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Dolores Fuentes

Dolores Fuentes, Esophageal Cancer

When Dolores Fuentes, 87, told her daughter Elba Fuentes that she was having difficulty swallowing and keeping food down, “I knew I had to bring her to New York Methodist—‘My Methodist’ I call it,” she said. “I wouldn’t take her to any other hospital.” And it was a good thing she brought her to NYM’s Emergency Department when she did, because although she didn’t know it at the time, Mrs. Fuentes not only had esophageal cancer, but endometrial cancer—cancer of the uterine lining—as well.

From the Emergency Department, Mrs. Fuentes was immediately admitted to the Hospital for surgery. Because the cancerous blockage in her throat was making it difficult for her to eat, the esophageal surgery took priority over the endometrial cancer surgery.

“Initially, there was concern about Mrs. Fuentes’s age and how her 87-year-old body would withstand two major surgeries over a relatively short time,” said Richard Lazzaro, M.D., chief of thoracic surgery at NYM, “but we assessed her cardiac and pulmonary functioning and she was in excellent shape!”

However, Mrs. Fuentes’s age was not the only surgical challenge: due to her strict religious beliefs, she could not receive any blood or blood products duringthe procedure—a technique known as “bloodless surgery” would need to be utilized. “I have had five ankle surgeries and two total knee replacements at NYM, all bloodless” says daughter Elba Fuentes. “I refer the Hospital to everyone in my community, not only because the quality of care is superior, but because the medical staff will respect my personal and spiritual beliefs.”

The Bloodless Surgery Program at NYM employs use of special medications, instruments, equipment, and procedures to minimize blood loss, and, using the latest technology, gives patients alternatives to blood transfusions. The medical records of patients in the Bloodless Surgery Program are carefully coded so that patients can feel confident that their requests will be honored.

“Mrs. Fuentes’s esophageal surgery required an abdominal as well as thoracic approach,” said Dr. Lazzaro. “Using traditional, ‘open’ surgery, the potential for blood loss is significant. However, utilizing the minimally invasive daVinci robotic surgical system, I was able to more precisely perform the surgery under magnification and view the procedure three-dimensionally, which allowed me to perform the surgery with minimal blood loss and trauma,” says Dr. Lazzaro.

Eight weeks after her successful—and bloodless—first surgery, Mrs. Fuentes was able to undergo surgery for endometrial cancer.

“I needed to perform a total hysterectomy—removal of the uterus, ovaries and fallopian tubes,” says Constantine Gorelick, M.D., gynecologic oncologist at New York Methodist Hospital. “After Mrs. Fuentes was fully recovered from her surgery with Dr. Lazzaro, I was also able to perform the hysterectomy using the daVinci robotic surgical system. Using the robotic surgical system for both the thoracic and the gynecologic cancers was ideal for Mrs. Fuentes: it is minimally invasive, which is less traumatic to the body, and also results in significantly less blood loss, which is important when following bloodless surgery techniques,” said Dr. Gorelick.

“The key to success in these challenging cases involves a truly multidisciplinary, interdepartmental approach through all transitions—from preoperative assessment to the operating room, from the recovery room to home. It is that continuity of care that defines our Hospital,” says Dr. Lazzaro.

“Once again,” Elba Fuentes says, “I am thankful for New York Methodist Hospital. Not only is my mother now cancer free, but everyone was so great when we were at the Hospital. They took such good care of my mother and they went out of their way to make sure that we were both comfortable and had everything we needed. They looked out for both of us.”

Read more real life patient stories in the 2011 NYM Annual Report.