Digestive Healthcare of Georgia’s Dr. Niraj Khandelwal was nominated for a Piedmont 360 Award, a monthly award given out
by Piedmont Healthcare to employees who “go above and beyond the call of duty to deliver an excellent patient experience.”
Dr. Khandelwal, who practices out of DHG’s Fayetteville and Newnan locations, diagnosed a patient with a very critical case of pancreatic cancer and was instrumental in ensuring that the patient was able to undergo surgery just one week following the original diagnosis — a role that has greatly enhanced the patient’s chances of surviving long-term.
The patient was referred to Dr. Khandelwal from his primary care physician after experiencing the symptoms of having a bad taste in his mouth and of belching. To learn the source of the problem, Dr. Khandelwal ordered an ultra sound and an upper endoscopy.
That is when Dr. Khandelwal discovered a large mass on the man’s pancreas — cancer. The next step was to determine whether the patient would be a candidate for surgery — but that only would be the case if the cancer had not metastasized, or spread to other areas of the body.
Two days later, with Dr. Khandelwal shepherding the case through the healthcare system, personally calling other physicians and staff to ensure no time was wasted, the patient underwent an MRI. The MRI determined that the cancer, indeed, had not spread and that the patient could be a candidate for surgery. However, the patient had one more obstacle before he could be scheduled for surgery to remove the tumor.
Because of his advanced age, the patient had to receive clearance from his cardiologist for what is called a “Whipple” procedure, a complex six-hour operation. Pancreatic cancer ranks among the most deadly kinds of cancer but a Whipple procedure helps to enhance long-term survival rates.
According to WebMD, only 6 percent of pancreatic cancer patients are still alive five years after their diagnosis. However, those who undergo a successful Whipple procedure have a five-year survival rate of up to 25 percent. In terms of how many pancreatic cancer patients are candidates for the Whipple procedure, WebMD reports that only about 20 percent of patients are eligible.
This is what Dr. Khandelwal was charged with helping to determine, along with the patient’s cardiology team and others, during a relatively short time interval back in April.
“It’s a very tight area of the anatomy where a lot of sensitive organs come together,” Dr. Khandelwal explained of the Whipple procedure. “There’s the bile duct, the small intestine, the liver, the pancreas. The surgeon has to re-wire the anatomy because the anatomy there is so intricate and complicated. It’s one of the longest surgeries in the G.I. field. A general surgeon is not going to be able to do a Whipple procedure. It would have to be a pancreatic surgeon.”
Dr. Khandelwal said a cardiologist is required to sign off on the procedure because of the length of the time during which the patient must remain under anesthesia.
“You are lucky if you can get it and even luckier if you can get a Whipple that catches (the cancer) early enough,” Dr. Khandelwal said.
Thanks to Dr. Khandelwal’s involvement, the patient received clearance and underwent a successful procedure. The patient has had some complications from the surgery but, more than four months later, appeared ready to resume chemotherapy. While a long road remains ahead, because of Dr. Khandelwal’s diagnosis and action, the patient has a much improved outlook.
“He’s alive,” Dr. Khandelwal said. “Things are going well for him.”