh Bajaj to discuss his cancer treatment. The plan involved 19 rounds of chemotherapy and 35 radiation treatments.
“Everyone responsible for my care -- from the physicians to the nurses -- was outstanding. I wanted the best hospital and cancer team and that is what I received at McLeod,” explained Duane.
Two years after completing his cancer treatment, Duane developed severe headaches. He communicated his issues with Dr. Bajaj who ordered a PET (Positron Emission Tomography) scan to detect if the cancer had returned.
The scan revealed the lung cancer had metastasized to Duane’s brain. Dr. Bajaj referred Duane to Neurosurgeon Dr. William Naso with the Florence Neurosurgery and Spine Center.
Using intraoperative neuronavigation, Dr. Naso performed a craniotomy to remove a portion of bone then under a microscope resected a one inch tumor in Duane’s brain, sparing normal brain structures. To ensure the destruction of the residual cancer cells, Duane returned to McLeod Radiation Oncology for treatment of the surgical area as well as two other small brain lesions.
“The thought of enduring radiation again was not something I wanted to do,” said Duane. “But, Radiation Oncologist Dr. Larry Grubb explained stereotactic radiosurgery (SRS) to me and it sounded much easier and required fewer treatments.”
During stereotactic radiosurgery, the team targets tumors with great precision and accuracy to deliver an ablative dose of radiation, overwhelming all of the abilities of a cancer cell to defend itself.
“We focus the radiation onto the area of disease to completely cover it with the dose necessary to ablate the met,” explains McLeod Chief Medical Physicist Tobin Hyman, MS, DABR.
“This non-invasive, painless treatment utilizes a set of multiple beams that intersect at a single point on the tumor. The beams remain focused on the area as the linear accelerator rotates around the patient’s head.”
Advantages of SRS for patients like Duane include the ability to receive treatment close to home. “A cancer diagnosis is a life changing event for all of our patients,” says Dr. T. Rhett Spencer, McLeod Radiation Oncologist. “Some of these patients are also living with advanced disease. The decision by McLeod to invest in the technology to plan and accurately deliver these types of cancer treatments means patients do not have to leave home to receive the highest level of care.
“At this point in their cancer journey, patients often want to reach certain milestones. They wish to spend quality time with their family and friends. We make that possible by offering these cutting-edge cancer treatment options.”
With a fewer number of treatments, SRS benefits patients by saving them time. Compared to conventional radiation therapy which involves smaller daily doses of radiation in 25 to 35 treatments over five to seven weeks, SRS delivers five to ten times the daily dose of radiation in one to five days of treatment. The increased dose improves the effectiveness of this form of treatment.
The most common use of stereotactic radiosurgery involves the treatment of metastatic disease inside the brain. Metastatic disease occurs when the cancer cells break away from where they were first formed, travel through blood or the lymph system, and form new tumors (mets) in other parts of the body such as the brain. The met is the same type of cancer (i.e., lung or breast) but in an area away from the location of the primary disease. Mets develop in the brain, lung, spine and liver.
In early 2019, Duane learned the cancer had returned in his lung. This time, the radiation team used stereotactic ablative radiotherapy (SABR) to treat these mets.
Unlike SRS, which specifically treats tumors in the brain and spine, SABR treats tumors in the body.
In addition to metastatic disease, the team treats primary cancers such as small lesions in the lung, adrenal gland, prostate and liver using stereotactic ablative radiotherapy. For example, they can treat a non-small cell lung cancer measuring five to seven centimeters. SABR also provides a potential curative treatment option for patients with early stage lung cancer who may not be candidates for surgery because of other medical conditions, such as heart disease.
A few months after his SABR treatment, Duane required stereotactic radiosurgery to obliterate two additional mets in his brain. “I slept during the procedure,” said Duane. “In one short treatment, they targeted those two areas and I was on my way back home.”
Although he is living with metastatic cancer, Duane says, “I feel better than ever. My cancer treatments over the last three years have been successful and allowed me to continue enjoying each day. I look forward to spending more time with my wife Beatrice and our family and friends thanks to God and my medical team at McLeod.”
The Honorable Harry McDowell, a Loris real estate proprietor and retired judge of
Horry County, never thought brushing his teeth would lead to a diagnosis of cancer.
“It’s a funny story,” said Judge McDowell. “My dentist recommended for me to start using an electric toothbrush and one morning two of the bristles fell out as I brushed my teeth.”
One of the bristles fell into the sink and the other was nowhere to be found. Judge McDowell believed he swallowed the other bristle.
“It felt like I had a fishbone wedged in the back of my throat,” said Judge McDowell. “I did everything I could from eating bread to gargling vinegar in hopes the bristle would become dislodged.”
After a few days of irritation in his throat, Judge McDowell scheduled an appointment with his internal medicine physician, Dr. Jonessa Atienza with McLeod Internal Medicine Seacoast. Dr. Atienza examined him, but found no evidence of the bristle. Concerned for her patient, Dr. Atienza referred Judge McDowell to Otolaryngologist Dr. Sarah Novis with McLeod ENT Seacoast.
