Each of the boys wore a T-shirt that said, “My mom is a hero.”
Inside, Cathy Pane, a 39-year-old high school math teacher, finished the last of 12 cancer treatments as her husband, Tony, held her hand. Tears filled his eyes as he pondered the frightening journey that the family has experienced over the last nine months. Yet, they’ve remained unflinchingly positive, referring to infusion appointments as their “twice-weekly dates” since time alone is a rarity for the couple as they manage busy lives and sports schedules for their sons, Max, 11, Frankie, 9, Sal, 7 and Luci (pronounced Lou-chee), 5.
Cathy beamed with relief and pride as she looked through the windows to the sea of supporters who have helped her family endure a battle with an extremely rare cancer.
And now, she had finished.
While her doctors will continue to monitor her, Cathy’s scans show “no evidence of disease,” meaning that she has beaten cancer for now.
She thanked the staff members who have given her life-saving treatments. She and Tony brought them cookies frosted with bows to signify their victory over cancer.
Cathy grinned and told the infusion center team: “You were wonderful. I hope I never see you again.”
Then, the couple walked out to the hospital courtyard and Cathy rang a bell to symbolize the end of her treatments.
With cancer in her rearview mirror, she could head home, hug her husband and kids and get ready for a celebratory trip to the Bahamas.
Specialized cancer experts team up to treat rare small bowel cancer
The Panes’ ordeal began last summer, months after the COVID-19 pandemic threw a giant wrench into everyone’s lives.
Cathy has worked for years as a math teacher for an online high school. So, she knew how to teach remotely. But, for Cathy and her husband, who works as a technology expert, keeping the four boys on track with remote school and navigating altered or upended sports programs was an adjustment.
Still, the family members escaped COVID-19 and everyone stayed as upbeat as possible.
Then in August, Cathy started experiencing abdominal pain.
She sought help from her doctor and went to a hospital in Denver, where tests showed she had large masses in her ovaries. The doctors there thought she had ovarian cancer, but knew she needed help from experts who deal with the most complex forms of cancer. So, they referred her to doctors at the University of Colorado Cancer Center on the Anschutz Medical Campus, a move that may have saved Cathy’s life.
The University of Colorado team jumped into action on two fronts. First, they used chemotherapy to attack Cathy’s Stage 4 cancer. She was able to go through those treatments right near her Highlands Ranch home at the cancer center at Highlands Ranch Hospital.
Second, the doctors began a complex hunt for the source of the cancer.
“It was a bit of a mystery where the cancer was coming from and whether there was more cancer in her body,” said Dr. Steven Ahrendt, Cathy’s surgeon and a professor at the University of Colorado School of Medicine.
Cathy first went through a surgery to remove her ovaries.
“They likely weren’t the source,” Ahrendt said. “It looked like it was coming from somewhere in the GI tract.”
A 13-hour surgery solves a cancer mystery
But, scans of the stomach, colon and pancreas were all negative.
“They weren’t sensitive enough to pick it up,” Ahrendt said.
So, he knew he had to hunt for the source visually during a complex, 13-hour surgery.
In January of this year, Ahrendt conducted what’s known as a cytoreductive surgery with hyperthermic intraperitoneal chemotherapy at UCHealth University of Colorado Hospital.
Ahrendt uses the method to conduct a thorough search for cancerous tumors throughout the abdominal cavity.
Once Ahrendt removes any visible tumors, he circulates a heated chemotherapy treatment throughout the abdominal cavity. The patient is rotated during the treatment to ensure the drug goes where it is needed.
During Catherine’s surgery, Ahrendt traced the source of the cancer to a surprising location, not her ovaries or the colon, but rather to her small bowel.
“Once you’re in there, surprisingly you can see things that don’t show up on scans,” Ahrendt said.
He was able to remove all of Cathy’s tumors and confirmed that the source of her illness was small bowel cancer.
A team approach that speeds up cancer treatments for patients
Dr. Christopher Lieu is Cathy’s medical oncologist and works closely with Ahrendt.
He says the multidisciplinary team approach at the University of Colorado Cancer Center was vital for Cathy. Only a handful of academic medical centers in the country would have been able to treat small bowel cancer.
“It’s a very rare cancer. There are only about 5,000 new cases in the U.S. each year. To put that in perspective, there will be over 150,000 new diagnoses of colorectal cancer this year. It’s rare to begin with and Cathy’s presentation (with tumors in her ovaries) is rare too,” said Lieu who is also an associate professor at the University of Colorado School of Medicine.
