Patient Endured 9 Years of Chemotherapy for Cancer He Never Had
This is a MedPage Today story.
This story was originally published by ProPublica. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
Anthony Olson wanted a career, children, a partner with whom he could hike Montana's trails. Despite the diabetes diagnosis at age 4, the anemia, the kidney transplant that failed at age 29, the dialysis, he clung to those dreams. He attended community college and later moved from his parents' house in Helena to study accounting at Montana Tech in Butte. He thought he might live a nearly normal life.
All of that was taken away in early 2011 when an oncologist at St. Peter's, Helena's only hospital, diagnosed him with myelodysplastic syndrome (MDS), a blood disorder that's often described as pre-leukemia. The life expectancy of MDS patients is short. "He told me that without treatment, I'd be dead before the end of the year," Olson said. He was 33.
"That diagnosis changed the direction of my life," Olson, now 47, told me.
Olson couldn't have known that he was one of many patients who, according to court records, may have received inappropriate, harmful, or unnecessary treatments from Thomas C. Weiner, MD. As I reported earlier this month, administrators at St. Peter's suspected Weiner, who directed the hospital's cancer center, was hurting patients for years. Yet hospital administrators allowed him to keep treating people until late 2020, when they suspended and then fired him. Weiner has denied all the allegations.
"I trusted that he was doing what was best for me," Olson said of Weiner. "I never really questioned that until someone else told me that there was reason to."
I discovered Olson's story in a cache of records related to an ongoing legal dispute between Weiner and St. Peter's. I was struck by how similar his case was to that of another Weiner patient, Scot Warwick. Weiner had diagnosed Warwick with stage IV lung cancer and treated him with chemo and other therapies for 11 years, court records show; after Warwick died in 2020, his family learned, from both a biopsy and an autopsy, that he never had cancer. Weiner insisted that Warwick had cancer all those years and that other doctors "missed" the disease.
Olson's diagnosis was similarly flimsy, and he had been treated over nearly the same period of time. But there was a key difference between the two men: Olson lived to tell his story.
After he was diagnosed, Olson dropped out of college, moved back in with his parents, and began Weiner's prescribed regimen: 4 straight days on chemo, 4 weeks off. Repeat until he died. Olson endured this for 9 years.
"I stopped moving towards a career and a future and was trying to figure out, 'What can I do now? What's most important to me?'" Olson said. "I spent a lot of time thinking about that, but I didn't really have the money, especially with the cost of treatments, to do anything. I was kind of just stuck."
In our conversations, Olson downplayed what happened to him next. As chemo goes, he said he had it easier than most. He kept most of his hair, for example. But exhaustion from the chemo anchored him to his parents' basement. He sank into himself, tinkering with computers and dabbling in photography, "reaching for anything that I could do in my relatively short amount of time." He told loved ones he'd soon be gone. He asked his parents to take his car. His father refused.
Early in his treatment, tests showed the chemo had worsened Olson's anemia. Weiner placed him on weekly iron-rich blood transfusions. Over months and then years of chemotherapy and other treatments, Olson bonded with Weiner and St. Peter's staff. He thought of them as friends. As the iron levels in his blood continued to rise, the cancer center nurses began calling him "The Iron Man."
"I thought he was helping me," Olson said of Weiner. "I actually felt pretty fortunate that we had such a gifted doctor in such a small community."
His parents, too, believed they'd found "a miracle" in Weiner. Olson appreciated that Weiner had taken over as his primary care physician. Like dozens of Weiner's patients, Olson told me he thought he had found a sort of concierge alternative to the broken maze that is the American healthcare system. Weiner often fast-tracked patients for hospital stays, which made him popular with patients. It also increased his patient load -- as many as 70 patient contacts a day, records show. The more treatments and visits Weiner billed, the more money he made.
"He always made the process fairly easy," Anthony's mother, Patti Olson, said of Weiner. "So, if we needed medications or anything like that, he would bridge that gap for us. That went a long way in helping us through a lot of pretty difficult situations."
In 2016, Robert LaClair, MD, the kidney specialist who was managing Olson's dialysis, became concerned. After hundreds of blood transfusions, Olson's body was suffering from "iron overload" (a ferritin level of over 10,000), which can destroy internal organs. It could have killed him.
LaClair tweaked Olson's treatments, which improved his anemia and iron overload. He told him that he could now be a candidate for a new kidney, which would supplant the need for dialysis and maybe allow him to regain his life. The only problem? His chemo treatment disqualified him from the transplant waitlist.
Olson told me there were moments of real anger at his situation, "but most of the time, I think I was pretty level, and just did it because it had to be done, and this was the treatment. For a lot of it, I was amazed that I was still around and that it was working as well as it was."
By 2019, LaClair suspected that Weiner may have misdiagnosed Olson and urged his patient to get a second opinion. But LaClair kept quiet about his misgivings for years, according to records and interviews. Weiner was a powerful figure within St. Peter's and in Helena. He was earning $2 million a year and had threatened to sue the hospital several times, court records show. While his nurses adored him, others inside St. Peter's feared him. Many on staff credited him with forcing out two hospital CEOs who had challenged his pay, court records show.
