Doctor Finds Cancer During Prep for Gastric Bypass Surgery

PHOTO: Rachel Sandridge was diagnosed with stomach cancer after doctors prepped her for gastric bypass surgery. PlayCourtesy Rachel Sandridge
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A Maryland woman says she is thankful after a doctor caught early-stage stomach cancer during preparation for gastric bypass surgery.

Rachel Sandridge had decided to undergo gastric bypass surgery after her weight topped 430 pounds at age 29.

"I wanted to get my life under control," Sandridge told ABC News. "I had six months of classes and did that, and [had] to get pre-surgical testing done before you actually have clearance for surgery."

Part of that testing involved getting an endoscopy to look at her stomach to ensure there was nothing wrong. During that common procedure, Sandridge said, the doctor found signs of inflammation in her stomach, or gastroenteritis, and took a small biposy to sample.

Days later, Sandridge received a call from her doctor's office to come in and meet with the doctor on Monday.

"When you hear those words, you say, 'Something isn’t right,'" said Sandridge.

She was able to convince the secretary to get her doctor on the phone, and he told her cancer had been found in her stomach.

"It didn’t fully click. I was scared and really nervous," Sandridge said.

The diagnosis was especially difficult for the family because Sandridge's father had just died from liver cancer two years earlier.

"I know the toll it puts on you," Sandridge said.

During a second endoscopy, Dr. Steven Fleisher, a gastroenterologist and director of Interventional Endoscopy at Medstar Franklin Square Medical Center in Bethesda, Maryland, scraped cells across Sandridge's stomach to look for signs of further cancer and removed the tumor itself, Sandridge said.

Sandridge also got a PET scan and other follow up procedures, but there were no signs the cancer had spread.

"If he wouldn’t have picked that spot, he would have totally missed it," said Sandridge of the first biopsy. "And [if he] never caught the cancer ... I don’t know where my life would be right now."

PHOTO: Rachel Sandridge said she is thankful doctor was able to catch the early stage cancer before it spread. Courtesy Rachel Sandridge
Rachel Sandridge said she is "thankful" doctor was able to catch the early stage cancer before it spread.

Fleisher said a pathologist reviewed the tumor and determined it had been removed in its entirety. It also meant the cancer had been caught in its earliest stages.

That "means it is limited to the most superficial layer and has not spread through the muscle wall," said Fleisher.

Catching stomach cancer in an early stage is key to recovery. According to the American Cancer Society, 71 percent of people survive for five years if they catch the cancer in the earliest stage. Overall, the survival rate for people with stomach cancer is just 29 percent for five years.

"In Rachel's case, it was an unexpected and fortuitous finding," said Fleisher. “She is exceedingly pleased with the diagnosis and I truly believed we saved her life."

Dr. Christopher You, medical director of bariatric and minimally invasive surgery at Med Star Franklin Square Medical Center, worked with Fleischer to treat Sandridge. He said if the endoscopy hadn't been done the tumor likely would have not been found until it metastasized, because in a normal gastric bypass the bypassed stomach remains in the body.

"I think if we had not done that endoscopy and there’s no food passing that area, that tumor could grow with out anything going against it," said You, adding that the stomach is very hard to see through an endoscope after the surgery.

He added that some doctors do not do endoscopies before every gastric bypass because they want to avoid unnecessary procedures.

"The argument against it is you only find issues in patients in 1 in 5 cases, [so] 80 percent of the time you’re not going to find anything," said You. He added that issues can include less-dangerous problems such as inflammation or anatomical issues.

Sandridge was able to go through with her gastric bypass surgery, which removed approximately 80 percent of her stomach. You helped to create the pouch made from the top portion of her stomach and a surgical oncologist removed the lower portion of her stomach to examine for cancer cells.

A detailed study of the stomach found no cancer cells meaning Sandridge didn't even need any chemotherapy or radiation. She would just need careful monitoring in the years ahead.

"I was just relieved and definitely, definitely feel like a weight was lifted off my shoulders," said Sandridge on hearing the news.

More than seven months after her surgery, Sandridge said she feels healthy and active as she loses weight. She has dropped from 437 to 270 pounds.

"I just feel more blessed more happy," said Sandridge. "I make sure to take care of myself and I’m little more cautious. I step away from fried and greasy foods."