Article Category: PeopleCare

ScottCare

Published on March 03, 2022

Last updated 01:10 PM March 04, 2024

Every day, Scott Hullihen’s gaze falls on a very unique piece of art hanging in his home.

To the untrained eye, the spiraling streaks across the canvas could be mistaken for an abstract painting in a museum. But for Scott, it holds a much deeper, personal meaning: hope for a cancer-free future.

A closer look reveals a puzzling QR code in the corner of the print and, when scanned, it plays the very voicemail from his Wellstar radiation oncologist that got him through the most difficult days in his cancer journey.

“The picture is his voice in soundwaves. I get to see it every day,” said Scott. “It’s the most thoughtful thing I’ve ever seen in my entire life.”

The ebbs and flows of the piece show how he conquered the highs and lows of his difficult rectal cancer diagnosis, with support from Wellstar as the constant through it all.

Just like the highly personalized art print, his expert team of physicians formed a tailored care plan for Scott, right down to his DNA.

Together with his Wellstar team, Scott beat cancer and is back to living life to the fullest.

A surprising diagnosis

Scott was a typical guy in his 30s, working in technology and spending time with friends and family.

“Everything was normal,” he said. “I’d go to sporting events or concerts.”

But his diagnosis of colorectal cancer at just 35 years old was anything but typical.

“That was shocking,” he said.

In 2020, Scott’s stomach started hurting—and it didn’t stop. He started eating better and cut certain ingredients from his diet. He regularly rode his bike for 15 miles.

“I was getting in good shape!” he said.

But the pain continued, with an urgency to use the bathroom, constipation and blood. His doctor referred him to a gastroenterologist for a colonoscopy in August. Immediately after the procedure, he learned there was a tumor in his colon.

“It was a quiet car ride,” Scott remembered sitting silently next to his mother, who had driven him there.

That Friday, a biopsy confirmed it was cancer. Scott was immediately referred to the Wellstar Rectal Cancer Multidisciplinary Program, the first and only treatment center in metro Atlanta accredited by the National Accreditation Program for Rectal Cancer (NAPRC), a quality program by the Commission on Cancer.

Getting the highest level of rectal cancer care

After the weekend, Scott met with Dr. Sahir Shroff, a cancer surgeon.

“People raved about how good a surgeon Dr. Shroff is—I learned he was one of the best in the state,” Scott said. “He saved my life.”

The board-certified and fellowship-trained surgical oncologist reassured Scott.

“This is one of the most subspecialized rectal cancer programs in metro Atlanta,” he said. “Every person with rectal cancer is reviewed at our multidisciplinary meeting to provide the highest level of care.”

Select doctors are designated to stage and treat rectal cancer patients following evidence-based guidelines. The team includes colorectal surgeons, medical oncologists, radiation oncologists, gastroenterologists, pathologists and radiologists. Higher experience in treating rectal cancer leads to better outcomes for patients.

Scott also had a nurse navigator coordinate his cancer staging and treatment. Nancy Page answered questions and scheduled important appointments, such as CT scans and MRIs as well as meetings with various specialists.

A licensed Wellstar genetic counselor was also on Scott’s team. Amy Ekwurtzel found that Scott had two genetic abnormalities that make him slightly more susceptible to colorectal cancer. This information gave the team additional clues about the best way to care for Scott.

Don’t be afraid. Make an appointment. It’s uncomfortable to get a colonoscopy, and hopefully, they don’t find anything bad. But get it checked.

- Scott Hullihen

Wellstar Colorectal Cancer Survivor

Listen to Scott's Story

A compassionate call

That Friday, Scott consulted with Dr. Olusola Obayomi-Davies, a radiation oncologist. He also had an MRI of the rectum and CT scans of his chest, abdomen and pelvis at Wellstar East Cobb Health Park to see if the cancer had spread.

Dr. Davies knew stress and anxiety are common for people waiting for test results.

“It was a holiday weekend, and I wanted to tell him as soon as possible so he could enjoy his weekend,” Dr. Davies said.

