Multidisciplinary care crucial in guiding Vanderbilt employee’s bile duct cancer journeyOct. 10, 2023, 2:28 PM
by Matt Batcheldor
Blane Hollingsworth, PhD, had just recently been hired at Vanderbilt University as a senior lecturer in the Department of Mathematics in 2020 when he learned he had cholangiocarcinoma, or bile duct cancer.
Instead of lecturing at Stevenson Center as planned, at least initially, he would spend a lot of time a few buildings away — at Vanderbilt University Medical Center. His condition led him to become the first patient at VUMC to undergo a liver transplant under the protocol for cholangiocarcinoma.
“It is a truly inspiring story that shows our multidisciplinary approach to very difficult problems,” said Martin Montenovo, MD, MMHC, associate professor of Surgery and chief of the Division of Hepatobiliary Surgery and Liver Transplantation.
Hollingsworth was 44 and had just moved to Nashville with his wife, Megan Behringer, PhD, who had just started at Vanderbilt as assistant professor of Biological Sciences, when he started having strange symptoms. His skin was itching and turning yellow. He thought maybe he was allergic to something, maybe just stressed from the move and new job. But his symptoms got worse, and he ended up in the emergency department.
After imaging, he was diagnosed with cholangiocarcinoma.
His wife’s reaction? “He’s not going to die from something we can’t pronounce.”
“It’s just kind of shocking,” Hollingsworth recalled. “What does this all mean? What am I going to do?”
Megan recalled the couple didn’t have much time to process the news; immediately, they had a battery of doctor’s appointments to keep them busy. “It was just like, go here, do this,” she said.
Within two weeks, he had begun three weeks of twice-daily radiation treatments at Vanderbilt-Ingram Cancer Center (VICC) and was taking oral chemotherapy. Medication kept his nausea in check; mostly he just remembers being very fatigued and unable to teach.
Hollingsworth was in one of a select few medical centers that could treat a patient with his complex needs. The cancer treatments were just the start. To ensure all the cancer was removed, Hollingsworth would need a new liver, Montenovo said. His care required many multidisciplinary teams, including medical oncology, radiation oncology, hepatology and radiology, interventional radiology, gastroenterology and transplant surgery.
“Transplant for cholangiocarcinoma requires experts in surgery, radiation and medical oncology, all working closely together to craft an individualized treatment plan and care for these patients when they are at their sickest,” said Laura Goff, MD, MSCI, professor of Medicine in Hematology-Oncology and executive medical director for the VICC Cancer Patient Care Center.
After biopsies confirmed there was no cancer in his lymph nodes, Hollingsworth was placed on the waiting list for a liver transplant. By summer 2021, as he was nearing the top of the list, he was taken off chemotherapy in preparation for transplant, which was performed in August 2021 by Seth Karp, MD, H. William Scott Jr. Professor and chair of the Section of Surgical Sciences. His anesthesiologist was Phil Leisy, MD, assistant professor of Anesthesiology and Critical Care Medicine and associate director of the Liver Transplant Team for the Department of Anesthesiology.
“It is wonderful to see this team come together to offer this curative option to patients like Mr. Hollingsworth,” Karp said, “and it was my great pleasure to see his resilience and optimism through this difficult personal challenge.”
Immediately, Hollingsworth’s skin was no longer yellow, and he has been steadily recovering. “It is truly incredible to see patients looking so much healthier after the transplant,” Goff said.
Montenovo said Hollingsworth will need to be followed for the rest of his life to ensure the cancer never returns, but he is cancer free, and his prognosis is very good. “The fact that he has been two years out from transplant, and he is free of disease, that’s quite promising.”
Today, Hollingsworth said he feels good. Through his ordeal, he said he’s been fortunate to live just a mile away from Vanderbilt, one of only a few select centers that could transplant a patient with his specific cancer. “I got lucky that we moved here when we did and that I was nearby,” he said.
Joseph Magliocca, MD, professor of Surgery and director of the Vanderbilt Transplant Center, said, “Tackling complex medical problems is best treated with a team approach, including specialists from many different disciplines, and cholangiocarcinoma is a perfect example. In the Vanderbilt Transplant Center, we are fortunate to have physicians who are leaders in their field who routinely come together to successfully treat these uncommon issues.”