Originally from Pennsylvania, Gary Fales retired and relocated to Germany in 1989 with his wife, Elvira, and daughter, Diana. Gary and his family were always pleased with the care they had received at a hospital located about an hour away from their home for the 24 years they had been living in Europe.
One day in August 2012, Gary was at the local hospital receiving care for a ventral hernia, a condition he was familiar with as he had experienced it in the past. As part of the evaluation for the care of his hernia, his physician ordered a CT scan in order to take a closer look at his abdomen. The results left him and his physicians stunned.
"That day, I found out I had tumors on both my right and left kidneys," Gary explained. "I had gone in for treatment for a hernia, and walked out with a cancer diagnosis. I couldn't believe it."
The mass on Gary's right kidney was large and represented an aggressive form of renal cancer. Gary's urologist recommended an immediate radical nephrectomy. In September, only one month after his initial diagnosis, Gary underwent successful laparoscopic surgery to remove his right kidney and repair his hernia.
"Because the cancer in my right kidney was so advanced, I knew chances were high that the tumor on my left kidney was also cancerous," Gary recalled.
Gary's urologist recommended a partial nephrectomy to remove the tumor on his left kidney. She did, however, acknowledge that there was a possibility that the left kidney would not be left fully functioning following the surgery, resulting in renal failure.
"I wanted to do my research before undergoing another operation, especially knowing that renal failure was a distinct possibility," Gary said. "I still hoped there was a way my left kidney could be saved."
Gary, still recovering from his first nephrectomy, contacted his cousin, a physician specialist who lives in Michigan, for advice.
"My cousin recommended looking into Cleveland Clinic, a world leader in treating complex urological and kidney conditions, including kidney-sparing surgery for kidney cancer, so I did exactly that."
Gary turned to the Internet, where he logged on to the Cleveland Clinic Web site. There, he learned about a program that would allow him to receive a second opinion on his renal mass from a Cleveland Clinic expert without having to leave his home in Germany.
The MyConsult® Online Medical Second Opinion program is a sophisticated, Web-based extension of Cleveland Clinic's 90-plus-year role as one of America's respected referral institutions. The secure, online program provides medical second opinions from Cleveland Clinic specialists for more than 1,200 diagnoses that may impact quality of life or may be more serious.
Gary knew that due to the severity of his condition, he had little time to spare in making a decision, so he started the MyConsult process right away.
Gary quickly received a MyConsult second opinion report from Michael Gong, MD, PhD, a Cleveland Clinic expert who specializes in kidney cancer and robotic and laparoscopic surgery.
"Dr. Gong's report was detailed, concise and easy to understand," Gary commented.
Based on the medical records, test results and imaging studies Gary had sent during the MyConsult process, Dr. Gong believed that because of the size and location of the tumor on Gary's left kidney, non-surgical treatment was not an option. Dr. Gong also advised against laparoscopic treatment due to Gary's ventral hernia history.
Dr. Gong did, however, believe that a partial nephrectomy would be Gary's best option. This surgery would spare much of the left kidney and leave it fully functioning.
"While my urologist in Germany was willing to perform a partial nephrectomy, Dr. Gong was so knowledgeable and confident in his MyConsult second opinion, that when he offered to personally perform my surgery at Cleveland Clinic, I wanted to take advantage of the opportunity."
Gary said he also felt more confident about having his second operation performed at Cleveland Clinic because he knew the facilities were world-class and the staff specialized in kidney cancer.
In November 2012, after working with the MyConsult Clinical Operations team to make arrangements for onsite appointments and surgery, Gary made the long journey from Germany to the United States to meet Dr. Gong and undergo the partial nephrectomy on his left kidney.
"Unfortunately, my wife was not able to travel with me, so I went to Cleveland Clinic on my own," Gary said. "Regardless, I had an outstanding stay. It was easy to get around and everything went smoothly from admission to discharge. The quality of service received was outstanding in every respect."
After Gary's procedure, Dr. Gong followed up with his physician specialist in Germany to provide details of the surgery and ensure a complete continuum of care.
Today, Gary is well on the road to a full recovery. He has slowly returned to a vigorous and highly regimented physical fitness program including both weight training and swimming at local facilities in Germany. His range of movement is back to normal and his blood pressure and lab results have returned to the normal range as well.
Gary says he is happy to report that 80 percent of his left kidney has been spared thanks to the partial nephrectomy he received at Cleveland Clinic following his MyConsult Online Medical Second Opinion. He is celebrating the small improvements he is noticing in his health every day.