Before he could drive his truck out of the parking lot, Scott received a voicemail from Dr. Davies who said the cancer didn’t appear to be in other parts of the body—excellent news. “It was the best voicemail I ever got!” Scott remembered. “It was a relief. I could have filled up a bucket I cried so much.”

Chemotherapy, a challenging game-changer

After the team reviewed Scott’s imaging, pathology and colonoscopy results, they staged his cancer and created a personalized treatment plan. A new evidence-based treatment called Total Neoadjuvant Therapy (TNT) was recommended, calling for chemotherapy followed by radiation combined with chemotherapy before surgery.

“The benefit of having chemotherapy first is that it shrinks the primary cancer in the rectum and addresses microscopic cancer that we can’t see in the body,” explained Dr. Michael Andrews, Scott’s medical oncologist and chief cancer officer at Wellstar.

Scott received chemotherapy through IV infusion treatments every other week plus continuous infusion. Extreme fatigue, nausea and weight loss made him want to quit. Dr. Andrews was sympathetic but encouraged him to keep going with the goal of a cure. He added IV fluid and steroids to Scott’s infusion treatments to ease the nausea.

Scott felt better and completed his chemotherapy course on December 16, 2020.

“I rang the bell—everyone clapped,” he remembered.

Best of all, a CT scan showed the tumor had shrunk by 80%.

“I couldn’t believe the difference!” he said. “I could go to the bathroom. There was no more pain.”

Did radiation make the tumor disappear?

Scott began external beam radiation therapy, paired with a low-dose chemotherapy pill to optimize the effectiveness of radiation. Dr. Davies used volumetric modulated arc therapy (VMAT) to precisely contour radiation targets into unusual shapes while minimizing toxicity.

“Dr. Davies kept it real,” Scott said. “He was cool in the way that he talked to me—not like a doctor, like a friend.”

This time, the CT scan showed that the tumor had disappeared. However, Scott still needed surgery.

“When we finish someone’s treatment, it looks like all the cancer is gone,” Dr. Davies explained. “But there can still be microscopic cancer that doesn’t show up on the scan. Surgery is important.”

Robotic surgery for a long, cancer-free life

In April, it was time for Scott to have complex rectal cancer surgery at Wellstar Kennestone Regional Medical Center. Dr. Shroff guided a da Vinci Surgical System robot to make five small incisions and peer into Scott’s abdomen with magnified cameras. The minimally invasive technology allowed Dr. Shroff to remove part of Scott’s rectum with precision. Two months later, Scott returned to the hospital so Dr. Shroff could reconnect his healed colon.

After surgery, Scott’s pathology found no evidence of cancer anywhere in the colon, rectum or lymph nodes.

“That’s about the best news you can ever give,” said Dr. Davies.

Scott said he couldn’t have gotten this far without his healthcare team—and the overwhelming support of his family.

“After my surgery, I was in the hospital for eight days and my mother was there everyday,” Scott said. “She is a saint and I couldn’t have done it without her. My dad, sister and my brother-in-law would visit often. Without their continued positive support during the entire process, it would have been so much more difficult.”

Advocating for good health

Scott sometimes advises and comforts acquaintances who are newly diagnosed.

“I say trust the process. The doctors and nurses at Wellstar are absolutely amazing—I can’t say enough good things about them,” he said.

He also jokes that he’s “lucky” to have annual colonoscopies. He encourages friends with symptoms to talk to their doctors about symptoms without delay.

“Don’t be afraid,” Scott said. “Make an appointment. It’s uncomfortable to get a colonoscopy, and hopefully, they don’t find anything bad. But get it checked!”

Scott and his girlfriend standing in front of the canvas art piece featuring the call from Dr. Davies.

The gift of a second chance

Today, Scott works in the telecommunications field, is active and spends time with friends and his girlfriend.

On his first chemotherapy completion anniversary, Scott’s girlfriend surprised him with a blue-ribbon cake (the colorectal cancer awareness color) and his unique, personalized piece of artwork.

He unwrapped three canvas art pieces displaying a zig zag and a QR code, which he scanned with his phone. His favorite voicemail—the one from Dr. Davies telling him his cancer was contained—played back.