Lieu said researchers have no idea why cancer struck Cathy’s bowels.
“She’s young,” he said. We don’t know why she got it.”
Doctors did do genetic testing and found no links there.
“Colorectal cancers are increasing in younger adults,” Lieu said.
The key for Cathy is that she ended up right where she needed to be.
“It’s a rare cancer for which we have expertise,” Lieu said.
The concept of team care is critical because Cathy didn’t have to bounce from expert to expert. All of her doctors and other team members saw her on the same day through the Colorectal Cancer Multidisciplinary Clinic. (Treatment of small bowel cancers fits within this clinic’s purview.)
“Normally, a patient with ovarian tumors would go first to a gynecological oncologist, then maybe two weeks later to a medical oncologist, then if they needed to see a surgeon, they’d go to them later. That process can take two months,” Lieu said.
But, when it comes to cancer, acting fast is critical.
The multidisciplinary model is entirely different.
“We all go see the patients together,” Lieu said.
That means that the doctors can confer in real time. They can discuss their hunches and their treatment plans so patients like Cathy get the most effective treatments as fast as possible.
Lieu and Ahrendt also sit side-by-side every day. So, throughout Cathy’s treatment, they were able to compare notes and pivot as necessary to ensure she received the best care.
“Steve Ahrendt is unique in that he can provide the kind of specialized surgery that only a handful of hospitals around the country can do,” Lieu said. “When you think about the uniqueness of Cathy’s case, that kind of care is essential.”
Cathy comes from a big family and has a large network of family and friends, all of whom cared deeply about getting her well again.
“She’s really amazing. She’s an incredibly courageous person with a wonderful attitude and an extremely supportive family,” Lieu said. “They all love her so much.”
Lieu is cautiously optimistic about Cathy’s prognosis. Cancer is sneaky and can come back. But, Cathy’s highly skilled team will be keeping a close eye on her.
‘I brought these boys into the world. I can’t leave them.’
As the last of Cathy’s chemotherapy flowed into her body at the infusion center on June 16, she and Tony pondered the significance of the moment.
“We made it. It was hard both physically and emotionally,” Cathy said. “But, I told myself, ‘I’ve got to do this and survive for them.’ My main inspiration is our four little boys. I brought them into this world and I can’t leave them.
“My job is not done yet.”
For Tony, the last chemo treatment marked a huge milestone in the battle against small bowel cancer and a day of gratitude.
“It’s a job done,” Tony said. “There’s no way we could have made it through this journey without friends. They gave the kids rides to school. Our family members back East have sent hilarious videos.”
Added Cathy: “All year, people have been coming to clean and organize our house, to bring meals and take the boys on play dates.
“One of my closest friends, Danielle MacDonald, took them to school every day. She’s been like an adopted mom to them.”
Keeping up with boys’ sports activities is a huge job in itself.
All four love soccer and play for Real Colorado. Sal also plays for Colorado Rapids Youth Soccer and his indoor futsal team made it to a championship tournament this summer in Florida.
Along with soccer, Max also loves hockey and tennis. Frankie enjoys Taekwondo and hockey. Sal loves tennis and Luci enjoys tee-ball and baseball.
Both Tony and Cathy come from big Italian families in New York. Cathy is the youngest of five kids; Tony is the oldest of four. They met through Tony’s sister back in high school, but didn’t start dating until after college.
The couple ventured to Colorado in 2006 for a new lifestyle and new jobs
They also found a supportive community that rallied the moment Cathy received her small bowel cancer diagnosis.
Tony’s mom moved in to help the family while Cathy’s family rented an apartment near their home and her mom and siblings took turns making trips to Colorado amid the pandemic to come help.
On the day Cathy finished her last treatment, their team of supporters rallied again.
Some brought posters with sayings like: “You crushed it. You are our hero,” and “Winning is the only option.”
Others brought flowers and balloons.
After each treatment, Cathy and Tony have done a selfie to celebrate. They were thrilled to knock out the twelfth treatment and selfie. They hope will be the last. Forever.
And now they are looking forward to simple milestones and family gatherings.
Tony and Cathy will celebrate their 13th wedding anniversary in July, then her 40th birthday later this year.
Within days, the Panes and some relatives are heading to the Bahamas. Cathy always has wanted to swim with dolphins. Everyone will enjoy playing on the beach, relaxing and enjoying life without thinking about cancer.
“We’re just going to go celebrate,” Cathy said. “We deserve it.”