Gayle Knoop doesn’t post about her cancer on social media, so most people didn’t even know she had been diagnosed with Stage 4 colon cancer with liver metastases in October 2024, or that the cancer had returned after nine months, or that she was preparing for Christmas 2025 to be her last with her family.  

She was trying to stay upbeat.  

“I’m at home over the holidays thinking this is probably my last Christmas with my family,” said Knoop, who has a husband, 22-year-old daughter, three dogs, and an older brother. “It was miserable.”  

After treatment, she had been cancer-free for nine months, but the cancer returned in her liver. Her hometown doctor told her the clinical team had met about her case, and she wasn’t a candidate for surgery. She could do Y90 radiation, which she did not want to do.  

Knoop said she finally “dug deep” and started going down all the rabbit holes and doing her research.  

It was different than the pressures she felt growing up playing volleyball, softball and basketball. This one was medical, and she felt hopeless, but she had a hunch there could be something out there for her.  

“I want to be here for my daughter. I want to see her graduate from medical school. I want to see her get married,” she said. “And I’m like, OK, get up off your ***, start digging. You’ve done it before. You can do it again. And it led me to Vanderbilt. And, to me, that was my answered prayer for God to put the right people in my path, and he did.”  

A better option than expected

With a little sleuthing and perseverance, she found something online with good reviews about Sekhar Padmanabhan, MD, just two-and-a-half hours away from her home in Louisville, Kentucky, at Vanderbilt-Ingram Cancer Center in Nashville. And it was in network for her insurance.  

She came to Vanderbilt-Ingram in search of the histotripsy surgery she read about online, but Padmanabhan instead performed robotic-assisted laparoscopic surgery on Knoop to remove the left lobe of her liver and two tumors from the right lobe.  

“The patient sheet just said she was there to discuss histotripsy, which she had read about online. Histotripsy was not what she needed; we had a better option than that,” said Padmanabhan, Assistant Professor of Surgery, who came to Vanderbilt-Ingram in 2021 to help build the robotic liver and pancreas program.  

“Obviously she was shocked when I said, ‘I think we can remove these tumors and potentially put you on a path for a curative-intent option,’” he said.  

Prior to 2022, there had not been a robotic liver resection done at Vanderbilt Health or in Nashville. There have now been more than 100 robotic liver resections at Vanderbilt Health.  

A word no one says with Stage 4 cancer

Padmanabhan said Knoop’s story amplifies the importance of educating not only community oncologists but also patients about new therapies and technologies available to them.  

“Gayle has a certain level of grit and is someone who will not be a defeatist … would not take ‘no’ for an answer. I am thankful that mentality is a part of her, because otherwise she wouldn’t have ended up here,” he said.  

“As I was looking through her labs and her scans and her history, in my mind, I was saying, ‘What are we missing here? Why are we not operating on her? She has a chance at a curative option, and why are we not offering that?’”  

Knoop required a couple of visits to Vanderbilt-Ingram to repeat scans, make sure her blood work looked good, and make sure her liver was healthy before she could have the robotic-assisted liver resection.  

“He offered me a 20% chance of a cure. You know, nobody ever says ‘cure’ with Stage 4 cancer, and he offered me a 20% chance at a cure,” she said. “And, for the first time, I had hope, and it wasn’t false hope. I had hope, and I had confidence in the people that I was dealing with.”  

The surgery also allowed her to go back to Louisville the next day instead of a more invasive surgery that would have included five days in an intensive care unit and a roughly 10-day hospital stay.  

“These successes need to be shared with the world”

Padmanabhan said he saw her in the clinic two to three weeks after her surgery, and she looked great and was back to her usual day-to-day activities. At a later follow-up with Justin Lo, MD, PhD, Assistant Professor of Medicine, her scans and blood work continued to look great.  

“When an institution and the people who make it up are this special, it deserves to be recognized,” Knoop said. “Tunnel vision is inevitable when this is your day-to-day life, but I truly believe Dr. Padmanabhan and his team at Vanderbilt-Ingram saved my life and could save the life of so many others. It is imperative that these successes are shared with the world.   

“I was more than a patient or cancer case. I was a wife, mom and sister who needed his incredible knowledge of advanced technology and his surgical skills to spend more time in these roles with my family,” she said.  

Padmanabhan said Vanderbilt-Ingram is “pushing the envelope” with new technologies like histotripsy and new programs like robotic liver surgery and robotic pancreas surgery, serving patients not only from Tennessee, but also parts of Kentucky, Alabama and Georgia.  

“Gayle’s story is obviously unique to her and very personal for her but, unfortunately, that is the story that we hear a lot, especially in this area,” he said.  

“Folks don’t necessarily have access to that care close to their home, so I would encourage people to see if there are newer drugs, treatments, surgeries, therapies and technologies that we can offer you that could extend your life, perhaps cure you in certain instances, but also ensure that we do all those things while maintaining your quality of life.” 

The post Resilient Stage 4 colon cancer patient discovers surgery option close to home   appeared first on Vanderbilt Health News.

Vanderbilt Health recently performed its 100th histotripsy, a noninvasive procedure in which highly focused ultrasound waves are directed at liver tumors to destroy cancer without ever making an incision. 

The recipient, Aaron Davis of Cleveland, Tennessee, had just celebrated his 52nd birthday days before the procedure and was surrounded in the Vanderbilt University Hospital operating room by a surgical team he’s come to greatly admire. 

Sekhar Padmanabhan, MD, assistant professor of Surgery, performed the procedure, in which a tub of water held over Davis’ abdomen served as the medium through which the ultrasound waves passed. In histotripsy, the focused ultrasound energy causes small gas bubbles in the tissue to rapidly expand and contract. This process forms a “bubble cloud,” forcing the targeted tumors to be liquified while avoiding damage to other tissue. 

