āThank God for a Kidney Stoneā ā Middlesboro Manās Diagnosis Leads to Cancer Discovery
LEXINGTON, Ky. (Aug. 24, 2020) ā Kidney stones are infamously painful. Even at their tiniest size, these mineral deposits can wreak havoc as they exit the kidneys, leading to the type of breathtaking pain thatās often compared to the experience of giving birth.
But for Middlesboro resident Michael Slusher, that pain turned out to be a wake-up call for something much more serious.
āIām probably the only person who says, āThank God for a kidney stone,āā he said. āBecause it discovered my kidney cancer before it metastasized.ā
The CEO of , Slusher was leaving work in early February when he began experiencing persistent pain in his abdomen that he initially thought were caused by his gallbladder. He didnāt make it home, instead turning right around and heading straight for the Emergency Department at Middlesboro ARH.
A CT scan showed stones in both kidneys ā and a 7-centimeter mass in the left kidney. Followup testing showed that the mass was malignant. Having lost both of his parents to cancer, he was immediately worried about the implications of this diagnosis.
āBoth of my parents died young of cancer ā my mother was 55; my father was 68,ā Slusher said. āSo when I got my cancer diagnosis, it was scary. I want to walk my daughter down the aisle. I want to hold my grandkids.ā
Slusher faced major surgery to remove the mass. He wanted his surgery to be performed laparoscopically to reduce his recovery time, and when given referral options by local urologist Dr. Seymour Kilstein, he chose the .
In 2019, Middlesboro ARH Hospital joined the , a group of community hospitals in the state that provide high-quality cancer services and programs in their communities with the support of the ŗ£½Ē½ūĒų Markey Cancer Center. He says this familiarity helped solidify his decision to come to Markey.
āWhen I was offered a choice, I knew where I was going without a momentās hesitation,ā he said. āAs part of the affiliate network, I had taken a group of doctors up to Markey for an orientation before I ever had my surgery. Iāve been to ŗ£½Ē½ūĒų several times and my daughter has had surgery there, so Iām very familiar with ŗ£½Ē½ūĒų and knew what to expect going in.ā
Slusherās oncologist at Middlesboro ARH, , referred him to Dr. Andrew James, a urologic oncologist with the ŗ£½Ē½ūĒų Markey Cancer Center. James specializes in open and laparoscopic/robotic-assisted surgery for the treatment of kidney, bladder, prostate, testicular, penile and adrenal cancers. While kidney cancer isnāt considered especially common, James says the team at Markey treats quite a few cases and Slusherās experience isnāt unique.
āWe see a lot of patients with kidney cancer,ā James said. āAnd most cases are asymptomatic and are found incidentally ā like in Mr. Slusherās case, found on scans or an evaluation for something else.ā
Prior to his surgery, Slusherās case was taken before Markeyās Genitourinary Multidisciplinary Tumor Board, where new solid tumor diagnoses are reviewed. This Board comprises a number of experts at Markey, including medical oncologists, surgeons, radiation oncologists, pathologists, and radiologists who meet regularly to discuss each case. These specialists bring their own expertise to discuss the available options and ultimately make a recommendation for the best course of care for that patient.
Even though Slusherās case was fairly straightforward, James said thereās value in bringing each new cancer case in front of the Tumor Board to ensure all treatment possibilities are considered by a multidisciplinary team.
āI think itās a great thing,ā James said. āAll new cases are reviewed there, and things may change upon our review. Weāve had times where, say, the pathology has been different, and thatās opened up other options for patients.ā
In late February, Slusher came to Markey for his pre-op visit with James. Due to the size and location of the tumor, the entire left kidney would need to be removed. On March 10, he underwent a left laparoscopic radical nephrectomy with James. And just a little more than 24 hours after the procedure, he was able to return home to recover.
āI was almost back to normal within two weeks, and was back to work within three weeks,ā Slusher said. āSo Iām very pleased with the care I got from Dr. James. You really canāt even tell that I had surgery on March 10.ā
āLaparoscopic surgery is a great way to go,ā James said. āItās not always an option, but it is possible in a lot of patient situations. Most patients leave after one night, and they have smaller incisions, less pain and less time in the hospital.ā
Because his pathology came back with negative margins ā meaning all the cancer was successfully removed ā Slusherās case didnāt require further treatment after his surgery. But he says Shanshal is working with James to see about having him join a clinical trial for immunotherapy as an extra precaution, with the hopes of preventing any potential cancer recurrence. Any followup or additional care he might need can be provided right in his hometown from Shanshal, with guidance from James as needed.
Itās the way the Markey Affiliate Network was designed to work ā keeping patients as close to home as possible for their treatment, with trips to Lexington only necessary when the patient requires more complex care (such as a laparoscopic surgery). Slusher notes that the decision to join the Markey Affiliate Network last year was a āblessingā and heās seen firsthand how the relationships between local and Markey providers can elevate patient care. While Lexington is a bit further away than Knoxville ā the next-largest city nearest to Middlesboro residents ā he says the slightly longer trip is worth it.
āWeāre in a relationship business; thatās what health care is all about,ā Slusher said. āAnd thatās the value of the network affiliation between Middlesboro ARH and ŗ£½Ē½ūĒų ā itās those relationships. If Dr. Shanshal picks up the phone and calls Dr. James, heās going to answer. Whereas if Dr. Shanshal is calling someone he doesnāt know, youāre not sure when you might get a call back.ā
And itās the relationships he has with his team at Middlesboro ARH, he says, that make his current job so enjoyable. After working in metropolitan cities like Chicago and Cleveland and with smaller community hospitals in his home state of Ohio, Slusher took the job as CEO of Middlesboro ARH, where heās been for more than a decade. Moving to Appalachian Kentucky was a homecoming of sorts, as both he and his wife have strong family ties to Eastern Kentucky, and he says thereās nowhere else heād rather be.
āIāve been the CEO here for 11 years, and itās by far the best job Iāve ever had,ā he said. āAnd the reason itās the best job Iāve ever had is because of the people I get to work with ā and thatās including the staff at Markey.ā
