by David Glick
To hear the words “You have cancer” can be devastating. But imagine learning that you have cancer in two places at the same time.
That diagnosis turned the life of Nazar Yeranosyan, 53, upside down.
An office manager, Yeranosyan enjoyed spending his time at home with his wife and four boys. They kept him active, but in July 2011, Yeranosyan unexplainably began to lose weight — a lot of it. A medical consultation with his family doctor and subsequent tests revealed Yeranosyan had developed a tumor in his brain. Then additional tests showed he also had a cancerous tumor on the upper lobe of his right lung.
Dan Raz, left, and Nazar Yeranosyan (Photo by p.cunningham)
The lung cancer had spread to his brain.
Suddenly his weight loss became the least of his worries. “The area hospital that diagnosed me with cancer told me that I should immediately begin chemotherapy treatments, and that I possibly had only six months to live!” said a shaken Yeranosyan, who lives in Encino, Calif. “I was frightened, to say the least.”
Not wanting to waste any time, but unsure of his next steps, Yeranosyan spoke with a family member treated at City of Hope for thyroid cancer — and decided to give City of Hope a call. “It was the best call I ever made in my life,” he said.
Behnam Badie, M.D., chief of the Division of Neurosurgery and director of City of Hope’s Brain Tumor Program, removed the tumor within Yeranosyan’s brain. It was located in the cerebellum, the part of the brain that controls the body’s motor movements. Then, to try to kill any cells that might remain, Yeranosyan underwent 15 days of radiation therapy.
With his brain tumor and radiation treatments behind him, it was time for Yeranosyan to discuss the best treatment for his lung cancer. He met with Marianna Koczywas, M.D., clinical associate professor of medical oncology. Koczywas thought surgery was the best choice, but wanted to see how his tumor reacted to chemotherapy first. Yeranosyan asked if he could receive his treatments at a facility closer to his home and Koczywas was receptive to the idea.
After four months of chemo, Yeranosyan’s tumor, originally measured at 8.8 centimeters, had shrunk to 5 centimeters. When he returned to City of Hope, Koczywas urged surgery to get rid of the remaining cancer and referred him to Dan Raz, M.D., assistant professor in the Division of Thoracic Surgery.
“In most cases when lung cancer has spread outside the chest, we don’t talk about treatment being curative. But with surgery, we can cure some patients whose cancer has only spread to one location,” said Raz.
“I felt performing minimally invasive surgery would give him the fastest recovery and best quality of life,” he added.
Lung cancer has a reputation for being aggressive and difficult to cure, but sometimes a specific tumor’s biology makes it more vulnerable to treatment. In about a quarter of patients with just one, isolated area of cancer spread, surgeons can cure the disease by aggressively removing the tumor, Raz explained. “The trouble is that we still can’t tell with a high degree of accuracy who that 25 percent of patients who present this way will be,” he said.
“In the future, genomic testing of tumors to identify molecular changes that signal good or bad prognosis might help guide treatment.”
As Yeranosyan underwent the minimally invasive right upper lobectomy, his family gathered in the second-floor surgical waiting area of City of Hope Helford Clinical Research Hospital, eager for news. When Raz emerged from behind closed doors with a wide grin on his face and told them the surgery was a success, the family breathed sighs of relief and embraced each other with tears in their eyes.
“City of Hope is the No. 1 place to be treated for cancer. Second is nowhere close!” said Yeranosyan’s son, Alex.
Now back home with his family, Yeranosyan has not yet returned to work after his bout with cancer. “I want to take the time to heal properly and be with the ones I love most,” he said. “I’m in no hurry to return to work just yet.”