"If any one of us came up against him, we would have been crushed," LaClair told me. "He had too much power and too much money."
LaClair finally took his concerns to the hospital's peer review committee, an internal group of doctors charged with examining questions about patient care. In early 2020, he became the committee chair and would lead the effort to remove Weiner. He acknowledged that he and the hospital waited too long to act.
In December 2020, St. Peter's fired Weiner, accusing him of "harm that was caused to patients by receiving treatments, including chemotherapy, that were not clinically indicated or necessary," among other allegations.
Weiner responded by suing the hospital for wrongful termination and defamation. Former patients created a Facebook group called "We stand with Dr. Tom Weiner" and held the first of hundreds of small protests outside the hospital. A Montana judge dismissed Weiner's suit. He filed an appeal, which is pending with the state Supreme Court.
When Olson learned that Weiner had been removed, he was outraged, convinced that he'd lost a brilliant medical mind, who had been kind and given him years he otherwise would never have seen. He and his parents cheered on the protestors. "I would have been probably one of those people, on his side, up until all this blew up and we found out what was really going on," he told me.
Olson didn't know that his case was among dozens that St. Peter's sent to outside medical reviewers at the University of Utah and The Greeley Company, a healthcare consultancy. The reviewers discovered that Weiner had ordered two bone marrow biopsies in 2011. The first showed signs of MDS, which researchers in recent years have found is commonly misdiagnosed. However, the second, taken 10 months later, indicated no disease.
Weiner shared the negative biopsy result with Olson but told him to ignore it; all it proved was that the regimen was working. Weiner continued Olson's chemotherapy.
That second biopsy, at the very least, should have prompted more testing to confirm or eliminate MDS, the reviewers wrote. It was unclear "why this second bone marrow biopsy result was ignored, and why another bone marrow biopsy was not done," the report said. "The patient may have been exposed to the toxicities of these treatments unnecessarily."
When I questioned Weiner about Olson's case, he dismissed the reviewers' conclusion that he should have stopped chemotherapy when the follow-up biopsy was negative. "That doesn't say you didn't have the disease," he said. "It just means that the treatment worked, and it knocked it away. It doesn't mean you didn't have it at the beginning."
I pressed Weiner. If the chemo had "knocked it away," wouldn't that call for adjusting the treatment? He said he continued chemo for another 9 years on the advice of experts at the Mayo Clinic. Olson scoured his medical file and found no evidence to support this claim.
After Weiner was gone, Olson received another biopsy, which came back negative. St. Peter's also retested the sample from the first biopsy. It, too, showed that he never had MDS. Despite the overwhelming evidence that Weiner had misdiagnosed and improperly treated Olson, LaClair felt he couldn't just say, "Dr. Weiner did this to you." Records show many Weiner patients bristled when told to get a second opinion or became hostile at the suggestion that Weiner had mistreated them.
"The worst part of the harm is that they believed in him," LaClair told me. "The harm that he's done to these people -- they're broken both physically and mentally because of what he did."
For years, LaClair could not comprehend why so many in Helena continue to support Weiner, but in watching the change in one of his favorite patients, he came to understand something: Olson didn't just feel betrayed; he was heartbroken. "You want to hear something that really makes you sick?" LaClair asked. "He said to me, 'I just wanted him to say he's sorry.'"
After receiving chemo through his 30s and into his 40s, Olson's cancer treatments were stopped in early 2021.
In a court filing that year, the hospital alleged that Weiner "misdiagnosed and/or failed to properly diagnose numerous other patients whose subsequent chemotherapy treatments may not have been warranted ... ." St. Peter's, however, did not provide a full accounting. The hospital reported that it had suspended Weiner to the state medical board, which declined to comment. But it's unclear whether St. Peter's relayed Olson's case or any of the other misdiagnoses to the board. Hospital administrators declined to comment on the case, even though Olson signed a medical privacy waiver granting them permission to talk to me. A spokesperson said in a statement that "St. Peter's is focused on moving forward, and we remain fully committed to providing the great care and experience our community deserves."
When I presented Weiner with examples of alleged patient harm, he denied that he mistreated anyone and remained unapologetic. He does acknowledge, however, that Olson suffered for no reason.
"I felt that he had MDS," Weiner said. "I was continuing this medicine to suppress it and control it for as long as possible, because he had no other option. Obviously, if I knew that he never had MDS, I wouldn't have done it, but I was under the belief from the reports and everything that he should continue it. Now, again, hindsight says that he got it needlessly, and that part of it, I'm sorry about. I am."
For Olson, the acknowledgement that he didn't have cancer is 13 years too late. In 2022, he sued St. Peter's for malpractice. The hospital settled and paid an undisclosed amount. Because Weiner was an employee of St. Peter's, he was not held liable.
No longer overloaded with iron or receiving chemo, Olson became eligible for a donor kidney. In the summer of 2023, he got one. He continues to struggle with an array of health issues, but he knows there's a chance he can live into old age.
Olson tries not to think about what happened to him. It takes him to a dark place. He still wants to see the best in people, even Weiner. But he sometimes can't help but wonder what motivated his former oncologist. "Did he just do this for money?" he asked. "Was he betting on me to die and just thought he could make more money?"