From a rare cancer to a rare hole-in-one: A golfer's triumphant return

Gary Jones is a rarity in more ways than one.

A year ago, he was diagnosed with ampullary adenocarcinoma, a very rare type of cancer that represents just 0.2% of all gastrointestinal cancers.

As he approached the anniversary of his cancer surgery, the avid golfer made a hole-in-one, which for an average player carries odds of one in 12,500.

Jones' journey back to the green wasn't easy. In August 2020, a routine physical revealed his liver enzymes were 10 times what they should be. An endoscopy found a blockage in his bile duct, and a biopsy determined there was a tumor located at the ampulla of Vater, a small opening where the bile duct and pancreatic duct join and empty into the small intestine.

"The ampulla is in a very deep part of the body, and like pancreatic cancer, you don't feel anything when you have a cancer developing there," says Arlene D'Souza, MD, hematologist and medical oncologist at Northwestern Medicine Cancer Center Delnor in Geneva, Illinois. "This is exactly why it's so important for people to get routine blood work. On the off chance your labs are abnormal, it will prompt a work-up that may find something that needs treatment."

Within a week of his cancer diagnosis, Jones was under the care of Northwestern Medicine Surgical Oncologist Akhil Chawla, MD, who performed a Whipple surgery to remove the tumor. A Whipple is a complex operation to remove the head of the pancreas, the first part of the small intestine, the gallbladder and the bile duct. It is used for malignant (cancerous) or nonmalignant (noncancerous), high-risk lesions found within the pancreas and surrounding areas.

"That area of the body is one of the most complex anatomically, because many important blood vessels and organs reside right next to where the ampulla is," Dr. Chawla says. "When we remove the tumor that is infiltrating those areas, the operation must not only address the tumor but also all of the lymph nodes that the tumor could drain into and spread."

For Jones and his family, the sudden need for an elaborate surgery was a shock to all.

"I was concerned initially. I'd heard of Whipple surgery and certainly never thought it would be happening to me," Jones says. "But I never felt like I could be in better hands than I was with Dr. Chawla. He told me, 'Gary, I'm confident that I can fix you,' and that was what I needed to hear."

Dr. Chawla removed the tumor and 17 lymph nodes from Jones' cancer site. The lymph node biopsy results were all negative, indicating no spread of disease. Jones started chemotherapy in December 2020 as a preventive measure.

"Ampullary cancers, even when they're in the early stage like they were for Gary, have a high risk of recurrence. Starting chemotherapy after surgery helps decrease the chances of recurrence," Dr. D'Souza says. "This particular chemotherapy is very hard on patients, but despite that, Gary was motivated to do as much as he could to get rid of this cancer."

About a month after finishing chemotherapy, Jones picked up his golf clubs for the first time in eight months. Although he was expecting to pick up where he left off, he soon realized he had to ease back into things. During chemotherapy, he had experienced neuropathy, a side effect causing numbness and tingling in the hands and feet.

"I played only nine holes a few times until I felt 18 could work," Jones says. "It took several rounds to feel as though I could play to my expectations."

On Aug. 30, Jones was playing golf with two friends at Hughes Creek Golf Course in Elburn, Illinois, when he got a hole-in-one on the 17th hole. He used a 6-iron, and the shot was 154 yards. After a challenging year filled with hospital visits and chemotherapy treatments, he couldn't believe his accomplishment.

"I'm still in disbelief," Jones says. "To be honest with you, it brought a tear to my eye because I didn't think I would play golf again. Dr. Chawla told me I would be back out there, and he was so right."

Although Jones still feels tired after playing 18 holes, his love of the game keeps him going.

"Like everyone else, I have good and bad golf days," he says. "One thing for sure is that I am in a much better place today than I was this time last year."

Jones continues to meet with Dr. D'Souza every three months for CT scans and blood work, and will keep that cadence for about three years. So far, there is no evidence of disease.

"Now I see him thriving and more like he used to be," Dr. D'Souza says. "He's back to playing golf and gaining weight. His appetite returned, and neuropathy is slowly improving. It's just nice to see people come full circle."

Both Dr. D'Souza and Dr. Chawla credit much of Jones' recovery to his support system and his positive attitude.

"Gary and his family placed a lot of trust in me, and I'm very thankful for that," Dr. Chawla says. "The process is oftentimes very up and down, yet throughout it all he was very patient and trusted that we would care for him the right way. Attitude plays a big role in outcome for our patients, and Gary came in with a great attitude and kept it up throughout the process."

While cancer of the ampulla is technically not pancreatic cancer, Dr. D'Souza says it is treated in a similar manner. For more information on pancreatic cancer, visit www.nm.org/conditions-and-care-areas/cancer-care/gastrointestinal-cancers/pancreatic-cancer.