Tom Sinton: On the road again

For Tom Sinton, 45, of South Fayette, the diagnosis of rectal cancer came as a complete surprise. A software developer, Virginia Tech graduate and husband of 19 years to Amanda and the father of three (Nate, 15; Emily, 14; and Luke, 12), Sinton was living a fulfilling life, with work he enjoyed and a thriving family. His cancer journey began with subtle changes in his bowel habits, in the spring of 2019. “It was just a change in frequency, not a big deal at all,” he recalls. “Then I saw blood in August. I had a colonoscopy which revealed a tumor in my colon.”

It was a shock, Sinton says. “When you see blood, you know it could mean cancer but you tell yourself it’s probably not, especially when you are young. I never expected to hear the word “cancer,” even though my father had a brain tumor during my childhood. It’s a very emotional experience, to be told that you have cancer. Amanda and I wanted to get going right away to fix it, to find the right people to take care of it.”

They did — they found Leigh H. Nadler, M.D., Chief, Division of Colon and Rectal Surgery at St Clair Hospital. Dr. Nadler is an experienced and highly respected colorectal surgeon, and was recommended to the Sintons by a friend. Dr. Nadler assessed the tumor and referred Sinton to medical and radiation oncology for preoperative treatment. Following a five-week course of radiation and chemotherapy to decrease the size of Sinton’s tumor, Dr. Nadler performed a successful robotic-assisted low anterior rectal resection of Sinton’s rectal cancer. Fortunately, the preoperative treatment down-staged the tumor and 40 lymph nodes removed were found to be normal. Sinton was discharged after three days of hospitalization and had an excellent recovery. A vascular port was placed by Dr. Nadler for additional postoperative intravenous chemotherapy.

Colorectal surgeons can choose among different approaches depending on the nature of the condition and the needs of the individual. At St. Clair, Dr. Nadler says, those options include traditional open surgery, laparoscopic surgery, robotic-assisted surgery, as well as transanal endoscopic microsurgery (TEMS). Traditional open surgery involves a longer incision associated with more postoperative pain, slower return of bowel function and a longer hospital stay. “In our hands, most colorectal conditions can be addressed with minimally invasive laparoscopic or robotic-assisted surgery,” Dr. Nadler says. “Robotic-assisted surgery provides a significant advantage for the patient, since we can see structures more clearly, which means that there is less risk of an injury, especially to nerves and blood vessels.”

Dr. Nadler, his partner Scott A. Holekamp, M.D., and other surgeons at St. Clair use the da Vinci XI, the most advanced robotic surgical system available. “Robotic-assisted surgery is really laparoscopic plus robotic surgery; the robot is simply a tool,” explains Dr. Nadler, who has over 10 years of experience with robotic surgery. “We control the movements of the robot. Through several small incisions, we insert thin instruments and a camera that enables us to see in 3D. My hands move the instruments and they respond immediately, moving exactly like my hands and wrists. I can view high-definition, 3D, magnified images from the robotic camera on a video screen. Robotic-assisted surgery is especially good for pelvic surgery and provides a significant advantage for treating rectal cancer, in that it allows to you to operate deep into the pelvis, since the instruments are longer and the camera is thinner. The da Vinci is especially helpful in men with a very narrow pelvis, since there is limited working space for a surgeon.”

Following the resection, Sinton was given a second course of chemotherapy from March through June, and Dr. Nadler removed the chemo port and reversed the temporary ileostomy in July. “Tom has had a great outcome,” Dr. Nadler says. “His prognosis is excellent: 40 lymph nodes were removed during the surgery and all were clear. His postoperative bowel function is back to normal.”

Although it has been a rough year, there were aspects of his experience that Sinton cherishes. “I felt that I was in good hands with Dr. Nadler; he was always very open and easy to talk to. You can ask him anything and he will give you a clear explanation. He walked me through this entire experience in a personal way. I would recommend him to anyone. The second thing is that the care at St. Clair was amazing. My operations took place five months apart, but when I was admitted for the second surgery the nurses remembered me — all of them. They gave me excellent care and a lot of emotional support. My second surgery took place during the COVID-19 pandemic, so I was alone in the Hospital. But the care was so great that I almost didn’t miss my family,” he says with a laugh. “At St. Clair, everyone is professional, but personally caring.”

Sinton is still recovering but improving every day and drawing strength from his Christian faith. He received a major boost in his spirits when he decided to take a trip with his daughter Emily to Cincinnati, where she was playing in a Club soccer game. “I had not done much driving, and I was nervous about it, but I wanted to do this for my daughter and myself. It was an awesome experience for us: the road trip, the game and the hotel were wonderful. It gave me back my confidence and a wonderful memory with Emily. I want to live a long life and always be there for my kids.”

 

LEIGH H. NADLER, M.D.