“Within the hour, I went upstairs to Dr. Novis’ office,” said Judge McDowell. “The fast coordination of care between the two physician offices impressed me.”
Dr. Novis ran a scope called a flexible laryngoscopy down Judge McDowell’s throat. This type of procedure allowed her to see the areas of his throat that are not visible through the mouth. Dr. Novis detected an abnormal mass at the base of the tongue area which looked concerning as a possible early malignancy. The most common type of malignancy in this area is usually squamous cell carcinoma.
Dr. Novis explained to Judge McDowell that she would need to surgically biopsy this area of his tongue.
“The tissue we biopsied did not show typical evidence of malignancy, so we sent it for further testing,” said Dr. Novis.
The results of the specialized testing indicated Diffuse Large B-Cell Lymphoma, a form of Non-Hodgkin lymphoma. This common type of lymphoma is an aggressive cancer that starts in white blood cells and grows in lymph nodes. Since Diffuse Large B-Cell Lymphoma can spread rapidly, Judge McDowell met with Oncologist Dr. Donny Huynh with McLeod Oncology and Hematology Associates at Seacoast, a department of McLeod Regional Medical Center, to discuss his plan of care.
“Judge McDowell’s cancer was contained to one location,” said Dr. Huynh. “I tailored a shorter course of chemotherapy specifically for him to minimize unwanted toxicity.”
Dr. Huynh prescribed three chemotherapy treatments for Judge McDowell, one cycle every three weeks at McLeod Health Seacoast.
“McLeod Health offers state-of-the-art diagnostic capabilities and cancer treatment options so our patients can receive care close to home surrounded by their support team of family and friends,” said Dr. Huynh.
The Infusion Services team at McLeod Health Seacoast worked closely with Dr. Huynh, the McLeod Pharmacy and other support areas to provide safe and holistic care to Judge McDowell.
“The Infusion Services team provided wonderful care,” said Judge McDowell. “I couldn’t have been treated better if I was a king.”
After completion of his final treatment, Judge McDowell rang the bell in the Infusion Department to signify the hope, courage and strength it takes to walk the cancer journey. The staff’s goal is to not only provide excellent patient care, but also bring hope to patients and their families.
“McLeod is one heck of an operation,” said Judge McDowell. “If I ever need to see a physician or seek medical treatment, I’m returning to McLeod Health Seacoast.”
Dr. Huynh is optimistic that Judge McDowell will make a full recovery. Statistics show the survival rate for localized Non-Hodgkin lymphoma is 75 percent.
The physicians and staff of McLeod Health Seacoast understand the importance of working together as a team to help guide patients to the specialists needed when time is crucial. Thanks to the quick action of his expert physicians, Judge McDowell is now on the road to recovery.
Like many retirees, Richard Ayers of Sumter, South Carolina, maintains a busy schedule – fishing, hunting, volunteering at church, and spending time with his wife, Vickie, and their beagle Bandit.
While working in the yard one day, Richard suddenly spiked a high fever. He sought medical care and received treatment for strep throat. A few weeks later, however, the fever returned and continued to come and go for a few months.
The fever rose again to a frightening 104 to 105 degrees. Alarmed, Richard decided to seek medical attention at the McLeod Health Clarendon Emergency Department located in Manning, South Carolina. Medical tests indicated a blockage in the bile duct, a tube that drains bile from the liver to the intestines.
Richard’s medical team at McLeod Health Clarendon then arranged for his transfer to McLeod Regional Medical Center in Florence for further testing and treatment.
Once there, Dr. Veeral Oza, Gastroenterologist with the McLeod Digestive Health Center, evaluated Richard’s condition and performed an endoscopic ultrasound (EUS), which revealed a pre-cancerous tumor. Given the findings, Dr. Oza prepped Richard for an Endoscopic Retrograde Cholangiopancreatography (ERCP).
“The ERCP procedure helps gastroenterologists treat diseases of the gallbladder, biliary system, pancreas and liver,” explained Dr. Oza. “Using an endoscope, or a long flexible tube with a light and camera at the end, we examine the inside of the digestive system. We also employ contrast dye and X-ray technology which enables us to see the bile duct, pancreatic duct and gallbladder to identify the source of the problem.”
During the ERCP procedure, Dr. Oza inserted a stent into the bile duct to allow the blocked fluids to flow through freely. Richard remained in the hospital for additional testing to determine the severity of his condition. A biopsy of the tumor, performed using the endoscopic ultrasound, confirmed pancreatic cancer.
While at McLeod Regional Medical Center, McLeod Surgeon Dr. John Richey with Pee Dee Surgical Group cared for Richard. A board certified general surgeon, Dr. Richey’s expertise includes advanced training in complex biliary and pancreatic surgery.
Because Richard continued to have a recurrent fever, Dr. Richey ordered a computerized tomography (CT) scan to determine the underlying cause. Results from the scan revealed pancreatitis. Furthermore, Richard also developed an infection in his large intestine that required antibiotics.
“Over the course of a few months, Richard battled numerous medical issues including pneumonia, pancreatitis, colitis, and pancreatic cancer,” said Dr. Richey.
