October 20, 2019
Doing two things at once sometimes makes perfect sense, like exercising while listening to a podcast or catching up on phone calls during your commute. But does it make sense in the operating room?
Breast cancer survivor Jean Crenshaw, 75, thought it might. When she needed a mastectomy and foot surgery in February 2019, she asked her doctors if they could do the surgeries at the same time, and they agreed.
A Coordinated Treatment Plan
Five months before her requested tandem surgery, Jean, a mother of four and grandmother of 10, felt a lump in her left breast.
“I’ve always had cystic breasts, so I didn’t think anything of it at first,” she says.
But her primary care physician sent her to get a mammogram and the results showed a 6-centimeter tumor and two enlarged lymph nodes.
With an official breast cancer diagnosis, in October 2018, Jean met with Debra Camal, M.D., a breast surgeon at Riverview Medical Center. Dr. Camal brought in oncologist Denis Fitzgerald, M.D., who ordered additional imaging to see if the cancer had spread to other parts of Jean’s body—fortunately it had not.
Together, Dr. Camal and Dr. Fitzgerald devised a treatment plan.
“It’s critical to coordinate a treatment plan when it comes to caring for cancer patients,” Dr. Camal says. “Since her particular type of cancer responds well to chemotherapy, we decided to start with chemo to shrink the tumor, then do the operation.”
For the next four months, Jean received chemotherapy treatment once every three weeks.
“It was rough. I had no appetite, so I lost 40 pounds. I also lost all of my hair,” says Jean, whose health was already fragile because she also has Parkinson’s.
Chemo was so difficult, in fact, that Dr. Camal and Dr. Fitzgerald told Jean to skip the last session. She was just too weak, and the tumor was already gone.
Even though the chemo obliterated the tumor, surgery was still necessary. “She had a large tumor and there was a chance it could come back,” Dr. Camal says. “Not all cancers are treated exactly the same, but we had to be more aggressive with this one.”
Two Times the Successes
Dr. Camal scheduled a mastectomy to remove the entire left breast and the enlarged lymph nodes for February 18, 2019. Before Jean agreed, however, she asked her podiatrist, John Connors, DPM, if he could perform surgery on her bunion and painful dislocated metatarsal joint at the same time.
“I asked her, ‘Are you sure you want to do this foot surgery right now with what you’re going through?’ And she said yes, that it would take her mind off the breast cancer,” Dr. Connors says. “So we wanted to make that happen for her.”
He and Dr. Camal spoke and agreed to do the procedures together. Both had performed tandem operations before, but never quite like this: Dr. Connors had worked simultaneously with orthopedic surgeons, and Dr. Camal had worked with plastic surgeons during breast reconstruction following a mastectomy.
Though they’d never completed these procedures together, they knew it could be done.
Because complications can arise from being under anesthesia too long, the surgeons had to work quickly. “I know exactly how long my procedures are going to take, so I went first,” Dr. Connors says.
At 8:15 a.m., Dr. Connors began Jean’s foot surgery with the assistance of his long-time colleague, podiatrist Kathleen Trotter, DPM. By 9:30 a.m., they scrubbed out. Minutes later, Dr. Camal entered the operating room to perform Jean’s mastectomy. About two hours later, both procedures were complete and without complication.
“If I was already going to be under, it just made sense to me to have both surgeries done at once, so I only had to go through one recovery,” Jean says.
She spent two nights in the hospital, then returned home to her husband, Tom, a pastor at a nondenominational church in Middletown.
A week after her release, she met with Dr. Camal to review her pathology report, which showed a complete pathologic response—meaning, no tumor was left after chemotherapy and surgery. However, Dr. Camal and Dr. Fitzgerald agreed that even though the tumor, breast and lymph nodes were gone, Jean still needed to receive radiation therapy to prevent any possible growth in the future. She completed that treatment at Riverview in May without any major issues.
“Now we know that we’ve done everything humanly possible to prevent it from coming back,” Dr. Camal says.
Today, Jean wears a prosthetic breast, opting out of another surgery to reconstruct her breast.
“I hope I don’t regret it looking back, but I didn’t want to undergo anymore surgery than necessary,” she says.
Her hair hasn’t fully returned, so she wears a wig. She still struggles with her appetite and strength, but she’s feeling better overall. And she’s incredibly thankful for her team of doctors.
“When I first got the diagnosis, my husband and I pulled the car over and prayed that we’d be directed to the right place,” Jean says. “When Dr. Camal’s office called half an hour later to say she could see me the next day, we knew we’d found it.”
However she got there, she’s glad she did. Now, she is cancer-free, her foot is pain-free, and she is thrilled that she can be both at the same time.
Learn about our Breast Imaging and Breast Cancer program’s comprehensive services, including breast screening, surgery, treatment and support.
Dr. Camal practices in Tinton Falls. To make an appointment, call 732-531-5200. Dr. Connors practices in Little Silver. To make an appointment, call 732-741-2300.
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.