Fighting advanced gastric cancer during COVID-19 pandemic: One man’s experience

Danbury Hospital

Summary:

  • Jairo Alarcon was diagnosed with stage IV gastric cancer and initially told his cancer was inoperable.
  • After six months of chemotherapy at Norwalk Hospital, Jairo’s tumor shrunk enough to allow for surgical treatment in December 2019.
  • After recovering from surgery, Jairo continued to receive maintenance chemotherapy at Norwalk Hospital during the COVID-19 pandemic. He found enhanced patient safety precautions to be “comforting.”

Jairo Alarcon, 61, of Norwalk, Connecticut, had heartburn for several years. He thought one of the causes could be from eating spicy foods. However, in December 2018, an endoscopy exam and biopsy revealed a cancerous tumor in his stomach. Jairo was diagnosed with stage IV gastric cancer.

Jairo, a father of five, had a diagnostic laparoscopic procedure to help guide the treatment plan. The procedure showed that the tumor was inoperable because it had spread to the peritoneal cavity in his abdomen. Jairo’s cancer care team recommended chemotherapy to shrink the tumor.

In March 2019, Jairo started a six-month chemotherapy regimen at Norwalk Hospital under the care of Dr. Richard Frank, director of clinical cancer research for Nuvance Health Cancer Institute and medical oncologist/hematologist at Norwalk Hospital.

Richard Frank, MD
Dr. Richard Frank
Director of Clinical Cancer Research for Nuvance Health Cancer Institute
Medical Oncologist/Hematologist at Norwalk Hospital
Consultant in Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center

“Jairo received the targeted monoclonal antibody Herceptin with FOLFOX, an infusion chemotherapy regimen, because his tumor was among the 20 percent of gastric cancers that overexpress HER2, a gene more commonly associated with breast cancer. Jairo had a great response to this treatment,” said Dr. Frank.

Jairo’s chemotherapy treatment was successful in shrinking the tumor. In December 2019, Dr. Margo Shoup, surgical oncologist, senior vice president, and system chair of the Nuvance Health Cancer Institute, performed surgery at Norwalk Hospital to treat his previously inoperable cancer.

Margo Shoup, MD
Dr. Margo Shoup
Senior Vice President, System Chair of the Nuvance Health Cancer Institute
Surgical Oncologist at Nuvance Health

A successful surgery

Before the surgery, Dr. Shoup performed a diagnostic laparoscopic procedure to look for cancer in Jairo’s peritoneal cavity. She found no evidence of cancer in this area indicating that the chemotherapy had resulted in resolution of any metastatic cancer, with the only remaining visible tumor being in the stomach.

“It’s very rare for a patient with stage four gastric cancer to have this type of response to chemotherapy. When it does happen, we are aggressive at surgically removing the primary tumor in the stomach,” said Dr. Shoup, who has expertise in this type of cancer surgery because she specializes in treating gastrointestinal (GI) cancer.

With confirmation that the cancer was contained within Jairo’s stomach, Dr. Shoup removed the tumor — as well as two-thirds of Jairo’s stomach — during a two-hour procedure called a gastrectomy.

“Not only was Jairo’s response to chemotherapy unique, he was home and eating four days after surgery, which is quite remarkable after all he had been through,” said Dr. Shoup.

“I’m spiritual, so I had a good mindset. I don’t worry about things that much,” said Jairo. “After surgery, I was sore, but once I was home, I was up and moving around pretty quickly.”

Nutritional support makes a difference

Jairo said he received nutritional support from his cancer care team during his recovery.

“With any type of GI cancer, the patient is more nutritionally needy because it involves digestion. The GI tract is vital in how we eat and digest nutrients. That’s why we connect with our GI cancer patients before they start treatment or have surgery to help them prepare for what they probably will experience afterwards,” said Bridget Bennett, MS, RD, oncology dietitian at Norwalk Hospital. “For Jairo, he was going through chemotherapy before surgery, and is currently going through chemotherapy. To support him through chemotherapy, we developed a nutritionally dense, high protein, high calorie diet that’s also healthy.”