Following successful treatment of these other conditions, Dr. Richey scheduled the Whipple procedure to treat the pancreatic cancer.
“The Whipple procedure is also known as a pancreaticoduodenectomy. It is a technically complex operation to treat tumors of the head of the pancreas, bile duct, and duodenum (first part of the intestine) and complications of chronic pancreatitis,” explained Dr. Richey.
“During a standard Whipple procedure, we remove the head of the pancreas, the top of the small intestine, the gallbladder, the bile duct, and surrounding lymph nodes,” Dr. Richey continued. “We then reconnect the remaining parts of the pancreas, bile duct and stomach to the intestine to allow food to pass through and digest. Most often performed as an open operation, the Whipple procedure requires an incision in the abdomen to allow for access to the pancreas.”
Prior to Dr. Richey joining McLeod Regional Medical Center, patients like Richard required transfer to other regional hospitals for this procedure.
Richard remained in the hospital from December 11, 2017 through the first of January 2018. During his recovery time, Richard lost more than 50 pounds and required both physical therapy and home health care.
Once he returned home, Richard credits his wife for taking care of his incision.
“Without a medical background it was challenging for me to help Richard, but McLeod Home Health provided both of us the assistance we needed at home. Our exceptional nurse and physical therapist helped Richard while also teaching me how to care for him. We valued the time they spent with us. Everything fell into place to get him well again,” said Vickie.
“Since the surgery, many people have told me how lucky I am,” said Richard. “I sincerely appreciate Dr. Richey’s youthful, energetic personality as well as his impressive level of knowledge. During my hospitalization, he stopped by my room every evening before going home to talk with me and see how I was feeling. He spent time explaining everything and answered all my questions. He went above and beyond what I could ever expect from a surgeon.
“My health comes from the Lord,” said Richard. “He brought Dr. Richey into our lives and worked through him to restore my health. If I had to do it all over again I would, as long as I can do it with Dr. Richey.”
Today, nearly one year after the surgery, Richard once again enjoys a busy retirement schedule. And, no one could be more thankful to have him back than Vickie and his beloved companion, Bandit.
Few surgeons change course midway through their illustrious careers to learn advanced, innovative technology. However, McLeod Thoracic Surgeon Dr. Wayne Holley did just that.
After caring for patients for more than 20 years, Dr. Holley called a “time out” in 2013 to learn a more advanced form of minimally-invasive surgery to treat patients with lung cancer and other diseases of the chest. This sabbatical involved a one-year thoracic surgical oncology fellowship at Memorial Sloan Kettering Cancer Center in New York. The oldest of the residents to undergo training in robotic-assisted surgery at 54 years old, Dr. Holley realized he could still keep pace with the younger physicians.
A Board Certified Thoracic Surgeon, Dr. Holley received his degree in medicine from Vanderbilt University School of Medicine in Nashville, Tennessee. He completed a general surgery residency at the University of Tennessee Health Sciences Center in Memphis. Dr. Holley also completed a thoracic surgery residency at the University of Mississippi Medical Center in Jackson, Mississippi.
He began his medical career performing cardiac surgery in Kingsport, Tennessee. He then spent 20 years performing vascular, thoracic and cardiac surgery in Albany, Georgia. After completion of his fellowship in New York, Dr. Holley cared for patients in Savannah, Georgia.
“Today, most of the training programs ask cardiothoracic surgery residents to declare a specialty -- cardiac surgery or thoracic surgery. Thirty years ago, cardiothoracic residency programs expected us to perform both heart and lung surgery,” explained Dr. Holley.
“I also see this reversal of roles in the area of robotic surgery. During their residencies, surgeons now learn about robotic surgery from day one and demonstrate a high level of comfort performing these surgeries by the completion of their residency. However, they demonstrate less confidence performing the type of surgery I originally trained in with large, open incisions.
“I did not undergo training in minimally-invasive surgery because I focused mainly on caring for my patients which left little time to learn the new technology,” explained Dr. Holley. “Yet, stepping away from patient care and completing the surgical oncology fellowship at Sloan Kettering enabled me to refine my skills as a surgeon. That one year made the difference for me.”
Robotic-assisted surgery, a form of minimally-invasive surgery, allows the surgeon to perform many types of complex procedures with more precision, flexibility and control than traditional techniques offer.
During a robotic-assisted surgery, the surgeon operates through a few small incisions, controlling the robot’s every move while seated at a console in the operating room. The surgeon’s hand, wrist and finger movements guide the robot manipulating the surgical instruments inside the patient. In essence, the robot becomes an extension of the surgeon’s hands. The surgeon views the surgical site through a high-definition 3-D camera. This magnified imagery provides enhanced visibility and improved precision for exact treatment and greater dexterity for the surgeon.
Thoracic robotic-assisted surgery also allows the surgeon to reach the lungs without spreading the ribs. “This form of surgery offers better visualization and more precision with smaller incisions,” explained Dr. Holley. “Twenty years ago, I performed this very same operation through large incisions in the chest and the side of the patient.”
