Expert Treatment for a Unique Type of Tumor

Devra and John Hunt John Hunt and his wife, Devra.

The pain in John Hunt’s abdomen was just a dull ache, so he didn’t worry. But when it sharpened into a searing cramp in June 2009, he made an appointment with his physician. A CT scan showed a large, solid mass in his abdomen.

"I asked my doctor, 'Could this be cancer?' He said, 'Possibly.' My heart sank," said Hunt, now 42, who was living in Chicago at the time. "My mind went a million places."

A biopsy revealed that Hunt had developed a gastrointestinal stromal tumor (GIST). Diagnosed in 3,500 to 5,000 Americans each year, GIST tumors originate in cells that line the digestive tract. They can spread quickly to the liver or elsewhere in the abdominal cavity. Hunt knew he needed a specialist.

Mitchell Posner Mitchell Posner, MD

After doing his own research, he learned about Mitchell Posner, MD, chief of general surgery and surgical oncology at the University of Chicago Medicine and an internationally known expert in the management of gastrointestinal cancers. Hunt immediately made an appointment.

"When my wife and I met Dr. Posner, we both liked him," Hunt said. "It was clear to us that he was a very skilled physician and an excellent communicator. He helped us understand what the game plan was and helped us gain confidence."

Posner said Hunt’s case was fairly unusual. "When I looked at his CT scan, I saw two tumors," Posner said. "The large one was located at the very early part of his small intestine, and the other one was further along in the small intestine."

In August 2009, Hunt had surgery at the University of Chicago. Posner removed the tumors, as well as segments of Hunt’s small intestine. "Probably about a foot of his small intestine was resected in total," Posner said.

Hunt was in the hospital for one week, unable to eat or drink anything for six of those seven days because his intestines had to learn to function again. "It was challenging," said Hunt, who was supported with intravenous nutrition. "I felt like I was on the sidelines. I wanted to get back to living my great life."

After Hunt was released from the hospital, he stayed home for five weeks before returning to work. For the past year, he has been taking Gleevec® (imatinib), a drug designed to prevent GIST tumors from returning.

"GIST tumors result from the overactivity of a specific gene, the c-KIT protooncogene," Posner explained. "Gleevec blocks the signaling pathway that causes the cells to progress. It is very effective."

The American College of Surgeons Oncology Group led a worldwide clinical trial from 2002 to 2007 that demonstrated the benefits of Gleevec. As chairman of the group’s Gastrointestinal Committee, Posner monitored the trial closely. "It followed 700 people with a GIST who tested positive for the KIT protein," he said. "After one year, 98 percent of the patients on Gleevec had survived without a recurrence of cancer, compared to 83 percent who took a placebo."

Hunt says he has experienced no side effects from the drug and is optimistic about his future. Now living in Seattle with his wife and two sons, he recently began a new position with Nordstrom, Inc. as national merchandise manager for infants and toddlers. "I feel great and I am so grateful," he said. "I have the highest regard and respect for Dr. Posner as a physician and person. I was lucky to have met him."

September 2010