One in a Million

Today, Susan Ressler, 67, enjoys doing pottery, volunteering at the library and performing with a local singing group, but not long ago, she was diagnosed with colon cancer and feared she would never have normalcy again. Susan, who lived in Hopkinton at the time, recalls how she was feeling tired and her stomach felt off. Her primary care doctor ordered bloodwork that showed she was severely anemic.

Susan followed up with Ajay K. BatraAjay K. Batra, MD, of Milford Gastroenterology Associates, MD who performed a colonoscopy that revealed a 5.5-centimeter tumor. She was then referred to Nora Fullington, MD, of UMass Memorial General Surgery at Milford. At Susan’s appointment in October, 2016, Dr. Fullington recommended a laparoscopic colectomy, a surgical procedure to remove all or part of the colon. While the prospect of surgery was intimidating, Susan says that she felt as if she were in good hands.

“She (Dr. Fullington) is very gentle . . . you just feel safe with her,” Susan notes. “She went over everything that was going to happen and what to expect. She’s so good at being specific and has such a way of reassuring people and making them smile. I didn’t feel anxious. I didn’t feel nervous. I felt safe. Dr. Fullington exudes confidence in herself and makes you feel the same way. She has a gift. She’s one in a million.”

The colon, also called the large intestine, is a long tube-like organ at the end of the digestive tract. According to Dr. Fullington, a colectomy can also be done for polyps that can’t be removed otherwise and could potentially develop into cancer, as well as for scarring, narrowing, or inflammation of the colon, which can occur with diverticulitis–inflammation or infection of small pouches called diverticula that develop along the walls of the intestines.

“For many patients, at least part of a colectomy is performed laparoscopically, if it is safe to do so,” explains Dr. Fullington. “Susan underwent a sigmoid colon resection which is removal of the loopy last part of the colon before you get to the rectum.”

During the minimally invasive procedure, the surgeon passes a tiny video camera through one incision and special surgical tools through other incisions made in the abdominal wall. Viewing the procedure on a video screen in the operating room, she manipulates the surgical tools to free the diseased section of colon from the surrounding tissue and removes it through the small incision in the abdomen. The healthy ends of the colon are then re-connected to produce a continuous loop of bowel, Dr. Fullington explains.

“We then remove lymph nodes, and try to include all the draining lymph nodes from that bowel so the pathologist can inspect them,” Dr. Fullington related. “On average, patients spend 2-3 days in the hospital depending on what part of the colon is removed. After colon surgery, you’ll want to have a couple weeks off without much planned. It’s important to move around and be active after surgery, but not to get back to work or significant activities for a couple of weeks. We send them home with pain medication and recommend a healthy diet with a lot of protein.”

Susan had her laparoscopic colectomy in November 2016. According to Dr. Fullington, her tumor was stage IIIB with three out of 13 lymph nodes testing positive for cancer. She called Susan personally to review the results and to tell her that her oncologist, Humberto A. Rossi, MD, of Dana-Faber/Brigham and Women’s Cancer Center at Milford Regional, would oversee her chemotherapy.

“I think it’s important to imagine that this is a family member going through this,” says Dr. Fullington. “You need to talk to the patient in a way that satisfies all their concerns, explain things very clearly, and address the needs of the emotional side of all this and the fear that goes along with it. I think it’s important to provide the information in actual steps of the process as it can be overwhelming.”

Susan spent two nights at the hospital and remembers Dr. Fullington stopping in to check on her several times.

“I was walking the next day and took a shower,” Susan says. “When Dr. Fullington called me at home to tell me they did find cancer in some lymph nodes, she said it was okay, you’re going to start chemo and I think it’s going to go just fine so don’t worry about any of that and I’ll touch base with you to see how you’re doing. I mean, who does that? She’s so amicable.”

Dr. Fullington put in her port for chemotherapy under sedation in the OR. The port, a small disc about the size of a quarter, is usually placed on the chest and sits just under the skin. A thin tube called a catheter connects it to a large vein. Chemotherapy medicines are given through a special needle that fits into the port.

Susan underwent chemo from December 2016 through June 2017. Later, Dr. Fullington removed the port in her office using a local anesthetic. Since then, Susan has moved to New Salem, where she enjoys keeping herself busy and living closer to her sister.

“I feel good,” she says. “It’s beyond me why anyone would ever think going into Boston is a better option with all that stress and anxiety. Everyone was so attentive and aware of the fact that you’re there because there’s a problem. They’re good people and they’re passionate about what they’re doing. The collaboration of Milford Regional and Dana Farber is the best thing that could have been done for the town.”

Read more about Nora Fullington, MD