Minimally invasive thoracic surgery produces better outcomes, much less pain, better staging of lung cancer, fewer postoperative complications and a two-day hospitalization as opposed to eight to ten days, according to Dr. Holley.
“In industry, that means the patient returns to work within two to four weeks instead of 12 weeks which benefits both the patient and the employer,” he said.
Dr. Holley brought his expertise in robotic thoracic surgery to McLeod Regional Medical Center in December 2017.
“This position has afforded me the opportunity to grow a thoracic surgery program,” said Dr. Holley. “I also discovered that McLeod has a progressive group of robotic surgeons, which I found impressive.”
All McLeod surgeons who offer robotic-assisted surgery as an option for their patients undergo additional specialized training. These surgeons perform robotic-assisted procedures in general surgery, thoracic surgery, gynecology and urology at McLeod Regional Medical Center and McLeod Seacoast.
McLeod now has 14 surgeons trained in robotic-assisted surgery and two da Vinci Robotic Surgical Systems. “As more McLeod Surgeons adopt this technology, the hospital will soon have capacity for a third robot,” said Dr. Holley. Prior to Dr. Holley’s arrival, McLeod Surgeons utilized a third generation robot, the da Vinci Si. The medical center installed the latest version available, a fourth generation robot, da Vinci Xi, in February 2018.
The number of thoracic surgeons performing robotic-assisted surgery in South Carolina remains minimal with three surgeons in Greenville, two in Charleston and one in Spartanburg. “This perfectly situates McLeod to provide this level of care from the Midlands to the Coast so patients do not have to travel to the Upstate or Lowcountry.
“McLeod instills an institutional culture of individual care and concern for patients that I find exemplary,” added Dr. Holley.
“With continued efforts, McLeod Health has potential to become a destination for thoracic oncology care. Our multidisciplinary team consisting of medical and radiation oncology, pulmonary medicine, interventional radiology, pathology and thoracic surgery deliver the best outcomes possible for patients with cancer of the chest.”
Some people live every day in fear of a sudden attack of intense pain shooting up from their jaw and across their face. Often, they turn to a dentist because their symptoms mimic a toothache. They are unaware that the source of their pain is a nerve located millimeters from the brain stem that transmits sensations from the face to the brain and controls the muscles used for chewing.
Debbie Floyd experienced this debilitating pain and the loss of her teeth over a span of nearly 30 years. She finally found relief in the form of a very precise radiation procedure that is typically used to eradicate cancer.
“In my early 20s, I began experiencing severe pain in my jaw and my face,” said Debbie. “I thought it was related to my teeth so I went from dentist to dentist seeking relief. I would undergo root canals, but the pain always remained after each procedure.
“The next course of action included extracting teeth one at a time to determine which tooth was the source of the pain. Eventually, all of my teeth were extracted, replaced with dentures when I was 52, yet I still suffered from excruciating pain.”
A talented music teacher and performer on stage and in church, Debbie said the worst part was how the pain would take over her life. “It caused me to be agitated and irritable. I simply wanted to be left alone when the pain kicked in.
“As a result, I avoided socializing because I never knew when the pain would hit. At school, if the pain occurred while singing with the children I would have to stop and wait for it to subside before we continued.”
Debbie explained that anything could trigger the pain -- eating, talking, a puff of wind, brushing her hair or the water simply hitting her face in the shower could cause it to flare up. “I could sometimes go up to four or five weeks without the pain then it would return with a vengeance to the point that I could have an attack of pain every day for a month. The only time I did not feel the pain was when I was asleep.”
Debbie heard of trigeminal neuralgia during a conversation one day with someone whose spouse had experienced the same type of pain. “Once I started researching the condition, I immediately thought to myself ‘this is what is wrong with me.’”
Trigeminal neuralgia is a chronic pain condition that affects the fifth cranial nerve also known as the trigeminal. One of the most widely distributed nerves in the head, the condition causes extreme, sporadic, shock-like or sudden burning facial pain. The trigeminal nerve is one of 12 pairs of nerves that are attached to the brain. The nerve has three branches that conduct sensations from the upper, middle and lower portions of the face as well as the oral cavity to the brain.
Blood vessels pressing on the root of the trigeminal nerve are often the main cause of the condition. The pain can range from sudden, severe and stabbing to a more constant, aching, burning sensation. Attacks may increase over time and medication to control the pain can become less effective.
Debbie made an appointment with Neurosurgeon Dr. James Brennan to determine if she indeed suffered from trigeminal neuralgia. An MRI confirmed what Debbie had suspected. Treatment for the condition often begins with medication. Dr. Brennan prescribed Trileptal, a medication used to treat seizures, to control Debbie’s pain. After six months, Debbie returned to Dr. Brennan and told him that the medicine only worked if she took more than he prescribed -- sometimes as many as six pills.
Dr. Brennan suggested a procedure that could ablate or block the nerve. The procedure called stereotactic radiosurgery (SRS) uses computer imaging to direct highly focused beams of radiation at the site where the trigeminal nerve exits the brain stem. The treatment causes the slow formation of a lesion on the nerve that disrupts the transmission of sensory signals to the brain.
