In early 2011, Jovetta Means, a lovely 64-year-old woman from Fort Wayne, Indiana, came to see me for a third opinion on a very rare tumor involving her aorta.
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Jovetta was found to have a mass inside the wall of her aorta, positioned close to her esophagus and stomach, near her heart and left kidney. The tumor caused Jovetta to begin having severe shortness of breath, as well as back and abdominal pain. She had blood clots throughout her body, including many within her lung, causing her breathing difficulty.
She and her family were devastated when she was told there was nothing that could be done to try to cure her cancer. Jovetta was told she had only days to live.
March 2011: Turning to the Clinic
Then Jovetta came to Cleveland Clinic, seeing me for her initial consultation in March. Our cardiothoracic surgeons confirmed that the tumor, at its current size and location, was inoperable. I recommended a course of radiation therapy to try to shrink the tumor and possibly make it operable.
The treatment worked. Jovetta’s tumor shrank dramatically, but our multidisciplinary team decided that there were still too many risks for surgery. The radiation therapy had done its job on the tumor, but had also weakened the wall of the aorta, creating a dangerous condition called a pseudoaneurysm. I desperately wanted to maximize Jovetta’s chance for lasting tumor control but also wanted to make sure additional radiation would do her no harm.
I contacted my expert colleague, Dr. Eric Roselli, in cardiothoracic surgery, and we came up with a novel plan. Dr. Roselli would surgically place a stent graft to protect the blood vessel wall. This was unprecedented: It was the very first time a stent graft has ever been used to protect the aorta from an aggressive treatment plan using high daily doses of radiation.
A month later Jovetta started her aggressive radiation treatments using a very precise technique called stereotactic body radiation therapy (SBRT). All the innovative technology our field has developed in recent years came together to create the best state-of-the-art radiation treatment for Jovetta’s cancer.
September 2011: An unforgettable follow-up
I recall the follow-up we did in late September like it was yesterday — a dozen of Jovetta’s family members had come to Cleveland from Pennsylvania and Indiana to lend their support. When they heard that her CT scan showed the tumor to be much improved, I happily received a dozen hugs!
Seeing such impressive tumor shrinkage on the CT scan was amazing. Yet the most heart-warming vision I experienced that day was the sight of Jovetta without an oxygen tube in her nose, with no problems breathing, and completely pain-free.
Jovetta is one and a half years out from starting her treatment, and continues to live her life to the fullest without any ill effects from her cancer or her treatment.
People assume that my job is depressing and my work days difficult. They always seem surprised when I tell them how uplifting and fulfilling my job is taking care of cancer patients like Jovetta.
Because I’ve got the best cancer team, at the best hospital in the world.