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Local specialty care benefits woman with rare tumor

Barb Callaghan

When Barb Callaghan, a resident of Missoula, experienced some unusual pains in her abdomen, she visited her local doctor. Subsequent testing revealed a large growth in her abdomen.

“[After some diagnostic testing,] it was further determined that I needed an endoscopic ultrasound (EUS). The concern was that I had a gastrointestinal stromal tumor (GIST),” said Callaghan. “This type of tumor is rare and lies within the inner lining of the GI tract. Biopsies of these tumors are risky because they are fragile tumors and there is risk of bleeding and the spreading of the tumor. I needed a specialist to do this type of ultrasound.”

An endoscopic ultrasound is a specialized procedure that combines endoscopy with ultrasound to secure images of internal organs. Only facilities with specialized equipment and specially-trained gastroenterologists can perform this procedure. Furthermore, if diagnosed with GIST, Callaghan would require the services of a surgical oncologist with unique skills and experience in removing this rare type of tumor. Because the tumor was located near the pancreas, it was likely that she would need a Whipple procedure, which is a difficult and demanding operation. Patients needing this procedure are advised to seek out a surgeon who performs a high volume of this type of surgery. To her relief, both of these types of specialists were available close by, at Kalispell Regional Medical Center.

Within the week, Callaghan traveled to Kalispell where gastroenterologist Dr. Robert Yacavone performed an endoscopic ultrasound, confirming the diagnosis of GIST. She was immediately scheduled for surgery with surgical oncologist, Dr. David Sheldon. The surgery was a success, and her treatment journey began.

“Dr. Sheldon played an important role in determining how and when I would begin my chemotherapy treatment,” said Callaghan. “Some physicians recommend chemo before surgery to first shrink the tumor. Because Dr. Sheldon was very familiar with the relatively new chemo drug that was planned for my treatment, he recommended that the tumor be removed immediately, then begin chemotherapy with Gleevac®.”

Gleevac® works by targeting specific type of cancer by attacking several different proteins believed to cause GISTs, so that most cells stop growing and multiplying, and some cancer cells even die.  Prior to the development of Gleevac®, a diagnosis of a GIST tumor was often terminal. Data indicated that in patients treated with Gleevac® after surgical removal of large tumors, the drug was more effective.

Callaghan noted that during her treatment, Dr. Sheldon gave her his personal cell phone number encouraging her to call him any time with any questions, and she felt comfortable doing so. Just weeks after her surgery, Callaghan was back to her active life, hiking in the Jewel Basin. From there, she sent a simple text to his number, “Greetings from the top of Mount Aeneas six weeks after surgery. Thanks for everything, Dr. Sheldon!! Barb Callaghan.”

For Callaghan, the diagnosis of cancer was frightening. But she credits local access to medical specialists as important factors in her positive outcome.

“I lost both my parents and my husband to cancer, so I know how real the threat can be. Having the opportunity to be so close to my home and my family during this time was monumental,” said Callaghan. “Without KRMC and those two physicians, I would have had to go to Seattle or Salt Lake City for these procedures – including a weeklong hospital stay. I got tremendous care and service in Kalispell for which I will be forever thankful. I do believe they played a big role in saving my life, and keeping me sane throughout the troubling time.”