Dr. Brennan arranged for Debbie to meet with the SRS team at McLeod Radiation Oncology to begin the planning process for the procedure. “The radiation team of Dr. Rhett Spencer, Physicist Tobin Hyman and Karen Jones, the nurse navigator, explained everything to me and answered all of my questions.”
“The treatment for trigeminal neuralgia requires extreme precision and accuracy because we are targeting and irradiating a nerve located only three to four millimeters from the brain stem,” said Dr. Spencer.
The TrueBeam STx linear accelerator at McLeod is specifically designed for the delivery of stereotactic radiosurgery.
“The radiation is focused into a circular beam about the diameter of a pencil,” explained Tobin. “These eight to ten pencil beams move in an arc around the patient’s head and intersect at the same point in space, creating a high intensity area about the size of a pea. The radiation dose targets the nerve, effectively ablating it, and providing pain relief. The dose used to perform this procedure is approximately 40 times larger than the dose your typical radiation patient receives on a daily basis.”
Prior to the procedure, Karen remained with Debbie as the team attached a frame to her head to keep her still during treatment. “I was awake during the procedure, but they gave me a medication so I would relax and keep still. After the procedure, they removed the frame and I returned home.”
Debbie was told not to expect immediate relief from the pain after the procedure because it can take up to six months for the pain to totally go away. “I had the procedure performed in November 2016, right before Thanksgiving. I started feeling much better in March,” said Debbie. “It has now been eight months since I’ve had any pain. I went from taking four pain pills a day to two, then only one, and I stopped taking it a few weeks ago.”
McLeod offers the only active linear accelerator (LINAC) based stereotactic radiosurgery program from the midlands to the coast. Since installation in October 2014, a total of 132 patients have received intracranial stereotactic radiosurgery. Of that total, 13 patients have undergone treatment for trigeminal neuralgia like Debbie.
“I was very pleased that McLeod offered the SRS procedure and I didn’t have to leave Florence to seek treatment,” added Debbie. “I honestly thought this pain was something I would have to live with for the rest of my life. I’m simply amazed that this treatment available at McLeod ended my years of suffering.”
Anne Kirby describes her radiation treatment for a brain tumor as “just a little blip in the road.” Thanks to advanced technology at McLeod and an excellent medical team, the tumor on Anne’s brain was destroyed in only one treatment.
In 2014, Anne suffered from severe back pain as a result of complex spinal issues. Having undergone surgery for this condition previously, Anne returned to Dr. James Brennan, a Neurosurgeon with Florence Neurosurgery and Spine, for treatment. Dr. Brennan determined that Anne needed additional surgery to alleviate her pain.
After a MRI before the procedure, Anne was surprised to hear from Dr. Brennan the day prior to the scheduled surgery. “Because a mass had been found on my kidney, he said he would be unable to perform my surgery. He immediately made an appointment for me to see a urologist the same day.”
After meeting with the urologist and undergoing further testing Anne learned that her left kidney needed to be removed because of the tumor’s size. A month after the kidney procedure, Anne finally underwent surgery for her back condition. Following the two operations, Anne sought the care of McLeod Oncologist Dr. Sreenivas Rao for treatment of the kidney cancer.
“Dr. Rao began running tests before I started on chemotherapy because an earlier scan also revealed there were small spots on my lungs. I had actually volunteered for a cancer research program at McLeod which involved additional detailed tests. That is when the spot on my brain was found.”
Dr. Rao sent Anne to Dr. Brennan to discuss removal of the brain tumor. Dr. Brennan explained to Anne that the tumor could be easily removed with the use of the new state-of-the-art radiation unit at McLeod.
Fortunately for Anne, she had the opportunity to receive the advanced services McLeod provides in its Center for Cancer Treatment and Research. The program includes a newly installed TrueBeam STx linear accelerator, which is specifically designed for the delivery of Stereotactic Radiosurgery (SRS) treatments. These treatments require extreme precision and accuracy to deliver large doses of radiation to the treatment site, reducing the amount of time during treatment and resulting in fewer treatments.
“This non-invasive treatment approach utilizes a set of multiple beams that intersect at a single point on the tumor. The radiation beam hits the tumor with a very high dose of radiation, but gives the brain just a low dose of radiation that it can tolerate. It literally is like taking a knife and cutting these tumors out without having to cut,” explained Dr. Brennan.
McLeod Radiation Oncologist Dr. Rhett Spencer has been treating patients at the hospital for 29 years. “Today, we have four dimensional CT scans and stereotactic MRIs to guide us in our treatment planning. Using these scans, we conform the radiation dose to the tumor target and verify the location and shape of the tumor during treatment. This linear accelerator also rotates in a 360 degree arc around the patient, delivering the radiation beam to any part of the body from virtually any angle. In addition, the treatment table is designed to move in six different directions, and the machine is equipped for image-based adjustments during treatment.”
Prior to treatment, a stereotactic protocol MRI is performed which involves double the contrast traditionally given, allowing the tumor to appear even more enhanced than it would on a conventional MRI.