As for what’s next? Scott’s healthcare team at Wellstar will continue to monitor his health so he can live his longest, fullest life.

“For some reason, I got a second chance, and I’m going to make the best of it,” he promised.

Learn more about the Wellstar Multidisipinary Program for Rectal Cancer—the first and only center in metro Atlanta to have the NAPRC accreditation.

Why the hesitation?

According to Dr. Daniel Fortes, a board-certified thoracic surgeon at Wellstar, the reasons for hesitation may include:

Guilt: “I smoked. If there’s a problem, I caused it.”
A lack of awareness about screening and insurance coverage
Fear that screening will find something abnormal

It's important for current and former smokers age 50 and older to champion their health and stay up to date on lung screenings. When caught early, lung cancer is more treatable and likely curable.

“Wellstar puts our patients at the center of their care,” Dr. Fortes said. “We do everything to minimize patient anxiety and maximize the speed at which they travel through the system, so that we can get them to their treatment as quickly as possible.”

What is lung cancer screening?

Lung cancer is the leading cause of cancer deaths among men and women. For many years, most cases were not detected until the disease was already advanced.

That began to change about 20 years ago. Research revealed that screenings with low-dose CT scans were finding cancer earlier, at a stage that is far more treatable. Today, we know that annual low-dose CT screenings for individuals at high risk have been shown to reduce lung cancer deaths by about 20%.

“That was a breakthrough,” Dr. Fortes said. “It was the first time we knew that there was something we could do to decrease the mortality of lung cancer proactively.”

The U.S. Preventive Services Task Force, a government agency, added annual lung cancer screenings to its list of recommended screenings. Medicaid, Medicare and most private insurance plans began covering the costs for patients over 50 whose smoking histories put them at risk.

The screening is painless and fast. Sometimes, the CT scan reveals a lung nodule, or a small, round growth. But not all nodules are cancerous. Old infections, scarring or inflammation can cause benign (non-cancerous) nodules. If the scan is abnormal, the patient will be referred to a Wellstar STAT Clinic for Lung Cancer.

Shorter time from diagnosis and treatment

At Wellstar, STAT Clinics (short for Specialty Teams and Treatments) provide dedicated guidance and help shorten the time from diagnosis to treatment. Within the STAT Clinic for Lung Cancer, the multidisciplinary care team may include a surgeon, pulmonologist, medical oncologist, radiation oncologist and a nurse navigator.

Before a patient visits the STAT Clinic, their team meets to review their scan and develop an initial plan. The patient and their family then meet with the appropriate team members on the same day. Their nurse navigator provides education, support and advocacy from diagnosis through treatment and recovery.

“This takes away a lot of anxiety from patients who are running from one office to another without an answer,” Dr. Fortes said. “They have a defined plan, and we expedite everything. Things happen much faster. Our average is about four to six weeks total from when we first identify a problem to the time a patient receives treatment. That’s compared to four months nationwide—and we’re trying to decrease the time even more.”

Advancements in lung cancer treatment

For patients with early-stage lung cancer, surgery to remove the affected portion of the lung and surrounding lymph nodes is often the center of the treatment plan.

“Many patients with early-stage cancer are candidates for minimally invasive techniques, either by video techniques or robotics,” Dr. Fortes said. “These techniques require small incisions in the chest without much disruption or trauma to the chest wall.”

As a result, patients have less pain after surgery and recover faster. They often leave the hospital after a day or two.

“There have been so many advancements that have changed lung cancer care,” Dr. Fortes said. “When we find lung cancer at the earliest stages and patients have surgery, they have up to an 85% chance of being cured.”

Who should get annual lung cancer screening

If you are 50 or older, currently smoke or smoked in the past, ask your healthcare provider if you should have lung cancer screenings.

The American Lung Association and the U.S. Preventive Services Task Force recommend annual screening for adults 50 to 80 who have a 20 pack-year smoking history. That could mean one pack a day for 20 years or two packs a day for 10 years.

