When he was diagnosed with stage I gastric cancer, Allen was hesitant when doctors said they would need to remove most of his stomach. He came to Memorial Sloan Kettering for a second opinion, where his cancer team proposed a minimally invasive surgical approach to take out the tumor and only part of his stomach.
Allen Wang was eating breakfast on an April morning in 2008 when he had a strange feeling in his stomach. His wife, Alice, suggested that he avoid drinking coffee for a few days and see if he felt any better.
Even though the feeling subsided, Allen decided to have it checked by his doctor because he had had a stomach ulcer once before. The doctor used an endoscope — a flexible, lighted tube with a lens on its tip — to examine his stomach and remove a few tiny samples for biopsy.
It’s “Something Bad”
“After a week, the doctor called me and said he found something bad — he found cancer,” Allen recalls.
“My first thought was ’Why me?’ My daughter’s wedding was in June, so I asked him what I should do.” Allen’s doctor referred him to a surgeon at a community hospital in Queens, New York, who, within minutes of meeting Allen, scheduled a surgery for the following week. The surgeon told Allen that as part of the surgery he would have to remove two-thirds of his stomach, which also would require a large incision. The doctor warned Allen that the recovery time would be lengthy, and Allen would need to make many dietary changes.
Uncertain about his options, Allen consulted his daughter, Carol, who encouraged him to get a second opinion at Memorial Sloan Kettering Cancer Center in Manhattan.
A Less Invasive Surgical Option
Within a week, Allen had an appointment at Memorial Sloan Kettering to see Vivian Strong, a surgeon who specializes in the treatment of stomach cancer. She had him undergo another endoscopy with one of the hospital’s gastrointestinal specialists and sent him for a number of tests, including a CT scan. With results in hand, Dr. Strong told Allen that his stomach cancer had been found very early and was stage 1, meaning that the cancer was only in the innermost lining of the stomach so only one-third of the stomach would need to be taken out in order to remove the tumor. Dr. Strong also informed Allen that he was a candidate for a less-invasive procedure called laparoscopy, which should make the recovery a little easier.
Laparoscopy is a surgical procedure that is performed using a thin, lighted tube with a video camera at its tip (called a laparoscope). The laparoscope is inserted through a tiny incision in the abdominal wall. Guided by this highly magnified image, the surgeon can operate through six tiny surgical “ports” using specially designed surgical instruments.
Having a doctor who could explain the medical details in a clear, simple way was important to Allen and his wife because English is not their native language — the couple, who have been married 34 years, immigrated to the United States from Taiwan in 1984. “My English is not very good, so after Dr. Strong said something, she would ask me if I understood.”
After Dr. Strong explained the surgery to him, Allen remembers that she asked him if he wanted her to be his surgeon. “I said yes. I had a feeling that she was the right one.”
Surgery — After His Daughter’s Wedding
With Dr. Strong’s OK, Allen decided to delay the operation until late June, after his daughter’s wedding. A few minutes before surgery, Dr. Strong came into the operating room and took Allen’s hand. “She said to me, ’Don’t worry — I’m going to take care of you. When you wake up, everything will be fine,’” Allen recalls.
“It touched my heart. She’s very, very nice and treated me like a friend.”
During the surgery, in addition to removing the cancer in his stomach, Dr. Strong removed 24 lymph nodes from his abdominal region to determine if the cancer had spread beyond the stomach. All of the nodes came back cancer-free.
Allen was able to go home three days later and was back to work 25 days after that. The recovery time following traditional open surgery can last between two to three months, so he was glad to be back to his regular routine in less than a month.
During one of the first follow-up appointments about a month after surgery, Dr. Strong recommended that Allen see her colleague, medical oncologist Raymond Meng, to talk about what additional, adjuvant treatment might be necessary.
The standard course of treatment after stomach cancer surgery is combination chemotherapy and radiation therapy for a series of weeks. Dr. Meng advised Allen to undergo this additional treatment to reduce the chance of his cancer coming back (recurrence), but Allen was opposed to having chemotherapy, which he viewed as toxic to his body. Because Allen’s lymph nodes were clear of cancer, Dr. Meng did not press Allen to pursue additional treatment unless the cancer recurred at any point in the future.
A Few Lifestyle Changes
As Allen learned throughout the course of his treatment, two of the strongest risk factors for developing stomach cancer are being Asian and having a diet high in salty foods and red meat. Prior to his diagnosis and surgery, Allen consumed a lot of red meat; his favorite food was Asian-style barbeque, which is very high in salt. With the help of his wife, Allen has been able to completely change his diet — he now eats lots of chicken and fish, fruits and vegetables, and no sweets. “My wife takes care of me — I really appreciate it. We are even closer than before,” he explains.
Going forward, Allen feels better than ever and is grateful for every day. “It’s very scary when you go to the doctor and he says you have cancer. But it happened, and we had to face it.”