“This means we are scanning the brain every millimeter not every five millimeters which is the standard with a conventional MRI so five times as many images through the brain are produced. As a result, we frequently find tumors that were not previously seen,” said Dr. Spencer.
Key to stereotactic radiosurgery is the planning required to map out the patient’s treatment. This involves a medical physicist who engineers the treatment plan and radiation dose required to precisely ablate the tumor while minimizing harm to healthy tissue around the lesion. Treatment is scheduled once the radiation oncologist and neurosurgeon approve the plan and ensure that everything is set to match up perfectly when the patient is on the table.
Karen Jones, the McLeod NeuroOncology Nurse Navigator, prepares patients like Anne for the day of treatment. She explains to them what to expect and answers any of their questions. Prior to the procedure, Karen remains with the patient as they are immobilized to keep their head from moving during treatment. This requires either a frame that is bolted to their head with four pins or the application of a special face mask.
“The mask was uncomfortable, but I did not have to be put to sleep or undergo surgery,” said Anne. “I did not feel anything during the procedure. When it was complete they removed the mask and I got up to leave. There was simply nothing to it. I walked out feeling the same way I did when I walked in. When I arrived home I rode around on my golf cart and watched my grandson pick up pine cones like I would on any other day.”
Anne added there was also no recovery time to deal with following the treatment -- which would not have been the case if she had required brain surgery
Anne has been among a total of 110 patients treated with intracranial stereotactic radiosurgery by the McLeod Neuro-Oncology Team since October 2014. This includes 13 patients suffering from trigeminal neuralgia, a painful nerve condition that requires the team to radiate a nerve located only four millimeters from the brain stem.
Karen says there are many other successful patient experiences like Anne’s. “Some patients with metastatic lesions that we have treated have other disease processes that affect their overall outcome, but we have achieved good success with the treatment of their brain tumor. For these patients, our goal is not only extension of life but to preserve quality of life.”
McLeod offers the only active linear accelerator (LINAC) based stereotactic radiosurgery program from the midlands to the coast. “The next closest comparable treatment program is the cancer center at Duke in North Carolina,” said Dr. Spencer. The hospital installed a second linear accelerator capable of performing stereotactic body radiation therapy in 2016.
“I am grateful that I did not have to go away to receive my treatment. I literally came down the road from my home to McLeod,” said Anne.
Since her procedure in April 2015, Anne has undergone four MRIs that have all been clear with no evidence of any new tumors.
Today, Anne reports that she is doing well. She married her high school classmate, Gerald Kirby, in July of 2016. The couple reconnected at their 50th high school reunion and are enjoying spending their golden years together.
Anne gives credit for her excellent outcome to God and the extraordinary care and services she receives from her medical team, especially Dr. Rao, Dr. Brennan and Dr. Spencer. She remains under Dr. Rao’s care for the treatment that is keeping the tiny tumors in her lungs from growing. Each day is another victory.
Deborah Mackey moved from a small town in Duchess County, New York, to Little River, South Carolina, 14 years ago with her husband, Gene. A retired school bus driver, mother and grandmother, Deborah enjoys all that South Carolina has to offer. She and Gene love to take trips and experience the freedom that retirement life brings. Living life to the fullest, Deborah never thought that her happy, go free way of life would come to a halt.
“I had never really been sick,” said Deborah.“But, one day I knew something was not right because I was having some rectal bleeding. When the bleeding continued and grew worse, I went to see Dr. Trevor Poole with Southern Surgical Group.”
Dr. Poole recommended that Deborah undergo a colonoscopy to detect the source of the bleeding.
“We are big believers in colonoscopies,” said Deborah. “We had several friends who did not take preventative measures to prevent cancer, and they did not survive. My father also died of cancer at the age of 36 when I was 14 years old.”
Following the procedure, Dr. Poole contacted Deborah with the results of the colonoscopy.“I was hanging Halloween decorations through the house when Dr. Poole called. He told me that I had colon cancer, and I needed to come to the office so we could discuss a surgery plan. He added, ‘This cannot wait.’
“I remember thinking there must be a mistake. The news did not sink in at that moment. In a state of shock, I removed all the decorations because I was no longer in a cheerful mood. I went to bed that night and it finally dawned on me that Dr. Poole was talking about me. Me! Not the man next door, but me,” recalls Deborah.
On October 12, 2015, Deborah arrived at McLeod Seacoast for surgery. The operation lasted longer than anticipated.
“During surgery, Dr. Poole found that it was a more complex situation,” said Gene. “He determined that Deborah had ovarian cancer that had spread to the uterus and the colon.”Dr. Poole immediately called in Dr. Joycelyn Schindler of McLeod OB/GYN Seacoast to assist with the surgery and perform a hysterectomy on Deborah.
“When I came out of surgery I learned the cancer had spread,” said Deborah. “I was relieved that the hysterectomy was able to be done at the same time. However, my worry was not over yet. I had to wait for the results from the lymph node biopsy. Thankfully, Dr. Poole came in the next morning and told me that I was going to be okay. He always promised me that he would not let anything happen to me, and he kept his promise.”
