SurgeonBlog

Life and Test Results

/ Dr. Lee Bryant / 15 Comments

I was diagnosed with malignant melanoma under my thumbnail on July 21, 2021. For those of you who have been tracking my cancer journey, you know that I am a surgeon. I then became a patient and began documenting my journey in this blog. After undergoing surgery, I completed a yearlong treatment plan of chemoimmunotherapy infusions. I had my last infusion on June 29, 2022. This blog recounts my story with a focus on a surgeon who became a patient. It also highlights melanoma awareness. Additionally, it explores the intersection of medicine and faith.

The great news is that my scans this past November (right hand and arm, chest, abdomen, pelvis) revealed no evidence of any recurrent cancer! My next round of scans and bloodwork is in May, 2025. I am blessed to have survived 3 years, having been told my 3 year survival rate was as low as 40 percent! I still remain high risk until year 5, when my prognosis will improve.

I was remiss in waiting so long to update my blog. This past Fall, the busyness of life seemed to take over. I had several trips to medical meetings, some vacation, a wedding of which I was the officiant in Dallas, and then the holidays. Reflecting back on this past year, I realized that it is very easy to fall back into the busyness of life and slip away from work, life, and health balance.

Let me go back to the summer of 2021 before my cancer diagnosis. The absolute craziness of the life of a busy surgeon was taking its toll. I was in the peak of my career, performing as many operations as ever. My hands were so overworked from operating and typing that I started getting trigger fingers and had multiple hand surgeries to repair them. In addition to being President of our large medical practice, I was also Chairman of the Board of Trustees of my medical center; a consultant for a large medical device company lecturing and traveling all over the country; Chairman of the Deacon Body at Brook Hollow Baptist Church in Nashville, Tennessee; singing in the church choir; leading a young adult small group at our house on Sunday nights; helping my father manage our horse farm; and lastly training for a triathlon! Whoa! And why? Was I getting greedy? Was I happy? Was I spending enough time listening to God and His plan for my life? I stopped…reflected….and actually prayed about it. Let me tell you something…be careful for what you pray! I prayed God would somehow slow me down and help me find some balance in my life. If you go back and read or have read the very first couple of my blogs in 2021, you know what happened. God did answer my prayers to slow down! He did it …His way…not mine! I was diagnosed with a deadly melanoma under my thumbnail that resulted in a partial thumb amputation, a year of chemo, and the process of learning how to operate again! Be careful for what you pray!

That very day that I got the depressing call from my pathologist about my diagnosis, something else happened, likely providential. Pastor Jack Foster is my dear friend, neighbor, and one of my spiritual mentors. Unbeknownst to me, he also had been worried that I had been going too hard in life. That very day, as he was driving by my house, he felt something tug at his heart strings; he slowed his vehicle down; and he almost pulled into my driveway to confront me. He felt called by the Lord to intervene. Interestingly enough, I called him shortly thereafter with my devastating medical diagnosis. He now has walked with me on this cancer journey. Together, we have felt the process of genuine sanctification taking place in my life. God has also given me a testimony and maybe this platform to encourage others.

As I reflect on 2024, I realize that the busyness of life is creeping back in. I am now a national officer in the American Academy of Otolaryngology. I am again one of the Deacons at Brook Hollow Baptist Church. My work load is closer to the busy old days. All of these are good activities in and of themselves. As I get further removed from that year of treatment, I feel myself gaining confidence in my prognosis. In turn, I feel myself losing that sense of humility and selflessness that weighed upon me heavily going through treatment. In 2025, I am challenging myself to strive for a healthy diet, exercise, and sleep. I plan to read more and try to spend more time in prayer. I have always made time and will continue to do so for my wife, kids, and 4 beautiful grandchildren. If you are in the same situation, I ask you to re-assess your life and schedule. Prioritize your Heavenly Father, your family, your friends, and your health! Life can change quickly. Be content with today. And don’t waste another day!

Melanoma Update

/ Dr. Lee Bryant / 24 Comments

I was diagnosed with malignant melanoma under my thumbnail on July 21, 2021.  For those of you who have been following my cancer journey, you know that I am a surgeon who became at patient and then documented my journey in this blog.  After undergoing surgery, I completed a yearlong treatment plan of chemoimmunotherapy infusions, having completed my last infusion on June 29, 2022. This blog recounts my story with a focus on a surgeon who became a patient, melanoma awareness, and the intersection of medicine and faith.