The guidelines apply whether you still smoke or have quit within the past 15 years. You do not need to have symptoms to be screened.

Remember: Finding cancer early, when no symptoms are present, increases your chances of being cured or living longer with lung cancer.

Take the next steps toward screening

Learn more about lung cancer screening at Wellstar.
Call (470) 793-4AIR to learn more about eligibility, financial assistance or to schedule a screening.
Read about a patient whose lung cancer screening results showed cancer in an early stage.
Need a doctor? Find a Wellstar provider and book an appointment.

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Highlights

Genetic Testing: A Critical Tool in Cancer Treatment

It's been over three decades since genetic testing was first introduced as a tool for patients at risk of hereditary cancer syndromes. In its early days, genetic testing was expensive and time-consuming (often taking up to eight weeks for results). Fast forward to today and genetic testing is now a routine part of cancer care. It’s more accessible, comprehensive and, perhaps most importantly, significantly impactful for patients and their families.

Physicians help identify patients who could benefit from genetic testing, especially when someone has a personal or family history of cancer. Genetic testing can improve treatment outcomes, guide preventive care and provide vital information for the patient's family.

Benefits of genetic testing

1. Understanding the cause of cancer

One of the most common questions from patients newly diagnosed with cancer is, "Why did this happen to me?" While many cancers are the result of environmental factors, aging and sporadic mutations, genetic testing can offer a more definitive answer. For patients with hereditary cancer, knowing their cancer is genetically driven can help ease feelings of uncertainty and guilt.

For many, this knowledge brings a sense of empowerment, as they now have the opportunity to make informed decisions regarding their treatment and potential preventive measures for the future. This hereditary cancer risk was present since birth, and there was very little if anything the patient could have done differently throughout their life to prevent their diagnosis.

2. Personalized treatment options

For patients with cancers like breast, ovarian, pancreatic and prostate, identifying genetic mutations (like BRCA mutations) can open the door to personalized therapies. The earlier in the diagnostic process the genetic test is ordered, the quicker the patient can be matched with appropriate treatments.

Knowledge of genetic mutations can also guide surgical decisions. Patients with BRCA-positive breast cancer may be candidates for risk-reducing mastectomy or salpingo-oophorectomy—both of which can lower the risk of future cancers. These decisions are most effective when genetic results are available before surgery.

3. Identification of additional cancer risks

Cancer does not always occur in isolation, especially in patients with hereditary cancer syndromes. For instance, patients with Lynch syndrome, a leading cause of colorectal cancer, are also at increased risk for uterine cancer—up to 60%. If identified before a colon resection, this knowledge could allow a hysterectomy at the same time if necessary, minimizing the risk of a second cancer and optimizing care.

Beyond immediate cancer treatment, genetic testing can also lead to additional screenings that might otherwise be missed. For example, the ATM gene is a known contributor to prostate and breast cancer. But patients with an ATM gene mutation are also at elevated risk for pancreatic cancer. While general population screening is not typically recommended, high-risk patients should begin annual imaging and/or endoscopic ultrasounds as early as age 50 or 10 years before the earliest known pancreatic cancer in their family.

4. Informed decisions for family members

A cancer diagnosis doesn’t only affect the patient—it impacts their entire family. Once a genetic mutation is identified, relatives can undergo testing to assess their own cancer risk and talk to their care teams about screenings.

Testing the affected patient first is the most informative strategy for relatives. Patients with negative genetic test results can be reassured that relatives are not at significant risk for the same diagnosis.

The role of genetic counseling in cancer care

Genetic counselors provide the expertise necessary to interpret complex genetic results, discuss the implications for patients and their families, and offer psychological support throughout the process. Genetic counseling not only helps patients make sense of their genetic test results, but also provides them with the tools to make informed decisions about their health.

Counseling also helps address the emotional and psychological aspects of genetic testing, from potential feelings of anxiety to guilt and even empowerment. Research shows that genetic counseling has a positive impact on patient knowledge, reduces anxiety and can improve overall psychological well-being during a cancer journey.

Learn more about genetic counseling at Wellstar.

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