After the surgery, Deborah stayed in the hospital for five days.“My recovery process was much easier than expected, and the nursing staff at McLeod Seacoast was excellent. My experience was the ‘Rolls Royce’ of care.”
The day Deborah left the hospital is one she will never forget.“It was an autumn day, and when I came out of the double doors of McLeod Seacoast I was in awe. The sun was glistening through the trees, and it made them sparkle so beautifully. I got out of the car in my driveway and just stood there taking in all the beauty around me. I said to myself, ‘Look, you still have everything.”
Following her recovery from surgery, Deborah had to undergo six months of chemotherapy. It did not take long for her to become very close with the Infusion Services staff at McLeod Seacoast.
“My nurses, Dana and Tonya, took such great care of me during my treatments,” said Deborah. “Every time my treatment was over, they gave me a big hug and told me they loved me. I cannot describe to you how uplifting my chemotherapy experience was. I actually liked to go in for treatments.”
Infusion Services at McLeod Seacoast began in May of 2015 with space for four patients to receive chemotherapy. During the past year, the need for infusion care has grown rapidly and this Fall the department is expanding to accommodate 11 patients at one time. The new wing in the Same Day Services suite has been designed to meet the needs of the growing community McLeod Seacoast serves and offers convenient access to infusion care.
“Our patients are like family to us,” said Dana Tyree, an Infusion Services nurse. “We get to know them on a personal level because we care for them over a long period of time. We share in their victories and become their support system in times of need.”
“Those nurses are a part of my family now,” said Deborah. “They made me strong. I visit with them when I come to the hospital even though I have completed my treatments.”
With treatment behind her, Deborah says she is growing stronger each day. She enjoys going to the recreation center, walking and taking day trips with Gene discovering all the charming small towns and area festivals along the coast. She also has more time now to spend with her children, Melissa, Nicole and William and her grandchildren, Gianna and Nicollette.
“Now that everything is over, I think about how it all happened. I see the faces of the people who cared for me, and I know I will never forget them. I am forever grateful to Dr. Poole and his staff and everyone at McLeod Seacoast. There is a lot of love in that hospital,” added Deborah.
Carolyn Bellamy is known for her strength and positive outlook on life. Anyone she comes in contact with walks away a little happier. Carolyn has worked in Nutrition Services at McLeod Loris for 20 years. As part of the staff at McLeod Loris, she is accustomed to taking care of sick patients and their families, comforting them with kind words. This is what she likes most about her job. But, the day Carolyn learned she had Stage 2 breast cancer, she was the one who needed encouragement.
Carolyn’s journey began when she performed a self-examination on her left breast. “In my heart, I knew that something was not right,” said Carolyn. “When I performed the self exam, I noticed that my breast was swollen. I knew I needed to make an appointment to get it checked out.”
Carolyn made an appointment at McLeod Loris Primary Care to see Nurse Practitioner Wanda Grainger. “After a thorough examination and many questions, Wanda recommended that I get a mammogram. She noticed in my file that I was overdue,” said Carolyn. “She immediately called the Radiology Department at McLeod Loris and made me a same-day appointment for a mammogram. I could tell Wanda thought it was urgent that I get a mammogram that day.”
The mammogram results were abnormal, so an appointment was made for Carolyn to see McLeod Surgeon Dr. Amanda Turbeville the next day. After examining Carolyn, Dr. Turbeville ordered an ultrasound guided biopsy.
“When the biopsy results came back, Dr. Turbeville told me that I had a mass that was Stage 2 breast cancer,” explained Carolyn. “My oldest son, Neil, was with me when I received the news. He was trying to be strong for me, but I could tell he was upset. I did not panic when I found out. I knew the Lord had a plan.”
Carolyn was scheduled to have surgery the following week. Prior to surgery, she met with Dr. Turbeville for a pre-surgery consult. “Dr. Turbeville was very detailed during my consultation, and I appreciated it. She showed me on a diagram what was going to happen during surgery and where the mass was located in my breast. It made me feel better that she was direct and clear. She told me, ‘No worries, you are going to be okay.’ And, she was right.”
“Carolyn underwent breast conservation surgery which allows a woman to keep her breast,” said Dr. Turbeville. “As part of this surgery, a lumpectomy is performed, which is a procedure that involves selective removal of a tumor from the breast. This differs from a mastectomy, which involves the removal of the entire breast. A sentinel lymph node biopsy was also completed during surgery, where dye is injected into the breast. This precautionary procedure was performed to ensure the remaining lymph nodes did not need to be removed.”
Following Carolyn’s outpatient lumpectomy, she said her experience and results were excellent. “The same-day services staff was amazing,” said Carolyn. “They put me at ease, and I knew that God was guiding Dr. Turbeville and her team. I could not have asked for any better care.”
Carolyn was out of work three to four weeks after surgery. “I had very little pain after surgery. I followed Dr. Turbeville’s instructions on recuperating, but I was determined to get back to work quickly. Working at the hospital is therapy for me. Helping others is what got me through this experience,” explained Carolyn.
