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Jefferson Surgical Solutions

"When you can't eat my husband Joe's cooking, you know there's something really wrong with you!"

Eleanor Nadolski of Northeast Philadelphia looked forward to coming home from her job at an area bank to dinner prepared by her retired husband. But in October 1996, she started feeling a little pain, which she ignored, hoping it would go away. Her appetite diminished as the pain grew progressively worse and fear settled in. When, in January 1997, she finally got the courage to see a doctor, she learned she had colon cancer.

Intuitively, Eleanor felt a teaching hospital would be the best place for treatment. Her gynecologist referred her to Thomas Jefferson University Hospital, where she underwent a colonoscopy, CAT scan and MRI, revealing that her cancer had spread to both lobes of her liver. The turning point came when Eleanor met Scott Goldstein, MD, Director of Jefferson's Division of Colorectal Surgery. Because Eleanor, at age 64, was otherwise in excellent health, Dr. Goldstein decided upon a then-unconventional surgical approach in collaboration with Ernest Rosato, MD, Director of the Division of General Surgery. This involved excising the tumors from Eleanor's colorectal area, followed by cryoablation, or freezing, of the cancerous lesions in her liver.

Eleanor was impressed with Dr. Goldstein's compassion as well as his professionalism. "He was so kind to me and gentle with me. He didn't even know me, yet he took me under his wing and made me feel so comfortable!"

"I can't stop telling everyone exactly what Jefferson did for me."

Following pre-operative chemotherapy and radiation therapy, Eleanor underwent the procedure on February 21, 1997. It took several hours and required a temporary colostomy, and was followed by 13 days of inpatient recuperation and six months of postoperative chemotherapy and checkups until September 29, 1997, when Dr. Goldstein officially pronounced her cancer-free. Eleanor has remained so ever since.

Now retired, Eleanor enjoys sharing the cooking with Joseph, as well as their excursions to Atlantic City and time with their grandchildren. Her three adult sons, Joe, Tom and Kevin, each of whom she has referred to Dr. Goldstein for screenings, have participated with her in a radio spot for Jefferson. "I can't stop telling everyone exactly what Jefferson did for me," she says. "My family and I hope it inspires other people to seek treatment promptly if they feel pain."

The Surgeons Speak

Eleanor was the first patient at Jefferson – and among the nation's first – to benefit from the application of cryoablation technology in conjunction with resection. She had Stage IV cancer; her primary, colorectal cancer had spread into both halves of her liver. That was ordinarily considered an inoperable, incurable situation. But because she was an otherwise healthy 64-year-old woman, we took an aggressive approach.

First, we performed a partial proctectomy. After removing a large portion of her rectum, we focused on several lesions in her liver. We excised the smaller ones near the surface; we killed the larger, deeper tumors by freezing them. It took several hours, during which we very carefully managed Eleanor's fluids and body temperature.

This procedure demonstrated that new technologies like cryoablation and radiofrequency ablation could help patients whose disease may not fit the classic models for standard resection. Since Eleanor, we have performed it successfully on several other patients.

- Scott D. Goldstein, MD, and Ernest L. Rosato, MD

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