After suffering from severe back pain, Frank DiLeo, 43, feared he had a ruptured disc. Soon, the Allentown man learned something far more serious was the root of his pain, metastatic cancer. Even worse, the tumor in his lung, that was the origin of the metastatic bone cancer in his back, had created a life-threatening heart condition that, without the quick diagnosis and action of the team at St. Luke’s University Hospital in Bethlehem, could have been deadly.
Today, DiLeo is a living testament to St. Luke’s lifesaving multidisciplinary teamwork.
The pain began one morning in the middle of August. DiLeo, the Director of Instruction at the Executive Education Academy, a business charter school in Allentown, was practicing yoga when something snapped. Suddenly, he felt excruciating pain throughout his lower back. He used over-the-counter pain relievers and chiropractic care to cope with the pain for nearly two months. When the pain persisted, he considered treatment from a pain management specialist. He had an MRI to see if it was in fact, a bulging disc. Instead, the MRI showed “spots” throughout his lumbar area.
Right away, DiLeo saw his family doctor, Neal Berkowitz, MD, who ordered blood work and immediately referred him to medical oncologist Yacoub Faroun, MD. During his appointment a couple of days later, Dr. Faroun confirmed that, based on his MRI report, DiLeo likely had cancer. The oncologist also performed a physical and noticed that DiLeo had tightness in his chest and bulging veins in his neck.
“Dr. Faroun was convinced that I needed to be admitted to the hospital immediately,” DiLeo said, “He was very emotional about it and said, ‘If you were my brother, I would have you admitted.’ I was surprised. I had planned to go back to work after the appointment. I thought that I had just pulled something in my back. Never in my wildest dreams did I think I had cancer.”
After being admitted that evening, a CT scan determined that there were lesions throughout DiLeo’s lower back, spine and skull. He also had a lung tumor. A subsequent biopsy of DiLeo’s iliac bone determined that lung cancer was the source. Even worse, it caused fluid to collect around his heart. This condition kept his lungs from expanding. Untreated, it could have caused his heart to stop from tamponade, a very serious condition in which the heart can't pump enough blood to the body due to a buildup of fluid around the heart.
The following day, he saw medical cardiologist Jovan Plamenac, MD, who explained that DiLeo had pericardial effusion, a condition characterized by too much fluid in the saclike structure around the heart. To treat it, the cardiologist urged him to have a procedure called a pericardial window.
“Dr. Plamenac did everything he could to make sure I had the procedure that day,” he said. “He contacted the thoracic team and Dr. Justin Manchester saw the immediate need for the surgery. He created space in his surgical schedule and performed the procedure. All three doctors took the time to care about me and literally saved my life that day.”
During the procedure, Dr. Manchester removed a small part of the sac to allow excess fluid to drain. Nearly 700mL of fluid drained from a sac that normally contains 20-30mL. Over the next 11 days, DiLeo remained in the hospital while tests were performed, and fluid continued to drain from the pericardial sac. During this time, DiLeo also saw pain specialist Rebecca Ballentine, MD, who explained how pain can affect a patient’s emotions, mental state and relationships.
“Dr. Ballentine even took me outside one day just because I hadn't been out for so long,” he said. “It was really nice. We just chatted. She didn't have to do that.”
Meanwhile, DiLeo received radiation treatments, an echocardiogram, MRIs and a bone biopsy to determine the type of cancer. The biopsy revealed he has small-cell adenocarcinoma. Further tests revealed he was a good candidate for targeted therapy, a type of treatment that works on certain types of cancer to block the growth and spread of cancer cells. He has since started taking Tagrisso, a pill to treat lung cancer.
DiLeo has followed up with his care team, including Dr. Ballentine for palliative care, which focuses on relieving pain and other symptoms of a serious illness. Dr. Ballentine helps him manage his economy of energy and plan for all areas of wellness, including physical, mental, social and emotional wellbeing. In addition, to monitor lesions found in his brain, he has seen Daniel Ackerman, MD, of St. Luke’s Neurology Associates in Bethlehem.
DiLeo feels much better than before he began treatment. He credits the team for saving his life. Also, he appreciates the concern and kindness they showed him in the hospital and continue to express during his outpatient visits.
“From oncology to palliative care, to cardiology, thoracics and neurology, the empathy and compassion that everybody shared was evident,” he said. “Many of the people who came and read my chart, identified with me because I am relatively young for being diagnosed with cancer. They made me feel like I wasn’t just another number with cancer, but someone who was a human being that they cared about and were determined to help get better.”