Bridget Bennett, MS, RD Oncology Dietitian at Norwalk Hospital
Bridget Bennett, MS, RD
Oncology Dietitian at Norwalk Hospital

Bridget continued, “We also developed a diet that enabled Jairo to maintain his weight, heal from surgery, and handle more chemotherapy.”

Jairo’s wife of 32 years, Irene, took charge of his diet, which included low complex carbohydrates and no sugar.

“It’s awesome that Irene was involved, we counseled both of them. Together, we developed a nutrition plan to meet Jairo’s needs and his desire for a healthful diet,” said Bridget.

“I eat full meals and still have spicy food, but in moderation,” said Jairo.

Jairo (left) with his wife Irene (right)
Jairo Alarcon (left) with his wife Irene Alarcon (right)

Resuming chemotherapy during the COVID-19 pandemic

After his recovery from surgery, Jairo began bi-weekly maintenance chemotherapy treatments at the C. Anthony and Jean Whittingham Cancer Center at Norwalk Hospital under the care of Dr. Frank, who is also a consultant in the GI oncology service at Memorial Sloan Kettering Cancer Center (MSK). Jairo continued treatment throughout the COVID-19 pandemic.

Although Jairo said he noticed some changes during the pandemic, he described his treatment as “smooth” and said the changes were “comforting.” Overall, Jairo said he didn’t encounter any drastic obstacles when receiving care. “I noticed that they were spacing the seats more, and wearing a mask was different,” said Jairo. “I also sterilized my hands and had a temperature check before entering the cancer center, and I noticed more cleaning and disinfecting. They also divided the room in the infusion suite.”

So far, Jairo said that his chemotherapy treatment has been tolerable. Jairo, who is a New York Life insurance agent, takes advantage of the time he spends at the cancer center to get his work done. “I like coming to the Whittingham Cancer Center,” said Jairo. “I get spoiled.”

Jairo has remained cancer free 16 months after starting treatment at the Whittingham Cancer Center and seven months after surgery.

“We believe Jairo’s outcome is a result of aggressive cancer management and extraordinary care — which continued during the pandemic — and his perseverance and focus on surviving,” said Dr. Frank.

Dr. Frank also said the entire cancer support team was instrumental to Jairo’s care. Whittingham Cancer Center provides patients complimentary nutrition and psychosocial support for individuals and families.

Reducing COVID-19 risks

Jairo said that the COVID-19 pandemic has made him more aware of how germs spread, and he’s taking steps to reduce his risk of exposure to the virus — especially due to his weakened immune system as a result of his chemotherapy treatment. “I usually don’t worry, but I’m aware that I need to be more cautious because of my age and the fact that I am immunocompromised from the chemotherapy treatment,” said Jairo.

As communities reopen, Jairo said it’s important to be careful and follow COVID-19 public health recommendations — especially if someone is receiving cancer treatment. Jairo, for example, wipes down his car. He also said he sanitizes his arms and hands when he goes out and gets back home. His family is also more careful around him.

His advice for people receiving cancer treatment:

“Follow recommendations from your doctors, and go the extra mile to take care of yourself,” said Jairo. “It’s interesting because there are positives to cancer and the pandemic — it makes you take a second look at life.”

About MSK Physicians at Norwalk Hospital

In a first-of-its-kind cancer care collaboration, Memorial Sloan Kettering Cancer Center (MSK) medical and radiation oncologists and care practices are integrated with the existing cancer program at the C. Anthony and Jean Whittingham Cancer Center at Norwalk Hospital. The aim of the program is to accelerate access to the newest cancer treatment options in the comfort of Fairfield County residents’ local community setting. To learn more about MSK physicians at Norwalk Hospital and the cancer care program, please visit MSKatNorwalk.org.

CONTACT
Amy Forni, Manager, Public Relations
(203) 739 7478 | Amy.Forni@nuvancehealth.org