This blog was started to keep my patients informed of my progress. As I have continued to feel better, my surgical practice has ramped back up to normal. And I have taken on some additional work responsibilities. I was elected as the Secretary of the Private Practice Section of the American Academy of Otolaryngology/Head & Neck Surgery.

But as is typical of any major health crisis or really any major life crisis that effects behavioral changes for the better in our lives, it is easy to get busy with work and fall back into old habits. I have not been updating my blog lately, but plan to keep it more updated. Also, when one feels better physically and spiritually, it is easy to drift into old habits. I teach a young adult group in our home on Sunday nights. I always tell my group that you never drift into good habits, only bad ones. Anything you do to improve yourself is intentional, not something into which you drift. So in this new year of 2024, I have tried to refocus on wellness to help my body continue to battle this melanoma. I have been intentional on getting enough sleep. I have been working out more regularly and giving up sweets. Lastly, during the Lenten season, I have tried to refocus spiritually.

Things we can control such as our sleep pattern, our diet, our exercise pattern, our stress level, and our spirituality can work together to reduce chronic inflammation in our bodies. As I have mentioned in earlier blogs, science has shown that chronic inflammation in the body aids and abets tumor biology, helping tumors either develop or progress more rapidly. Some of the inflammation caused by tumors is from genetic mutations and intrinsic factors of the tumors beyond our control. But a lot of extrinsic factors can also cause chronic inflammation such as chronic infections, an inflammatory diet high in sugar, autoimmune diseases, obesity, tobacco use, and excessive alcohol consumption.

My last two rounds of laboratory work up and extensive imaging were in May and November of 2023. They revealed that I continue to have no evidence of recurrent melanoma cancer. Because of the stage of my melanoma and the tumor biology (acral type with high mitosis and ulceration), I remain at very high risk for recurrence. My type of melanoma tends to be very aggressive and many do not survive the first three years. However, the risk for this type of melanoma is more “front loaded,” meaning that as time goes on, my risk starts to drop. I have another round of imaging on May 2, 2024. I am praying for continued good news, because that is near the three year mark, when my risk begins to drop some, and my prognosis improves.

I am planning a big celebration that weekend if all is good…more on that later. I pledge to keep all those who are following more informed! And let’s all focus on wellness. Let me know if you want me to start writing about more specifics.

Lastly, for those in the Nashville, Tennessee, area and beyond, feel free to tune in to Morningline with Nick Beres on Monday, March 18, as we do a one hour live show discussing Springtime allergies and impact on our health. (https://www.newschannel5.com/plus/morningline)

I appreciate all the love and support!

My First Infusion

/ Dr. Lee Bryant / 10 Comments

As we left off, I was recovering from my partial right thumb amputation and sentinel node biopsy. And Kellee and I got the great news, in a providential type of moment, that my sentinel lymph nodes were negative for any cancer cells. I was found to have Stage II disease. Considering that my original lesion presented 5 years earlier, it seemed almost miraculous that my metastatic workup was negative. I took the liberty to assume that my age, lack of any other medical problems, healthy diet (no red meat or dairy), and exercise level (training for triathlon) maybe was keeping my immune system strong enough to battle. And now I did not regret my crazy decision to biopsy my own nailbed!

Almost 2 weeks after my surgery, I sought a second Oncology opinion, which is often a wise idea. As a matter of fact, for every single patient to whom I recommend an operation, I offer a second opinion because I want them to feel completely comfortable both with me and their decision. I got the exact same treatment recommendations, so I kept my original team of physicians where my care would be under the same umbrella. Because of the depth of my melanoma and some other histologic factors, such as ulceration and high mitotic activity, it was felt that I would need further therapy to reduce the risk of recurrence. There are new promising drugs, that are called PD-1 receptor blockers, which help restore the T cells of our own immune system, prevent deactivation of our T cells by tumor cells, and thus restore our body’s ability to combat and destroy tumor cells. These drugs are in a class called biologics, and the treatment is a form of chemotherapy called immunotherapy, administered by intravenous infusion.