“Histotripsy is a novel procedure, but one that shows a great deal of promise,” said Padmanabhan. “Thanks to generous philanthropic support, we’re building a world-class program to continue offering this technology to patients who can benefit from a noninvasive surgical option that yields excellent results.”  

Vanderbilt-Ingram Cancer Center is among the first institutions to offer histotripsy. Appealing to patients for its noninvasive nature, it avoids many of the traditional drawbacks of surgeries that use incisions, including pain management. 

“When I had my liver resection, that was some of the worst pain I’ve ever felt in my life,” said Davis. “And I’m allergic to many pain medications, too. Being able to get put to sleep for surgery and wake up without the pain of having my abdomen cut open changes everything.” 

Davis had previously been in Padmanabhan’s care to receive a hepatic artery infusion pump, which successfully delivered high doses of chemotherapy to his liver while minimizing toxicity to the rest of his body. And although the cancer returned, Davis knew he was in good hands with Padmanabhan and Kristen Ciombor, MD, MSCI, associate professor of Medicine in the Division of Hematology and Oncology, who eventually helped him settle on histotripsy as the best option to treat his latest recurrence of cancer. 

“The doctors at Vanderbilt-Ingram Cancer Center changed my life,” said Davis. “Having a care team who knew exactly what I needed and recognized that a newer procedure could help me has given me hope that I can continue fighting cancer.” 

The post Vanderbilt Health celebrates milestone for novel histotripsy procedure  appeared first on Vanderbilt Health.

From his infusion chair, Matt Duckworth would clap and yell “woohoo” each time he heard another cancer patient ring the bell to mark the completion of chemotherapy treatment, even though he knew he would never get that opportunity. 

On Friday, April 25 — seven months after his death — the bell pealed loudly at the Vanderbilt-Ingram Cancer Center infusion clinic as a plaque was unveiled in his honor and the announcement was made that patients receiving palliative chemotherapy would also get to ring the bell going forward. 

Duckworth was in the prime of his life at age 41, working as director of Population Health Operations for Vanderbilt Health Affiliated Network and doting on his three dogs with his wife, Suzanne, when he was diagnosed in 2020 with Stage 4 gastroesophageal cancer that had metastasized to his liver.  Although the chemotherapy didn’t cure his cancer, the treatments did extend his life for four years. 

“Matt had infusions weekly, and as we were sitting in the infusion room for hours at a time, we would hear the bell ring, and we would hear everybody clapping,” said Suzanne Duckworth. “He would clap and yell, ‘Woohoo!’ He just emitted such a positive vibe and aura. I would sit there and think, ‘He’s never going to get that because he has terminal cancer.’ Now, that thought might have come into his brain, but you would never know it because he never said it.” 

She asked Vanderbilt-Ingram about adding a plaque, and a ceremony was held in Matt’s memory to mark the occasion. Colleagues, family and friends shared stories about the man, who was beloved for his sense of humor, love for trips to Disney World and his affinity for dogs. His physician, Michael Gibson, MD, PhD, associate professor of Medicine, spoke about the relationship he developed with Matt and how much he enjoyed spending time with him.  

Suzanne Duckworth stated, “This is for you, Matt,” and rang the bell. 

His mother, Betsye, stood nearby wiping away a tear. On the plaque that had just been unveiled was a poem written by his sister, Jill Comfort.

I stand before the bell today 

Not for an end, but to proudly say 

I fought with every breath I had  

Through days of pain and times of glad 

I ring this bell for all I’ve done 

For every battle, fought and won 

For every day, for every try 

I ring the bell — head held high 

Ten years younger than Matt, Comfort had come to Nashville from Mississippi, to help Suzanne, who is a Vanderbilt nurse, with her big brother when he began hospice care. It had also bothered her that Matt never got to ring that bell, so she bought him one and read him the poem she had written.  

“But he wouldn’t ring the bell because that was admitting defeat,” Suzanne Duckworth said. 

A native of Clinton, Mississippi, Matt excelled in life, attaining an undergraduate degree in journalism, a Master of Science in public relations and then a Juris Doctor from Mississippi College of Law with honors followed by a Doctor of Healthcare Administration.  

He and Suzanne married in 2003 and eventually moved to Nashville, where they both established careers at Vanderbilt University Medical Center.  

“When things were running down, he didn’t want to give up,” Comfort said. “Then one day, he asked me if I would read the poem at his funeral and ring the bell. That somehow transpired into where we are today. We talked about how there were other people in his situation that don’t get that opportunity who are needing treatments for years and years. They need some encouragement.” 

Suzanne Duckworth approached Julie Bulger, manager of Patient- and Family-Centered Care at Vanderbilt-Ingram about allowing any chemotherapy patient to ring the bell regardless of whether they had completed treatment or achieved remission. 

“When Suzanne shared her idea about a new plaque, I deeply appreciated what she said, how when Matt heard the bell, he felt happy for those who rang it,” Bulger said. “It is rung traditionally at the end of treatment, but many patients may never have that opportunity. This thought comes from a lot of places, not only from Matt, but Suzanne articulated it so beautifully.  I believe this is going to resonate with many people.

“The bell can be rung at any time. It doesn’t have to be the last day of treatment. It can be rung because you’re having a bad day, and you’re fighting, and it’s hard. Or you have achieved a different milestone. You want to ring that bell because it’s going to mean something for you, and you want to feel uplifted,” Bulger said.

The post All cancer patients at Vanderbilt-Ingram will have the opportunity to ring the bell  appeared first on VUMC News.

Two Vanderbilt-Ingram Cancer Center (VICC) investigators have earned grant awards from The V Foundation for Cancer Research, continuing the foundation’s support for innovative cancer research initiatives at VICC. Raymond Blind, Ph.D.