May 7, 2020
Patients arriving at John Theurer Cancer Center, part of Hackensack University Medical Center, are often greeted by a uniformed parking valet whose warm smile and gentle manner put them at ease. It’s second nature to him. He truly knows how they feel.
A few years ago, Bob Rhein was working in a printing facility when he fainted and was rushed to Hackensack by ambulance. Oncologist Tracy Proverbs-Singh, M.D., recalls that Bob was bleeding from his mouth, and a biopsy done during an endoscopy found cancer at the junction of his esophagus and stomach. A PET scan was done to check for spreading, but what it found instead was a very bright lymph node in his neck: Burkitt lymphoma (a blood cancer that originates in the immune system).
Adds oncologist Lori A. Leslie, M.D.: “Burkitt lymphoma is one of the fastest-growing malignancies with the potential to double in size in a matter of days. Due to that, it is considered an oncologic emergency.”
Since Bob was diagnosed with two unrelated cancers, the team had to focus on the most life-threatening cancer first: the lymphoma. “He received three cycles of intensive inpatient chemotherapy,” says Dr. Leslie. “He then underwent concurrent chemotherapy and radiation for the esophageal cancer.”
The effects of all that radiation were brutal. Bob recalls: “I couldn’t roll over in bed. I couldn’t walk. I was helpless.” He was ready to give up, but he still faced surgery to remove the esophageal tumor, which was at the bottom of the esophagus where it connected to his stomach.
His beloved wife, Nancy, had struggled with ovarian cancer for a decade before passing away in August 2017, and he felt continuing his treatment was more than he could bear. Then he realized the treatment wasn’t just for him. His daughter, Lauren, would be devastated to lose both parents to cancer so close together, so he decided to fight as hard as he could to survive for her. Fortunately, he had an exceptional care team at Hackensack who worked with him to make that possible.
In Good Hands
Bob was fortunate that his esophageal tumor was found while it was still treatable. Often, such tumors aren’t diagnosed until they’re much larger and have metastasized. “A little bit of luck,” Dr. Proverbs-Singh says.
Another fortunate event was Bob meeting Hackensack thoracic surgeon Nabil Rizk, M.D., M.S., MPH, who has long specialized in esophagectomy surgery and has performed it more than 1,000 times during his career. Bob was impressed even at his first meeting with Dr. Rizk. “He was very compassionate and competent,” Bob says. “He told me exactly what was going to happen. I had a lot of confidence in him and his team.”
On March 15, 2018, Dr. Rizk operated. He considered Bob a higher-risk patient because of the prior lymphoma treatments and a weakened immune system. During surgery, he opened the front of Bob’s abdomen and removed the cancerous portions of his stomach and esophagus. He then made an incision on the right side of his chest, removed an additional portion of his esophagus, and used the remaining stomach to bridge the gap and connect it to the remaining esophageal tissue. There was concern that in his weakened condition, Bob might be susceptible to pneumonia or leakages where the sutures made the new connection. Fortunately, those problems did not occur and the surgery was a success.
After 10 days in the hospital, Bob spent a couple of weeks at a rehabilitation facility, where staff cared for the feeding tube that connected to his small bowel, supplemented his oral diet and helped him increase his strength. He was determined to get his life back and worked hard to make that happen.
Planning for the Future
As Bob continued to recover, he resumed the activities he loves. Bob had never formally stopped coaching the golf team at Immaculate Heart Academy in Washington Township, New Jersey, even when he was too weak to leave the clubhouse. Now he is also back to coaching the basketball team. An avid golf player himself, he says: “Last year I’d hit a ball 40 yards and fall down. Now I am hitting the ball 220 yards and I walk the six miles of the course—no cart!”
There have been some reminders of his struggles against cancer. The new configuration of his stomach means he needs to eat four to six small meals per day rather than fewer, larger ones. He also needs to raise his head 30 degrees when he sleeps to prevent reflux. Aside from these considerations, he has no restrictions on his activities and has been able to return to all the pastimes he enjoys.
Today, he remains cancer free. He continues to receive excellent follow-up care, which includes scans every six months and seeing his doctor every three months.
When Bob is working as a valet and sharing his story, people often want to know how he did it. He credits the wonderful care he received from everyone at Hackensack. “I tell them to get a calendar and plan out the whole year. Plan for the future, so you have something to live for. Works great,” he says.
Learn how Hackensack Meridian Health treats thoracic cancers.
Dr. Proverbs-Singh practices in Hackensack and North Bergen. To make an appointment, call 551-996-5855. Dr. Leslie practices in Hackensack. To make an appointment, call 551-996-5855. Dr. Rizk practices in Hackensack. To make an appointment, call 551-996-5960.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.