There's No Place Like Home

By Gary Quackenbush

San Francisco has everything Tony Spruill loves — from sharing cultural experiences at the symphony, art museums, and special events with Ben Bayol, his committed partner of 33 years, to taking walks in Golden Gate Park and the Presidio. Tony takes advantage of San Francisco’s moderate climate and the vast array of attractions the city has to offer.

Leading an active lifestyle has been his joy, helping him stay fit and healthy. His healthy choices, coupled with annual physical exams and living close to CPMC, would prove to be a life-saving combination for Tony.

A Life-Changing Event

When Tony was a young boy growing up in North Carolina, he experienced a serious accident. While walking to the recreation center across from his home, he was hit by a truck. He was bleeding internally and underwent an emergency splenectomy, removing his entire spleen; during that procedure, he received a blood transfusion.

When Tony was 22 he moved to San Francisco. He initially planned to stay for six months but wound up living here ever since. In the early 1980s, during a workplace blood drive, he decided to make a blood donation. Afterward, he received a letter informing him that he was infected with hepatitis B; this was later linked to his childhood transfusion, when blood was not routinely tested for the hepatitis virus.

Early Detection Through Routine Checkup

Ever since he contracted hepatitis B, Tony has been diligent in keeping up with his regular medical exams. In 2011, during his annual checkup, his primary care physician Robert Napoles, M.D., found that Tony’s liver panels were elevated, and ordered an ultrasound. The scan suggested the presence of a large tumor, and a liver biopsy revealed that the tumor was hepatocellular carcinoma, or liver cancer, later attributed to the hepatitis B.

The news was devastating for Tony and Ben. Tony had been feeling fine and had no symptoms of liver disease. “There was a delayed emotional reaction. I was in denial at first, and Ben burst into tears,” Tony says.

Dr. Napoles believed the tumor could be surgically removed, and referred Tony to Robert Osorio, M.D., liver surgeon and surgical director of CPMC’s Liver Transplant Program. Dr. Osorio saw Tony within a week, confirmed the tumor was operable, and put him on the “fast track” to surgery.

“I told Tony he was a great candidate for surgery,” Dr. Osorio says. “We estimated that 60 percent of his liver would need to be removed.” Fortunately, the liver is a unique organ, capable of regenerating lost tissue.

Working Together

According to Dr. Osorio, “Tony and Ben are an incredible couple, and make a great team in taking care of each other. During consultations, they would take notes, ask many intelligent questions, and do their homework in between sessions. We had excellent two-way communication. I took time to provide answers to help them make informed decisions. The chances that his cancer could be completely removed were very good.” Five days after surgery, and the day before his birthday, Tony was discharged from the hospital and went home to celebrate with friends and family.

Jennifer Guy, M.D., director of the Liver Cancer Program at CPMC, reviewed Tony’s postsurgical MRI images and confirmed that there was no sign of disease. Continued followup imaging studies will keep Tony’s doctors informed of any changes to his liver in a timely fashion. “CPMC’s multidisciplinary approach to patient care brings a dedicated team of liver specialists to patients, rather than having patients obtain several opinions on their own, saving valuable time. This team collaborates, reaches consensus, and addresses the clinical, psychological and social aspects of each case. A coordinator is assigned to each patient and we offer education, support groups, and provide easy access to the team,” explains Dr. Guy.

“The CPMC doctors and staff were great and took excellent care of me before, during and after surgery. They were also very sensitive to Ben’s feelings and made him feel comfortable,” Tony explains. “I can’t imagine what would have happened without the extraordinary initiative, teamwork and skill that Dr. Napoles and my CPMC team provided. They’ve given me a whole new reason to love living in San Francisco!”

For more information on the CPMC Liver Cancer Program, visit cpmc.org/advanced/liver/.