Elizabeth Pegueros received the diagnosis no one wants to hear.
The 32-year-old mother of an eight-year-old daughter didn’t think much of her persistent cough. She always took good care of herself by getting plenty of exercise, ate right and didn’t smoke. She was confident it was just allergies or maybe a lingering infection to blame. Besides, she didn’t have health insurance. So, she thought, why waste money going to the doctor just to be told there wasn’t really anything that could done?
When the problem just wouldn’t go away, Elizabeth finally decided she needed to get to the bottom of it. In April, she was horrified to learn her issue wasn’t a cold, allergies or even pneumonia. Elizabeth had lung cancer. By the time she learned it was there, it had already advanced to Stage IV and the disease had spread to her ovaries, bones and kidneys.
Pegueros suddenly found herself in intensive care with a high fever and her lungs were filling up with fluid. The outlook was bleak. Her doctor told her a physician at JPS Health Network, Interventional Pulmonologist Dr. Paras Patel, could attempt a breakthrough new procedure on her Monday morning. It could clear her lungs of fluid and make it easier for her to breathe. But the doctor told Pegueros, with the way her health had deteriorated so quickly, it didn’t seem likely she would survive through the weekend. He advised her to spend her last few hours saying final goodbyes to her family.
“I remember that I stayed awake that entire weekend,” Pegueros said, adding that the nurses on her floor took turns sitting with her all night, braiding her hair. “I was afraid if I went to sleep that I wouldn’t wake up again. I just wanted a chance. If I could make it until Monday, maybe a miracle would happen.”
When Monday morning came, Pegueros was still holding on to life. Patel operated. He put stents in the patient’s bronchial tubes which allowed her to breathe better, even though one of her lungs was 75 percent full of tumors.
Patel said lung cancer patients typically have their breathing restricted by inflammation in their diseased lung and by the invasion of the tumors themselves. As the cancer chokes off air passages, it weakens patients’ bodies and greatly reduces their ability to fight the disease. The stent procedure doesn’t defeat the cancer, according to Patel. But it does give the patients a better chance to live by allowing them the time and the opportunity to get treatment.
“Eventually, as the cancer grows their airways close off,” Patel said. “By keeping them open, we can make them stronger so that patients can withstand chemotherapy or radiation. We work closely with Oncology to remove tumors and put in stents and it gives them a much better chance to fight back against cancer.”
Six months later, Elizabeth is still going strong.
She endured four rounds of chemotherapy and radiation treatments and spent a month in the hospital. But now she’s back at home, living a normal life with her daughter. Pagueros is making sure to create as many memories as she can with the bonus time Dr. Patel gave her. They just got back from a family vacation to Hawaii.
“Dr. Patel is truly a blessing,” Pegueros said. “What he has done for me is absolutely wonderful. I can’t thank him enough.”
When he came to JPS about a year ago, recruited by JPS from a hospital in Shreveport, Louisiana because of his cutting edge skills, Patel became the only doctor in Fort Worth who performs the stent insertion procedure. In that time, he’s done the operation about 50 times. He also performs other procedures that give lung cancer patients a much better chance to fight the disease, getting them from discovery of a potential problem to treatment of the disease more quickly.
Via a bronchoscopy, a procedure during which a doctor inserts a tube with a camera on its end through a patient’s bronchial tubes into their lungs, Patel can figure out what’s going on more quickly than can be done by imaging and exploratory surgery.
Patel said it used to take as long as four months from the time that a spot was found on a patient’s lung until it was biopsied, diagnosed and staged so they could begin treatment. Now he can access the spot of concern through a bronchoscopy and diagnosis and staging can happen in as few as seven days. By allowing treatment to start earlier, patients have the best chance to beat cancer.
“In four months, Stage I cancer can become Stage II cancer or worse,” Patel said. “We can diagnose and stage earlier now than we ever could before.”
Patel also treats patients with tracheal stenosis, a narrowing of the windpipe that often occurs after radiation treatment of prolonged use of a breathing tube. Patients can be treated through bronchioscopic tracheal dilation, a procedure in which the trachea is widened, often through the use of a balloon. The effects of the dilation are temporary, usually lasting three or four months.
“That used to be something that JPS would send patients other places to be treated,” Patel said. “Now we can do it here, which is a tremendous cost savings for JPS. It’s great for the patients because they don’t have to go somewhere else every three or four months for the rest of their lives.”
Pegueros said she thinks it’s wonderful that the best possible care is available right in her home town.
“I’m always researching and asking questions about my situation,” Pegueros said. “So, I decided to get a second opinion, just to see if anything else can be done. The doctors I talked to were very impressed with the treatment I am getting and said there’s absolutely nothing they would do that I’m not already getting. I couldn’t be happier with Dr. Patel and JPS. I’m still here because JPS is here.”