Nebraska man overcomes rare cancer thanks to ‘seamless’ care plan

In the spring of 2023, Jim McCoy went to Methodist Hospital for what he thought would be a routine back surgery. By time he left, he’d learned he had a rare tumor on the base of his tongue.

“I was just a regular guy cruising along until my disease,” said McCoy, 73, who lives near Louisville, Nebraska.

What followed was a cancer journey highlighted by expert care and teamwork at Methodist, and McCoy’s positive attitude and outlook.

A surprise discovery

Both McCoy and his medical team were surprised by the discovery.

He had no symptoms that might indicate he had cancer – no sore throat, no trouble swallowing or breathing. Instead, he was focused on persistent back pain caused by arthritis and stenosis – a narrowing of spaces in the spine. MD West ONE neurosurgeon Stephen Doran, MD, planned a laminectomy to remove part of his vertebrae and relieve pressure and pain.

But as Wes Hubka, MD, an anesthesiologist with Anesthesia West, was inserting a breathing tube to prepare McCoy for the procedure, he paused. The base of McCoy’s tongue caught his attention.

“Managing the airway is one of the primary responsibilities of an anesthesiologist. We see thousands of normal airways,” Dr. Hubka said. “This wasn’t consistent with typical airway anatomy, so consulting another airway expert was appropriate.”

Andrew Coughlin, MD, a head and neck surgical oncologist at nearby Methodist Estabrook Cancer Center, quickly arrived, examined the “relatively good-sized tumor” and opted for a biopsy.

McCoy’s back surgery proceeded as planned. Meanwhile, the biopsy confirmed his tumor to be squamous cell carcinoma. McCoy’s post-operative care and planning now included a conversation with Dr. Coughlin about cancer treatment.

“He explained to my wife and me what they found and what we needed to do,” McCoy said. “My reaction was, ‘We’ve got business to do. Let’s get started.’”

Multidisciplinary care

Within a few days of back surgery, McCoy was home and ready to begin his cancer battle.

Just as unusual as his lack of symptoms was the lack of an obvious cause. He rarely drank alcohol and didn’t use tobacco. And while many head and neck cancers are caused by human papillomavirus (HPV), testing showed that wasn’t McCoy’s case.

“It’s just kind of bad luck that his cells did that and developed cancer in that spot,” Dr. Coughlin said. “That’s really, really rare.”

Subsequent CT and PET scans confirmed that the cancer hadn’t spread to his lymph nodes, but the tumor was in a delicate location. 

“Just because of the size of it in the location, we said that surgery probably wasn't in his best interest,” Dr. Coughlin said. “That's when we got the radiation and medical oncologist involved.” 

Dr. Coughlin teamed with medical oncologist Yungpo Bernard Su, MD, of Nebraska Cancer Specialists to develop a plan for treatment at Methodist Estabrook Cancer Center. 

“In the case of the head and neck cancer oncology team, our multidisciplinary team meets in person every Friday to develop treatment plans together,” Dr. Su said. “And on a daily basis, it's the physician-to-physician real-time communication and coordination that make our care possible.”

The plan: By using chemo-RT, a combination of chemotherapy and radiation to kill cancer cells, the doctors aimed to target the cancer while preserving organs and function for long-term quality-of-life goals.

Over the next seven weeks, McCoy avoided some of the common side effects of treatment – hair loss and nausea – but did experience severe constipation and lost 45 pounds.

Still, his outlook remained bright.

“I just went through it like you’d go through the common cold,” he said. “My mood was always upbeat, always positive, always forward.” 

‘We are all one team’

With each treatment appointment, McCoy came away impressed by the planning and collaboration that went into his care.

His care plan, coupled with his positive attitude, proved effective in treating his cancer. Three months after completing his therapy, scans showed no evidence of cancer. 

“Everything went swimmingly well,” McCoy said. “I really enjoyed the whole team, but those two, Dr. Coughlin and Dr. Su, they worked so well together. They even set their appointments at the same time. The coordination and professionalism were terrific.”

Now, nearly three years since the surprise discovery of his tumor, McCoy remains cancer free and has returned to an active life as a retiree – traveling to his summer cabin, fishing and enjoying time with family. He can make those memories now, he said, because of the seamless collaboration and resulting care he experienced.

“Seamless is the perfect word,” Dr. Su said. “There are no barriers as far as the Nebraska Cancer Specialists partnership with the Methodist head and neck surgical oncology and radiation oncology teams. We are all one team working together for our patients.”

Dr. Coughlin agreed.

“It's just all the little things and all the people he needed to see throughout all of this, and it worked out really well,” Dr. Coughlin said.