The first photo shows a pale, gaunt man in a hospital bed, a tube in his nose and blood pressure cuffs on his arms.
The second shows a well-fed man in a checkered shirt and jeans, jumping in the air and clicking his heels in front of a row of banjos.
Two photos. One year apart. Same man.
The photos are of Mike Morgan, 56, of Lebanon, MO. Morgan celebrated the first anniversary of his liver transplant on April 7 by emailing the photos, captioned, “One year later and STILL KICKING,” to liver transplant coordinator Melissa Behr.
Mike had suffered from a rare form of cancer – cholangiocarcinoma – cancer of the bile duct. Until a few years ago, the prognosis for cholangiocarcinoma was uniformly dire. Patients were usually told to go home and get their affairs in order.
Mike, however, was lucky enough to be referred for treatment to Washington University physicians at Barnes-Jewish Hospital, where a pioneering protocol of chemotherapy, radiation and organ transplant is giving certain cholangiocarcinoma patients, such as Mike, a second chance at life.
“This is a very novel therapy,” says William Chapman, MD, chief of abdominal transplant at Washington University and surgical director of liver transplant at Barnes-Jewish. “You can probably count the number of centers in the country that offer something like this on one hand. But it’s been very effective thus far.”
Mikes’s transplant story began in late 2008 when a drunk driver fleeing police crashed into the music store he had owned for almost 30 years and burned it to the ground. Morgan worked non-stop to re-open the store, which was known in southern Missouri as a mecca for bluegrass and other musicians.
“Mike always says if you can play it, we sell it,” says his wife, Kathy Morgan, a third grade teacher in Lebanon.
Despite support from his staff, his wife Kathy, and their two daughters, Mike found the rebuilding process extremely tiring. He chalked it up to stress until July 2009, when one of his daughters remarked that Mike’s eyes looked yellow.
Kathy, too, noticed the jaundice, and Mike saw his family physician.
The results of lab tests and an exam led the family physician to refer Mike immediately to a gastroenterologist in Springfield, MO. The family doctor thought Mike might be suffering from pancreatic cancer.
“We knew it wasn’t going to be pretty,” says Kathy Morgan.
In Springfield, Mike had the first of several endoscopic procedures to examine his pancreas and liver. The exam revealed that Mike’s jaundice was actually caused by a biliary tumor, a growth on his bile duct. The tumor was obstructing the flow of bile from Mike’s gall bladder and damaging his liver, causing him to become jaundiced.
The gastroenterologist immediately referred Mike to Barnes-Jewish Hospital where Washington University physicians are known for treating biliary tumors.
Mike first saw hepatobiliary surgeon Stephen Strasberg, MD. Initially, he gave Mike and Kathy bad news – simple surgical removal of the tumor wouldn’t be possible in Mike’s case.
The good news, Dr. Strasberg told the Morgans, was that they were at one of a handful of centers in the U.S. that could offer a therapy protocol for cholangiocarcinoma.
“In 2005, we put this protocol together,” says Dr.Chapman. “One of the unique aspects of our center is that we have the expertise here to be able to offer an in-depth, multi-disciplinary therapy like this.”
Mike met with Dr. Chapman and the liver transplant team.
“As soon as we met Dr. Chapman, I had this feeling of calm come over me and I knew everything was going to be okay,” Kathy Morgan says. “He has an air about him that just inspired confidence in us.”
But Dr. Chapman explained to the Morgans that the treatment protocol had strict criteria and several complex stages. Over the coming months, Mike would undergo a six-week course of chemotherapy, followed with a five-week course of chemotherapy, with concurrent radiation treatments to shrink the tumor and keep it from spreading.
He would also have to undergo a surgical procedure to make sure the cancer had not spread outside of his liver.
He would have to be on oral maintenance chemo until a donor liver became available, and then he would have a transplant.
Despite losing weight, making frequent trips to St. Louis for checkups, treatments and hospitalization, and battling fatigue and infections, Mike tried to live as normal a life as possible, even opening a new music store.
Then, late on April 6, the Morgans got a call from the Barnes-Jewish transplant office that a donor liver had been found and they needed to get to St. Louis as quickly as possible.
The three-hour drive from Lebanon was bittersweet, Kathy says.
“We could finally see the end of the road for Mike’s illness,” she says. “But at the same time, we felt guilty. We knew that getting a donor liver meant that someone had lost someone they loved. We prayed the whole time we were driving.”
At Barnes-Jewish, Mike got the donor liver in a six-hour surgery performed by Dr. Chapman. Afterwards, Mike was taken to the surgical intensive care unit. In a hospital gown, with tubes in his nose and his arms, Mike gave a thumb’s up.
His sister took a photo.
Mike progressed quickly and was soon out of the hospital. Over the past year, he has recovered – though he’s had some bumps in the road.
Dr. Chapman says that evidence so far is showing the cholangiocarcinoma protocol is effective in eradicating the disease and that Mike has an excellent prognosis.
“I can’t say it was easy or fun,” Kathy says of the experience, “but it was worth it.”
The proof, she says, are in two photos.
Contact: Kathryn Holleman