Surgery gives two-time survivor new life

With a family history of colon cancer, Brian Folloder has been getting regular colonoscopies since he turned 35. But in 2009, when he was 62 years old, a screening blood test for medical insurance showed a possible sign of cancer. So, Brian had a CT scan.

It showed no evidence of cancer. Yet, Brian’s son Justin, a physician assistant in Surgical Oncology at MD Anderson, insisted Brian get a six-month follow-up scan at MD Anderson.

The scan revealed Brian had a pancreatic neuroendocrine tumor that would require surgery.

“My son just kept telling me, ‘Dad, you’re going to be fine.’” Brian says. And Justin was mostly right.

Finding life through surgery at MD Anderson

When Brian arrived at MD Anderson for surgery, he was scared. “I was crying like a baby because I thought people came here to die,” he says.

Brian quickly found the opposite to be true.

After a nearly eight-hour surgery with Jason B. Fleming, M.D., to remove the tumor, his gallbladder and lymph nodes, Brian was pancreatic cancer-free. But he would need to be followed for Barrett’s esophagus, a condition that made him more likely to develop esophageal cancer. The condition was incidentally discovered during the biopsy of his pancreas.

“My care was managed by an amazing team of doctors. And you know what they did?” Brian says. “They gave me more time to live.” 

A second round of cancer

In September 2010, Brian had an endoscopy as part of his surveillance under gastroenterologist Jeffrey H. Lee, M.D. It showed cancer. Following a biopsy, Brian was diagnosed with esophageal adenocarcinoma.

Wayne Hofstetter, M.D., director of MD Anderson’s Esophageal Surgery Program, was consulted for Brian’s care. “He was thorough,” Brian says. “He presented me with two treatment options and was clear that the choice was mine.” 

Brian could opt for a novel technique known as endoscopic mucosal resection, which allowed Dr. Hofstetter to preserve his esophagus. The procedure uses an endoscope with an attached device to reach and then remove the tumors. The alternative option was an esophagectomy – surgery to remove part of his esophagus.

“Choosing between the two was not an easy decision,” Justin says.   

Choosing endoscopic mucosal resection surgery

An endoscopic mucosal resection would require aggressive surveillance post-procedure – serial endoscopies and scans for an indefinite amount of time. “This can be a bit riskier for managing the disease,” Justin explains. “An esophagectomy is a more aggressive approach to remove the cancer, but causes permanent lifestyle changes and has its own set of risks.”

Brian made his decision after connecting with other patients through myCancerConnection, MD Anderson’s one-on-one support program for patients and caregivers. After speaking with four patients, Brian says he found his cure. 

He choose an endoscopic mucosal resection, followed by serial radiofrequency ablation with Marta Davila, M.D., to manage residual disease.

A new perspective after cancer

Since the endoscopic mucosal resection, Brian has remained cancer-free. “I know not everyone has a success story – my mother died of colon cancer when I was 15 years old,” Brian says. So at 69 years old, with a wife of 25 years, six kids and 10 grandkids, he feels grateful to be alive.

“MD Anderson gave me life -- twice,” Brian says. “And now, I am focused on maintaining a healthy lifestyle and giving back.”