Exceeding all expectations after a July 23 whipple procedure, Holyoke’s Brett Cumming now prepares for a liver transplant in the near future.
That’s a lot to digest for a young man who will turn 20 this Saturday, Aug. 2.
Cumming started experiencing severe stomach and back pain almost two years ago, had his gallbladder removed in January of 2013 and has had multiple diagnosis procedures.
May 27 tests confirmed he has cancer of the bile ducts. Last week’s whipple procedure removed part of the stomach, part of the pancreas, part of the small intestine and the bile ducts—and rerouted his digestive tract.
This procedure removed the problem area and will hopefully prevent the spread of cancer.
According to his parents, Beth Zilla and Rick Cumming, as of Sunday, July 27, Brett was exceeding all expectations following his surgery at the University of Colorado Hospital in Aurora.
His mom reported he was walking on his own. His anticipated three-day ICU stay ended up being only one day. And his total hospital stay could be less than a week, when it was originally targeted to be closer to 10 days.
“It’s hard to keep Brett down,” said his dad. “He’s determined to get out,” added his mom.
Brett Cumming, 2013 HHS graduate and standout athlete, is pictured in 2013 baseball action. Now fighting bile duct cancer, he is recovering from a July 23 procedure and anticipating a liver transplant when recovery is complete. He continues to embrace life and will soon start his sophomore year of college at UNC in Greeley. —Enterprise file photo
Brett will be a sophomore at the University of Northern Colorado in Greeley and anticipates being fully recovered and ready for the start of the fall semester.
In the meantime, early this week, Brett’s dad was going through an evaluation process to determine if he’s a potential liver donor for his son. Since finding a live donor is the only way to dictate when a liver transplant can occur, Rick said he is hoping that he can be the donor for his son.
In a letter giving details leading to Brett’s current health status, Rick emphasized that Brett is a strong, healthy young man with a very positive attitude and a bright future ahead of him.
“Brett is surrounded by a loving family, loyal friends, a caring church family and the wonderful Holyoke community standing strong around him in support as he goes through this ordeal,” added Rick.
Aug. 17 fundraiser
First Christian Church of Holyoke is planning a fundraiser to assist with Cumming’s medical bills Sunday, Aug. 17, at the Phillips County Event Center. A meal (prepared by Allyn Robinson) and silent auction are planned from 5-7:30 p.m.
Several silent auction items are already in place. Those who have something they would like to donate may contact Monica Powell at 970-854-4744.
It all began in the fall of 2012
Toward the end of Cumming’s high school senior year football season in 2012, he began experiencing severe stomach and back pain.
Detailing his son’s close to two-year health condition, Rick said Brett discovered his pain would occur after eating greasy foods such as cheeseburgers. Lying flat on the floor was the only way he could tolerate the pain.
A HIDA scan revealed that Brett’s gallbladder was not functioning at all, so he had that removed in January of 2013.
Rick said that while Dr. James Schiefen removed the gallbladder, he examined the bile ducts and noted an area of concern. He suspected Brett might have primary sclerosing cholangitis, which is an inflammation and subsequent obstruction of the bile ducts. It can lead to bile buildup in the liver, ultimately causing liver failure.
Even after having his gallbladder removed, Brett continued to experience episodes of severe abdominal pain. A colonoscopy revealed he had ulcerative colitis, which is a long-lasting inflammation of the digestive tract.
Dr. Dowgin, a gastroenterologist, prescribed UC medication and concurred with Dr. Schiefen’s diagnosis of PSC.
Next up in Brett’s medical referrals was Dr. Bambha, a liver specialist at the University of Colorado Hospital in Aurora. She ordered the first of what has now been five endoscopic retrograde cholangiopancreatography tests for Brett.
In an ERCP procedure, a camera is sent down the throat into the stomach and ultimately into the bile ducts to take pictures, cell brushings and tissue biopsies.
Just before he headed to his first year at college, Brett had his first ERCP Aug. 7, 2013. Dr. Yen, the doctor who performed the ERCP, notified the family Aug. 18 that the ERCP revealed that Brett had cancer of the bile ducts, or cholangiocarcinoma.
“We felt like our world was crashing in around us,” said Rick.
Dr. Bambha confirmed that the ERCP test results showed cells with high-grade dysplasia with possible carcinoma. Rick said this means pre-cancerous cells that can develop into cancer.
Another ERCP was scheduled for Aug. 27, 2013. Prior to that, Dr. Yen asked Brett if he would participate in a study where they use an experimental camera to get a closer look at the bile duct wall. He explained that the earlier test procedure can give a false positive for cancer 40 percent of the time.
“Once we heard this, we felt a bit of relief,” said Rick. Brett agreed to participate in the study, and good news was received a week later in the test results, which showed he did not have cancer.
Rick said the cells still showed high-grade dysplasia, and Dr. Bambha recommended to continue ERCPs every three months to keep a close eye on the area.
A liver biopsy at that time showed that Brett has stage II fibrosis of the liver. Rick said there are four stages of scarring or hardness of the liver, with stage IV being the most severe. It is called cirrhosis and requires a liver transplant. Dr. Bambha told the family that Brett has probably had liver disease his whole life but it’s just starting to show up.
At the end of January this year, Brett went through a two-day liver transplant evaluation and was given a score of 8 on the Model for End-Stage Liver Disease scale.
Ranging from 1-40, the MELD scale measures the necessity for having a liver transplant, with 40 meaning one is needed immediately. There are over 16,000 people in the United States waiting for a liver on the transplant list.
During Brett’s recovery from his fifth ERCP on May 27, Dr. Yen said he thought the PSC was progressing. A few days later, the test results confirmed that Brett has cancer of the bile ducts.
According to Rick, Dr. Bambha said this type of cancer is very rare in young adults and is usually found in adults in their 70s. She also said the cancer diagnosis allows her to use exception points to raise Brett’s MELD score to 21.
The whipple procedure conducted July 23 was performed after a team of doctors at UCH in Aurora consulted about the best way to proceed.
After Brett heals from the whipple procedure, the doctors want him to have a liver transplant, said Rick.
Since finding a live donor is the only way to dictate when a liver transplant can occur, Rick hopes to be able to donate his liver for his son. Results of his evaluation process early this week should be known soon.
He explained that a live donor has to have a compatible blood type with Brett and be between the ages of 18-55. The donor would have two-thirds of their liver removed. It would then regenerate back to full size in about three months.
Most-likely donor candidates are close blood relatives, said Rick. Since Brett’s mom has lupus, an autoimmune disease, she can’t be a candidate. His younger brother Bradley is too young and has vitiligo, also an autoimmune disease, which disqualifies him as a donor.
Not letting anything hold him back, Brett will start his college semester at UNC in August, focusing on full recovery from surgery.
Holyoke Enterprise July 31, 2014