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Cancer Medicine's Dark Corners

Gregory D. Pawelski

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During July, 1998 my wife Ann had a 3.5 cm metastatic tumor resected from her right cerebillum by a Dr. Ralph Lehman at Hershey Medical Center. Histologic features were consistent with metastatic papillary adenocarcinoma with extensive necrosis from the ovary. This brain surgeon advised us when she recovered to return to our home in Reading, Pa. and receive radiation therapy to the local tumor bed. At the same time, he instructed me to have Ann receive an MRI of the spine because of his suspicions of either another tumor, on her spine or a herniated disc, causing her leg problems. Because Dr. Lehman's medical associates left no script, instructions or referral, Dr. Albert Yuen a radiation-oncologist at Reading Hospital took upon himself to give Ann 5 fractions (at 20gy per) of local radiation to the tumor bed PLUS 20 fractions (at 20gy per) of Whole Brain Radiation. Whole Brain Radiation induces neurological deterioration, dementia or both. Patients develop progressive dementia, ataxia and urinary incontinence after Whole Brain Radiation. Local radiation to the tumor bed has been applied to patients to avoid these complications. The treatment method recommended for brain metastases of large solitary tumors exceeding 2cm in diameter is surgical resection followed by 5 fractions of local radiation to the tumor bed. Ann received an Unenhanced MRI to the spine that showed a 1cm lesion. Instead of performing an Enhanced MRI to the spine to further evaluate, Reading Hospital performed a Bone Scan that showed normal bone imaging. Enhanced(contrast) agents increase the sensitivity, conspicuity and accuracy of an exam. The agent most commonly used is Gadolinium. The properly prescribed medical procedure for all brain and spinal MRI's is Enhanced(contrast). An Enhanced MRI was not performed. Dr. Yuen told us that the lesion was nothing and not to worry about it. Well, nine months later, she was admitted to the Reading Hospital for a week of testing and evaluation for unexplained falls and light-headiness. Dr. Theresa Mecurio, a medical oncologist who admitted Ann said that Ann was supposed to be seen by an Internist(for her blood pressure) and a Neurologist(for a spinal tap). At the end of that week, a Dr. Nick Leasure, another medical oncologist calls me on friday to say Ann DID NOT HAVE CANCER and he'll let her go home the next day. Ann went home the next day in time to fall and break her hip in four places. After waiting two days to be operated on, they finally repaired her hip, by a Dr. Latman, an orthropedic surgeon. After surgery, when physical therapy was to be performed immediately, Ann did not become coherent, she was lethargic. For two days, I tried to track down the Neurologist, Dr. Clifford Reed who was supposed to do the spinal tap the week before. When I found him to ask about the previous week's spinal tap, he told me he did not perform one on Ann. I forced him to perform a spinal tap on Ann, then and there. Afterwards, tests results showed Adenocarcinoma nodules in the spinal fluid. After the Pathologist did not want to sign off on his diagnosis, I yanked Ann out of Reading Hospital and took her to Hershey Medical Center for proper medical treatment. We found out by Dr. Harold Harvy, a medical onocologist at Hershey Medical that not only Ann had Adenocarcinoma nodules in the spinal fluid but also Leptomeningeal Carcinomatous. An Enhanced MRI showed now 3 metastatic tumors on her spine. Spinal metastases can grow into adjacent structures, such as into the meninges from the spine. The largest of these tumors grew into the meninges on the spine into the spinal fluid(hence adenocarcinoma nodules in the spinal fluid). Drs. Leasure and Reed FAILED TO DIAGNOSE CANCER in Ann. Radiation injury to the brain by Whole Brain Radiation has a progressive (2-3 years) and insidious course. Radiation Necrosis is part of a series of clinical syndromes related to central nervous system complications of radiation. It generally occurs 6 months to 2 years after radiation therapy. Radiation Necrosis can be fatal!! It causes pathological changes that impair vascular integrity. It causes cerebral infractions(strokes). Ann suffered a stroke to the left basal ganlia area, around the New Year 2000. Because of the negligent overradiation she received, not to mention the massive other medical malpractices, Ann died of Cardio-pulmonary failure, caused by advanced Radiation Necrosis. I was "lied to", "not made aware of", "fudged", "no mention of", "should have informed me but didn't", "not significant", "assumed I was informed about this but wasn't", "did not make it clear to me" or "never told" from every doctor Ann was involved with at Reading Hospital. "THIS SCARES ME!!" Drs. Leasure, Cescon, Mercurio, Ramsey & Lusch(Berks Hematology-Oncology Associates) never mention to me of the vast and insidious neuro-toxic side effects of chemo-therapy with Cisplatin and Methotrexate. When I approached their office after we discovered Ann had a cerebellar metastatic tumor, they said, "what do you want us to do about it?" Dr. Yuen at Reading Hospital, never mention the vast and insidious side effects (Radiation Necrosis) of Whole Brain Radiation. Dr. Mercurio at Reading Hospital telling me Ann was to have a Spinal Tap (for good solid reasons) and it wasn't performed. Dr. Leasure at Reading Hospital, after a week of Ann being observed, evaluated and tested(but no spinal tap) tells me Ann didn't have cancer! Lets her go home to fall and break her hip in four places without finding out what was wrong with her. Dr. Reed at Reading Hospital, not performing the Spinal Tap on Ann. After he and Dr. Leasure have a little chat, decided not to give it to her. "Oh!, we've seen this many times before, no need to do a spinal tap". Because of Reading Hospital's medical neglect, Ann had to be treated at Hershey Medical with intrathecal methotrexate and spinal radiation. When both therapies are performed at the same time it doubles the theraputic dosages of each therapy(increasing the neuro-toxic effects on the brain). Dr. Harold Harvey began two treatments of intrathecal methotrexate . Dr. Stryker, a radiation oncologist at Hershey began performing seven fractions(at 20 gy per) of radiation to the spine. Ann was transferred from Hershey to Reading Hospital's rehabilitation unit after she was reclassified as an outpatient. Dr. Yuen at Reading Hospital, finished up the next eight radiation treatments. After Dr. Yuen was explicitly told that Ann needed only a total of 15 fractions(at 20gy per) of radiation to the spine, he wanted to give her 5 more fractions at a higher dose. I asked him why and he said,"we do things a little differently here, we are a lot more aggressive!" I stopped him at 15, called Dr. Stryker at Hershey to explain what happened and he told me I made the right decision and would back me up. Dr. Lusch at Reading Hospital, giving Ann her fourth and final methotrexate treatment, said her white blood or cell count was not up enough, yet gave the methotrexate to her anyway. Dr. Cescon at Reading Hospital, on a follow-up appointment after hospital release, to withdraw spinal fluid sample from her reservoir, wanted to give Ann another dose of methotrexate without doing any prior blood work. I did not allow it. Since the second methotrexate treatment at Hershey and on, all of her spinal taps were negative. Dr. Mercurio at Reading Hospital, on another follow-up, I asked her why Ann didn't get the Spinal Tap she said Ann was supposed to receive, she said, "I don't know?" I asked her why did your associate, Dr. Leasure tell me Ann did not have cancer, she said, "I don't know?" Hence the saying, "cancer medicine has been driven by external forces into dark corners, such as what amounts to generating more of an advertisement sent directly to a patient, than patient information and more disturbingly on TV and other media". There's this multi-billion dollar cottage industry called chemo-radiation therapy just waiting for an excuse to fullfil your cancer treatment needs.


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