About five years ago, Richard Bernstein started experiencing a mysterious pain in his right toe.
“I went to my podiatrist,” the 62-year-old Montvale, NJ, resident told The Post. “I thought I had fractured the toe, but he couldn’t find anything wrong with it.”
Two years later, the pain crept into his ankle, so he saw a sports medicine doctor, who thought he had stenosis — a narrowing of the spaces within the spine that is sometimes treated with physical therapy.
His foot and ankle pain continued, mildly affecting his mobility. Then, in March of 2022, his right leg noticeably swelled up. He went to his general practitioner, who took an abdominal scan during his examination. The doctor immediately sent him to see Dr. Michael Grasso, the Director of Urology at Phelps Hospital, who delivered some unsettling news.
“He told me I had four days to live,” recalled Bernstein.
The abdominal scan showed that the married father of one had a large cancerous kidney tumor and tumor thrombus that had grown up through the renal vein and filled the vena cava, which is the main vein draining into the heart.
Grasso had Bernstein admitted to Lenox Hill Hospital, so he, along with cardiothoracic surgeon Michael Hemli and vascular surgeon Alfio Carroccio, could perform a complex procedure to remove the tumor.
But preoperative testing revealed more pressing medical issues. Two of Bernstein’s main coronary arteries were 99% blocked, and his liver was failing because the malignancy was obstructing its function.
“He was walking a thin tightrope,” Grasso told The Post. “You have two situations that are life ending in a very short period of time, happening simultaneously.”
The trio of surgeons had to both remove the tumor and perform a bypass. The procedure took nearly 12 hours and was a medical symphony of sorts.
First, they needed to “control the circulation” by shutting off the flow of blood without harming the brain. To achieve this, they hooked Bernstein up to a lung and heart machine that cools the body to 18 degrees.
“We can’t just open the vena cava and scoop out the clot and close it again because the bleeding is torrential,” said Hemli. “We want to stop the circulation completely.”
While the body was undergoing the two-hour cooling process, Hemli and his team performed the coronary bypass. Then the trio went about removing the kidney and tumor.
“We opened the vena cava, and they opened the heart on the right side [and] freed up the tumor. I freed it up from below, pulled the snake out and they fixed the vena cava and started warming him up again,” said Grasso.
The “snake” — i.e. the tumor and tumor thrombus — to which he referred measured about a foot long and weighed nearly 2.5 pounds.
“I can’t say I fully recognized the complexity when I went in, even though Grasso told me it was complex. There was not much I could do about it and [that attitude] got me through,” said Bernstein.
According to Grasso, the pain was manifesting itself in Bernstein’s foot, ankle and leg because there was a venous blockage.
“The vena cava was being obstructed. There was pressure in his lower extremities,” said Grasso.
Kidney cancer notoriously presents late, when the tumor has progressed. The signs can be vague, like back pain, though urine in the blood is another indication.
Bernstein said he had a small lump on his chest that his doctor dismissed. However, he feels lucky.
“If my whole leg didn’t swell up, I would have dropped dead,” said Bernstein, who after the surgery was sedated for about three days. After a week, he left Lenox Hill to rehab at Phelps Hospital, where he built up his strength. He is now walking unaided and is slowly regaining the 30 pounds he lost.
The doctors believe they removed all of his cancer, so he doesn’t need to undergo any additional treatment. His focus now is on recovering from the intense surgery.
“I’m still suffering from a fog a bit,” said Bernstein, who now tells people experiencing vague symptoms to not disregard them.
“There was no serious pain at all. My advice is if something is wrong and they can’t find it, don’t give up looking,” he said. “Trust your feelings about your own body.”