“Carolyn is such an optimistic person with a strong faith in God’s plan,” said Dr. Turbeville. “She accepted her diagnosis with grace and has fought through this journey with a smile on her face.”
Today, Carolyn continues receiving chemotherapy treatment at Coastal Cancer Center in Loris. “Dr. Emily Touloukian and the team there are amazing,” said Carolyn. “They worked around my schedule and made sure chemotherapy did not conflict with my everyday life.”
Carolyn now has time to get back to focusing on what is important in her life: God, family and friends. She is active in her church, where her husband, Elton, has been the pastor for 15 years. She also enjoys spending time with her threeyear-old grandson, Micah.
Ultimately, Carolyn’s faith and determination enabled her to survive this journey. “The Grace of God is what saved me and placed me in Dr. Turbeville’s hands. I lost my hair and my appetite, but I never lost faith. I want to be a witness for others facing this same journey that you can beat it. I also want to remind women that early detection is vital."
At 79-nine-years old, A.V. Thompson is a busy man. He tends to the cows on his farm in Cades, South Carolina, and manages the 70 properties he leases. In addition, he still “piddles” around the garage he built on the farm for his mechanic business. It appears nothing can slow him down -- not even a diagnosis of lung cancer.
Calling himself a “Jack of all trades and a master of none,” A.V. worked in a number of fields while raising his family. “I started off working at Wellman Coleman Company in Lake City, then I went to a building supply business,” said A.V.“I was not happy in that work so I began doing mechanic work. After my dad had a heart attack, I went back and took over the family farm.”
While managing the farm, A.V. also spent time in the dairy business with his father-in-law. He continued to work as a mechanic, and went into the insurance business. Eventually, he settled down on his farm and built a garage for his mechanic business
Today, he tends to his cows and sells the livestock. He also builds trailers and erects fences.
It was not unusual for a boy growing up in the south to begin smoking at a young age. A.V. started the habit at 12 years of age, during a time when generations of families smoked, explained Gayle, A.V.’s wife of 55 years.
“I never thought about cancer when I was smoking,” said A.V.“People would say ‘A.V. you better quit smoking’ but I wasn’t worried about dying from cancer. It never crossed my mind.”
However, in the fall of 2015, A.V. began noticing that he felt chronically tired. “I would give out faster and need to take a break.”
A.V. made an appointment to see his family physician of 30 years, Dr. Albert Mims in Lake City. “Dr. Mims always said I amazed him because I was in my 70’s and I would not quit smoking or slow down.”
Dr. Mims examined A.V. and they discussed his recent symptoms. “Dr. Mims then told me that he wanted to send me for a lung screening at McLeod.”
Established in 2014, the McLeod Lung Cancer Screening Program involves undergoing a low-dose CT scan. It is recommended for people between 55 and 80 years of age who have smoked one pack of cigarettes per day for 30 years or two packs per day for 15 years.
“I had been following the medical literature about screening with low-dose CT scans for people at higher risk of developing lung cancer,” said Dr. Mims. “When McLeod started their program, I began to review charts on eligible patients. A.V. was an ideal candidate for the screening.”
“When Dr. Mims received the results of the scans, there was a spot on my left lung. He said we would not know if it was cancer until they did a biopsy. He then sent me to see Dr. Jona.”
McLeod Pulmonologist Dr. Vinod Jona explained that A.V.’s CT scan showed a nodule of 11 millimeters in size. “Based on his history of smoking and the size and the shape of the pulmonary nodule, we knew it was very suspicious for cancer.
“Shared decision making is one of the nine essential components of lung cancer screening. After discussing all the risks and benefits, I referred A.V. to McLeod Cardiothoracic Surgeon Dr. Carey Huber for thoracic surgery evaluation and possible resection of the lung nodule.”
“Using video assisted thoracoscopy, we biopsied the nodule and confirmed that A.V. had lung cancer,” said Dr. Huber. “I performed a lobectomy and removed the upper half section of his left lung. His lymph nodes were negative, and the pathology indicated the cancer was a stage one."
“Lung cancer is curable when it is detected early like in A.V.’s case. At stages three and four, the cure rates are dismal,” explained Dr. Huber. “The lung cancer screening program is by far the biggest advancement in lung cancer treatment in 20 years. We can now detect small, early stage, potentially curable lung tumors. I compare the use of low-dose CT scans for lung cancer to the strides we have seen in breast cancer detection with mammograms.”
Since A.V.’s cancer was caught early, he did not require chemotherapy or radiation treatment. “I came home and I have been doing alright. When they told me it was cancer, I said, ‘well it is what it is,’ and that is how I took it from there on out.”
Following the diagnosis, A.V. quit smoking and says he does not miss it. Besides a lingering cough that Dr. Jona told him may occur because of the scar tissue in his lungs, A.V. reports that he is doing well.
While he was in the hospital, A.V. also learned he was the first person diagnosed with lung cancer since the screening program began at McLeod.
“God bless the screening,” said A.V. “I’m happy Dr. Mims sent me for the screening. I believe that saved my life and I will forever be thankful to him, Dr. Jona and Dr. Huber.”