Looking for hope and a cure in Jacksonville

If there was a way to measure text message quality, the one Henri Spiegel received recently would rank pretty high on the scale.

“BENIGN!!!” read the message from her cancer surgeon.

The 62-year-old Miami Beach attorney had waited for that news since she first learned of her diagnosis and she continued to hope as she spent months finding the perfect doctor and then she hoped even more in the days after her surgery with Ron G. Landmann, MD, chief of Colon & Rectal Surgery at Baptist MD Anderson Cancer Center.

After an accident several years ago, Spiegel started experiencing pain at the base of her spine. She assumed it would go away as her body healed, but it didn’t.

When the pain continued for months, then years, Spiegel sought a diagnosis from a Miami neurosurgeon who told her, “I know exactly what you have, and you need to have it removed immediately.”

Turns out, a tennis ball-size tumor was slowly growing in the space directly below the lowest part of her spine (called the presacral). In the beginning stages, these tumors rarely cause symptoms and are usually discovered by accident or during another diagnostic procedure.

Presacral tumors are rare enough that most colorectal surgeons see only one a year, said Dr. Landmann. Given his referral practice from throughout the Southeast U.S., Dr. Landmann treats several each year.

“Because they are not common, you really want someone with high-volume experience and specialization,” he said. “These tumors can be complex to take out, and the surgery has the potential to damage organs if not done properly.”

Some tumor removals may even require a multidisciplinary approach with orthopedic surgeons, neurosurgeons and vascular surgeons, and others may benefit from the use of a surgical robot to remove the tumor through the abdomen, he added.

As soon as Spiegel knew her diagnosis, Google reinforced the surgical risks.

She wanted a cancer surgeon who had expertise in this kind of tumor removal. It took her almost a year to find the right doctor. After meeting with several surgeons near her hometown in Miami Beach, she felt she needed to continue looking.

Spiegel found Dr. Landmann’s biography online while he was in the process of transitioning from his previous employer to the Baptist MD Anderson team. She flew up to Jacksonville to meet with him, and he spent an hour reviewing her MRIs and explaining the surgery.

Because of his job transition, Dr. Landmann told Spiegel she’d find great surgeons at his previous hospital — or even in her hometown, if she wanted to stay close to Miami Beach. 

“But, I had to leave South Florida to find the surgeon I wanted,” Spiegel said. “Knowing he was moving, I told him, ‘Please, take me with you.'”

She appreciated that he didn’t put any pressure on where she elected to have the surgery. More importantly, as he looked at her MRI images, he showed them to her and explained in detail what they were looking at and how to resolve the problem. The brief ‘tutorial,’ complete with a question-and-answer session, was exactly what the South Florida lawyer needed to be put at ease.

“It’s a standard of care for us to be personal and humanistic, and to treat every patient as if they are our family members,” Dr. Landmann said. “Our patients are going through one of the most difficult challenges of their lives, and we have to guide them and their family through the process.”

Shortly after Dr. Landmann arrived at Baptist MD Anderson Cancer Center in Jacksonville, so did Spiegel.

Her surgery took place on Tuesday, June 5, 2018. Even though the procedure was slated to last five hours, it was over in less than three.

“The most difficult part of my surgery was being a passenger as my husband drove us home from Jacksonville to Miami Beach as my little dog sat on my lap,” Spiegel said. “I’m scheduled for a check-up, and then that’s it. Hopefully, I won’t ever need to come back [to Jacksonville] again, but if necessary, I do have [Dr. Landmann's] number.”

Dr. Landmann doesn’t expect Spiegel to need him in the future. The tumor, although sizable, was perfectly spherical and was removed completely intact. 

“I felt, based on my prior experience, that we could get a great outcome — a quick, safe and efficient operation with good long-term results,” Dr. Landmann said.

Less than a month after her surgery, Spiegel was able to take her one-eyed Chihuahua-terrier mix, Sammy Davis, III, for a walk around her block.

Dr. Landmann now refers to Spiegel by her hero, Supreme Court Justice Ruth Bader Ginsburg –"RBG" for short – who they talked about on occasion throughout Spiegel’s treatment. “For Henri, my 'RBG,' we went through the pre-, intra- and post-operative process in a controlled, orderly and judicious fashion – with just a sprinkle of humor. It helped put her mind at ease – and made my job even more fun and rewarding.”

“Every day, I feel exponentially better,” Spiegel said.