At age 57, Joseph Laurina plays soccer twice a week for the Stoneham Spartans in the New England Over-the-Hill Soccer League, the largest of its kind in the Boston area.
Watching him run up and down the field at Harry Della Russo Stadium in Revere, you’d never guess that only two years ago, he was diagnosed with lung cancer and later, metastatic brain cancer. Coordinated by an expert and multidisciplinary team at Tufts Medical Center, he received targeted therapy and innovative treatments that kept his goals in mind and were aimed at giving him his best shot.
Lingering pain and later, a diagnosis
In February 2016, Joe started having extreme pain in his hands and his knee swelled up. He attributed his symptoms to his two times a week soccer schedule and recently playing in a national tournament in Orlando.
He made an appointment to see his primary care doctor, who thought the cause might be arthritis so referred him to a rheumatologist in Stoneham. After examining Joe, the rheumatologist ruled out arthritis and then, on gut instinct, asked him to get a chest CT scan. She had seen a rare case where similar symptoms had been caused by lung cancer and wanted to make sure it wasn’t the same case for Joe.
The next day, Joe went for the scan. “After the test, the technician came over and asked me to take a seat,” Joe recalled. “I thought that was a little strange, especially when they told me they were getting a hold of my doctor. About 5 minutes later, he called me and told me I needed to come into the office that day. I knew that wasn’t good.”
Joe was diagnosed with stage 3A lung cancer. And, after spending a few months seeing a specialist at another academic medical center in Boston, decided to come to Tufts Medical Center for treatment.
“Within the first 3 minutes of my first appointment with the thoracic surgeon, Dr. Larry Brinckerhoff, I immediately felt at ease,” Joe said. “He told me to call him Larry, he explained my condition and options clearly and showed that he really cared. I knew I was in great hands at Tufts.”
A multidisciplinary team plans ahead for Joe
The next step after Joe’s initial appointment was the presentation of his medical history and goals at a multidisciplinary Cancer Center tumor board. Because Joe had been diagnosed with lung cancer, his case was presented to a team of oncologists, pulmonologists, thoracic surgeons, radiation oncologists, pathologists and other experts who specialize in monitoring and treating this disease.
“We first reviewed Joe’s current condition and medical history,” explains Radiation Oncologist Kathryn Huber, MD. “We knew that Joe was an otherwise active and healthy man, so we used that and his goal to continue playing soccer to help guide our treatment plan.”
The team, led by Dr. Brinckerhoff, determined that the best first approach would be a combination of chemotherapy and radiation under the care of Dr. Huber and oncologist Gary Strauss, MD. After Joe completed his chemotherapy and radiation, the team repeated his staging scans before moving on to surgery. As part of the restaging he had an MRI of the brain, they found 5 metastases on his brain.
“I was worried,” said Dr. Huber. “He didn’t have just one brain met, he had five. So, before we started the chemo and radiation treatments we immediately pulled in the Multidisciplinary Brain Tumor Center team including Suriya Jeyapalan, MD, Julian Wu, MD and John Mignano, MD. They got him in for a Gamma Knife procedure within a week and even in that short of time, he had developed a sixth brain met seen on the planning scan for the Gamma Knife treatment.”
Gamma Knife: An innovative procedure
Tufts MC is the only hospital in northern New England to offer Gamma Knife stereotactic radiosurgery. This state-of-the-art technology focuses 192 beams of gamma radiation precisely on the tumor, sparing the healthy brain tissue that surrounds it.
“One of the reasons we recommended Gamma Knife for Joe is that it has a low chance of side effects,” explained Dr. Wu. “Because the radiation is so precise and focused, the treatment can be done in an outpatient setting and the patient can go back to the things they like to do within a few days. Compared to full brain radiation, there is also less likelihood for cognitive decline and impact on long-term quality of life.”
The best shot
The Gamma Knife procedure was successful in treating the mets in Joe’s brain. Soon after, he started 3 rounds of chemo. This was followed by a surgery performed by Dr. Brinckerhoff to remove a small wedge of cancer remaining in Joe’s lung after the chemotherapy.
“The fact that we offered Joe this combination of treatment options is unique,” said Dr. Huber. “In other hospitals and Cancer Centers, they may not have seen or offered this aggressive treatment plan to someone who had that number of brain mets. But we knew that Joe was otherwise healthy and gave him his best possible shot at recovery.”
“Honestly, the treatment was a walk in the park for me,” Joe said. “I never lost my hair, only once after treatment did I feel that burning and trouble swallowing sensation. Tufts made it easy. I love Tufts. I’d take a bullet for every doctor and nurse – they truly care.”
Living his life fully
Now back to playing soccer, Joe comes back to Tufts MC every two months for check-up scans. And although a recent scan found another brain met, he feels confident in the Gamma Knife procedure and the expertise of the Tufts team.
“They’re smart doctors and Gamma Knife is easy,” he said. “It’s just another treatment. We’ve planned for this.”