Coordinating Heart and Cancer Care

Bob McFadden of Upper Macungie Township used to write songs about history and politics. These days, he’s writing songs about beating cancer and how St. Luke’s University Health Network doctors helped save his life.

Bob, 71, was on the drug Erleada to treat prostate cancer. Because the drug also has side effects, St. Luke’s urologist Frank Tamarkin, MD, and oncologist Heidar J. Albandar, MD, mandated regular blood tests.

“Erleada is a cancer-treating medicine that has side effects we need to watch for,” Dr. Albandar said. “It’s a very good and effective treatment, but there can be serious side effects with the liver, the kidneys, blood sugar and cholesterol.”

This past spring, Bob’s blood test came back with abnormally high cholesterol levels. A normal cholesterol level in a healthy individual is less than 200 mg/dL, borderline is up to 239, and high is above 240.

“Mine was around 385,” Bob recalled.

High cholesterol is a major contributor to heart disease, so Dr. Albandar referred Bob to Michael McCulloch, MD, a St. Luke’s cardio-oncologist.

A cardio-oncologist is someone who has expertise in heart toxicities that can emerge because of certain cancer therapies. The cardio-oncology program at St. Luke’s is specifically designed to help patients deal with the effects that cancer treatments may have on the heart.

“Some cancer therapies – in some patients – can increase the risk for heart disease,” Dr. McCulloch explained. “Being aware of that kind of correlation helps you determine when patients need to be followed more closely or need screening to be done.”

Bob’s attitude was incredibly positive throughout his treatment, but he’s a special kind of person. He’s got a degree in history from Rutgers University, served as a distribution manager at McGaw and B Braun, played softball until he was 67 when a torn rotator cuff ended that activity, is in a band called Et2Bruté, and just absolutely loves life. He is a frequent contributor to Letters to the Editor in The Morning Call. And he’s also a huge San Francisco Giants fan.

“When Dr. McCulloch saw me for the first time, the first thing he said to me was that I was a walking time bomb,” Bob said.

Dr. McCulloch put Bob on Crestor, a cholesterol lowering medication that blocks an  enzyme in the liver, causing it to make less cholesterol, as well as increase the breakdown of cholesterol already in the blood.

But Dr. McCulloch didn’t take a drug therapy-only approach. He referred Bob to a dietician, to improve his diet. Bob quit smoking and increased his activity level with frequent and longer walking.

Along the way, Bob also ended up with bladder cancer, for which he had successful surgery.

“Strike One was prostate cancer,” Bob said. “Strike Two was when it went to Stage 4, and then unbelievably my cholesterol went through the roof, and then to top it all off, bladder cancer.

“It’s disappointing to find out you have these diseases, but I've felt fine the entire time. The doctors and teams at St. Luke’s saved my life several times over. I couldn’t be happier with the way I went from doctor-to-doctor seamlessly. I’m in great hands at St. Luke’s.”