Cancer Survivorship: Eight Years as Patient and Surgical Oncologist with Stage IV DiseaseName : Dr. Alan Kawarai Lefor
Affliation : Professor
University : Jichi Medical University
Country : Japan
The patient is a 61y old surgical oncologist who was diagnosed with a stage IV neuroendocrine tumor (NET) of the pancreas eight years ago. This is the first patient with isolated metastases to the spleen and adrenal gland from an NET. This paper is a first person narrative documenting cancer survivorship over eight years of treatment in a patient with a unique perspective as patient and surgical oncologist.
Over the past eight years, the patient has undergone four major operations, and six minor procedures for treatment of the primary tumor as well as recurrences in the liver, spleen and adrenal gland.
The patient presented with anemia, eight years ago and was initially diagnosed by liver biopsy as having hepatoid carcinoma. Resection of the stomach, distal pancreas, spleen and colon revealed a huge left upper quadrant mass that was a pancreatic NET. Nine months later he underwent hepatic lobectomy. Percutaneous RFA was performed one year later followed by a second hepatic resection one year after that. This was followed by two more RFA sessions. A metastasis to the right adrenal gland was resected 90 months after diagnosis. The patient is now disease free, with the expectation that another recurrence will follow.
This patient’s complex clinical course has been described in three publications including a book chapter and two peer-reviewed papers, authored by the patient himself, about his own disease. Long term survival is not uncommon in this disease and is associated with a number of unique problems and perspectives including medical and psychosocial issues.
Alan Kawarai Lefor is a Professor of Surgery at Jichi Medical University in Tochigi, Japan, where he specializes in surgical education. He received a BS degree in Chemistry from SUNY Albany (1976) and an MA degree in Physical-Organic Chemistry from Wesleyan University (1978). Following graduation from SUNY Upstate Medical School (1982) in Syracuse NY (USA), he completed a residency in General Surgery (1989) and a fellowship in Surgical Oncology at the NIH (1985-87).
He served as Program Director in General Surgery and Chief of Surgical Oncology at Cedars-Sinai Medical Center in Los Angeles and Professor of Surgery at UCLA (1996-2007). He received a Masters degree in Public Health from UCLA (1999). He moved to his current position at Jichi Medical University in 2007 where his areas of clinical expertise are General Surgery, Trauma Surgery and Surgical Critical Care. He is the author of nearly 400 publications as well as 12 textbooks in English and Japanese, with translations into multiple languages.