My First Infusion:

Exactly 3 weeks after my surgery, I was scheduled for my first IV infusion. I would be scheduled for a full year of treatment, with the first 5 treatments being 3 weeks apart, and then the last 5 treatments being 6 weeks apart, as long as I could tolerate the therapy. This type of drug has common side of effects of nausea, fatigue, muscle pain, bone pain, brain fog, and others. More serious side effects include conditions such has liver toxicity, pneumonitis (pulmonary toxicity), renal toxicity, and others. The drug is intended to enhance one’s immune system against tumor cells, but also can cause the body to attack itself. Naturally, there was some anxiety about how well I would tolerate the treatments. A typical infusion day involves a check-in process, going to a lab to have an IV inserted, and having extensive labs drawn. I decided to try being infused with peripheral IVs to avoid a portacath placement if my veins would hold up. After the labs are returned and evaluated, there is an appointment with my Oncologist, after which I head to the IV infusion center for IV saline fluid, followed by my cancer drug infusion, followed my more saline fluids. It is quite the process and somewhat exhausting at times.

My Mistake:

That first infusion day, I had a gap between my Oncology appt and my infusion. Therefore, Kellee and I decided to grab some lunch at the hospital cafeteria, with the IV already in my arm and all covered up by coban wrap. I also happened to be a patient at the academic medical center where I trained as a medical student and resident physician. As we entered the cafeteria, it brought back memories of late dinners alone before a long night on call in the hospital, and memories of early morning coffee and breakfast after operating all night long. It also brought back memories of my nervous stomach and GI distress, memories that were soon to become reality again! I apologize but this is about to get personal! I had been eating so healthy (anti-cancer diet to be explained in another blog), and I thought I may want some comfort food. So, I skipped all the healthy stuff and went straight for the stir fry Asian food…spicy chicken over some fried rice and maybe a fried roll also. After I consumed all of my own plate, I proceeded to eat about half of Kellee’s plate as it was just too much for her. We then checked in at the infusion center. As we entered the private room, one of the nurses asked if I had eaten a light lunch because the infusions can make one very nauseated…bahahahahahaha. I did not have the heart to tell her I was already nauseated, bloated, and flatulent….well before the infusion ever started. Lesson learned! Thank goodness for nausea medication.

My Nurse:

In all seriousness, I want to close this episode sharing about the most wonderful nurse I had. I want to share with you how nurses make such a difference in the lives of patients. I also want to thank all the nurses that have ever worked for me in my office or with me in the hospital, operating room, ER, or surgery centers. I am just going to use her initial “M.” Although we had seen a lot of care providers, it had all been about my workup, diagnosis, prognosis, percentages, and treatment. As a physician turned patient, I soon realized that sometimes we have so much schedule pressure that we do not always embrace the emotional needs of our patients: their anxiety, their fears, their worries about their jobs, their concern for finances and medical bills, their concern about their families, their spiritual health and search for truth, etc. Here I was, a right handed surgeon with an amputated right thumb, currently unable to work, and worried if I would ever work again or when, worried about my family, worried about innumerable issues. So when M came out and called me and Kellee back, she made eye contact, the kind of eye contact that says “I see you and I know you are scared.” She asked, “How are you doing?” as she reached out and tenderly touched my shoulder, in a comforting manner. As we arrived in the infusion room, she asked if this was our first time, and we said yes. She asked a little bit about my story, and heard some of the craziness of my diagnosis, how I biopsied my own thumb, and my career as a surgeon. She connected with me and Kellee, and the first thing she did was to comfort us and tell us everything to expect. I shared some of my faith journey and the wooden cross that I kept in my pocket that had not left my side since it was gifted to me by some of my OR nurses. We talked about God and faith. And then, the most amazing moment happened. She dropped down on her knees between me and Kels. She took Kellee’s hand in her left hand and she placed her right hand on top my bandaged thumb and then proceeded to pray over us, asking God to comfort us and give us peace and strength, and to trust in Him. Tears were being shed! We greatly needed that emotional connection. My infusion then went flawlessly, with the exception of the GI distress which more than likely was related to my overindulgence of stir fry at lunch!!!

Moving forward, I plan to share how I spent my time recovering from surgery, regaining strength, preparing to return to work, and most importantly, how I embraced a new lifestyle with more balance and a deeper relationship with God.