A North Carolina man was given a terminal cancer diagnosis just before he was approved to donate one of his kidneys.
At 50, Jeff Stewart, had spent over a decade trying to donate his organ to someone in need. It wasn’t for a family member or anyone he knew personally, but it was because ‘it seemed like the right thing to do.’
After countless tests, fasting, and losing 75 pounds, the father-of-seven was finally approved as a donor in July 2022. But after a routine CT scan before officially joining the donor registry, Mr Stewart was rejected yet again.
This time it was because scans revealed a tumor that turned out to be stage four adenocarcinoma, a type of stomach cancer deemed incurable.
The pharmaceutical advisor was shocked as he had exhibited no symptoms, saying: ‘It was extremely lucky that they did spot it.’
TRAGIC: John, pictured with his youngest daughter, had no symptoms prior to his cancer diagnosis
Yet he was diagnosed with stage four stomach cancer after he tried to donate his kidney to a stranger in 2022
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Mr Stewart, now 52, is no stranger to playing the odds. In 1994, he won the Jeopardy! College Championship, taking home more than $25,000. Despite his past good fortune, however, he told The Patient Story: ‘I don’t hope to be cured.
‘I don’t expect to be cured of this. The numbers are what they are, and that’s okay.
‘I’m so grateful for the time that I’ve had and to be able to do things that I hope matter.’
Stomach cancer, which affects nearly 27,000 Americans and kills 10,000 each year, is usually diagnosed with an upper endoscopy, a procedure in which doctors insert a tube with a camera on the end down the throat and into the stomach.
However, when Mr Stewart underwent an endoscopy a few weeks prior to the diagnosis as part of the kidney donation protocol, his results came back clear.
Adenocarcinoma is a tumor that forms in the glandular tissue, which lines organs like the stomach and releases mucus.
More than nine in 10 stomach cancers are adenocarcinomas.
His doctors believe it didn’t show on the endoscopy because he had undergone gastric bypass surgery over a decade earlier.
Mr Stewart, pictured with wife, Jen, and all seven children
Performed up to 300,000 times a year in the US, gastric bypass surgery involves dividing the stomach and small intestine and connecting them in a ‘Y’ shape.
This means food bypasses the stomach and the first part of the small intestine, so the digestive system does not absorb all of the calories, resulting in weight loss.
In Mr Stewart’s case, ‘there was nothing to see’ because the tumor was in the part of the stomach that was no longer functional.
He said: ‘[The tumor] was in the bypassed part of my stomach. I would have no symptoms. Even if it had gotten quite bad, it wouldn’t have been running into food, there wouldn’t have been a blockage there until it had really gone much further outside of my stomach.’
The cancer was confirmed to be caused by a mutation in Mr Stewart’s FGFR2 gene.
Normally, this gene helps make proteins responsible for cell division, blood vessel formation, wound healing, and bone development.
However, a mutation can cause the protein to become overactive, which can lead to the development of cancer cells. Experts estimate this mutation is responsible for as many as one in 10 gastric cancers.
With localized cases, stomach cancer has a five-year survival rate as high as 75 percent, but that dwindles to just seven percent in stage four.
Doctors also found a tumor on one of Mr Stewart’s kidneys, which was a separate form of cancer called renal cell carcinoma unrelated to the stomach cancer.
It’s unclear if it was the kidney he was planning to donate or what stage it was discovered at.
Mr Stewart, quickly underwent surgery to remove both tumors, where doctors discovered the stomach cancer had spread deep within his stomach lining. Within weeks, he was started on several courses of chemotherapy, followed by radiation.
He said: ‘I didn’t have the type of chemotherapy that makes you hair fall out, but I did have the type that destroys your nerves.’
Mr Stewart is no stranger to playing the odds. In 1994, he won the Jeopardy! College Championship (pictured here), taking home $25,000 and a new car
He has undergone several courses of chemotherapy and radiation, but the treatments are mainly meant to slow the cancer rather than cure it. Both treatments came with a host of side effects
The medications, particularly a chemotherapy drug called oxaliplatin, would send shockwaves through his body any time he picked up something mildly cold like a carton of ice cream.
‘It felt like being tased,’ he said.
After just the first treatment, Mr Stewart experienced a burning sensation on his arm that felt like it was on fire, but it felt cool to the touch at the same time.
He said: ‘I’ve never felt anything like it, and it stayed that way for days.’
Radiation also came with side effects, including extreme fatigue.
‘Your light turns dim as you just want to sleep,’ he said.
For Mr Stewart, chemo and radiation are not meant to cure his cancer, but are meant to help slow the disease down and make him more comfortable. Even if doctors decide to offer him more experimental treatments, he estimates they may only give him an extra few months.
He said: ‘[Treatment] has to kill every single cancer cell, and if it doesn’t, I die. And it didn’t, for me. I’m not depressed, but the years grind. It is harder.
‘It makes very simple things more important. It can be invigorating. There’s a certain joy in knowing you have a canvas this large and not “I don’t know how large.” I can fill that canvas. I can make something out of that.’
As part of his coping process, Mr Stewart wrote a memoir (pictured here) for his children with all of his best advice ‘so they would have it after I’m gone’
As part of his coping strategy, Mr Stewart wrote a memoir, Living: Inspiration from a Father with Cancer, to put ‘all of my best advice for my kids in it so they would have it after I’m gone.’
The book includes messages like acknowledging luck and good fortune and trying not to focus on things you can’t control. The goal is to help his children and his wife of more than 30 years, Jen, cope with his death in the long run.
He said: ‘I have seven kids. I hope that the pain of my death, when it comes, will not be too devastating for them and for my wife and my parents or my sisters.
‘Those parts I do hope for. But I don’t hope for a cure because nothing in the pipeline is close.’
Of all the advice in the book, Mr Stewart noted the best is about kindness.
He said: ‘Kindness is all that matters. It’s nice to be smart, it’s nice to be wealthy, it’s nice to be strong, it’s nice to be brave.
‘But if we are not kind, nothing else matters.’
