His family rushed him to the hospital. A brain tumor was found. The surgeons were going to take it out with the help of an investigational drug.
"Well, they said that it was experimental, a trial thing, they said how good it worked," remarked the patient's wife, Lillian Rotella.
He had a tumor called a glioblastoma, a brain cell cancer with a typical life expectancy with treatment of only one to two years.
While the biggest part of the tumor is quite apparent, there are often tentacle-like extensions that don't show up to the naked eye or even on MRI scans.
A technique approved in Europe helps doctors find these tentacles. Surgeons at Allegheny General Hospital trained with the pioneering surgeon from Germany to learn this new technique.
AGH is just one of four medical centers in the country with a research protocol using this special drug specifically for this type of brain cancer.
Three hours before surgery, patients take a drug by mouth called amino levulinic acid or ALA.
It goes into the rapidly dividing cancer cells and gets turned into a substance that lights up. This doesn't happen in normal tissue. In ultraviolet light, all the areas of the cancer, obvious and unobvious, light up red.
The surgeons cut until all the red is gone, as long as they aren't getting too close to crucial parts of the brain that control language, speech, movement and sensation. Instead of getting 90 percent of the tumor the ordinary way, the ALA helps them get 5 percent more.
"So far, all the cases we did we have above 95 percent resection, which is the best you can achieve with this type of tumor," says AGH neurosurgeon Dr. .
"Dozens of specimens which have glowed, which look perfectly normal under the surgical microscope, stuff that I would have left there, two months ago before I had this drug, all are tumor. Even stuff that doesn't show up on the MRI," AGH neurosurgeon Dr. Quigley emphatically testifies.
It only seems to work for certain brain tumors. Slow growing and highly malignant tumors won't glow.
Every patient still gets the customary radiation and chemotherapy after surgery. The more tumor taken out, the better patients do.
"This is great, everything went well, they got more of the tumor out than they expected to, and just looked forward to what would happen next," says Lillian.
AGH has FDA approval to do 50 cases with ALA. The drug is being studied for safety and for how well it works.
The only issue has been some mild and temporary liver abnormalities. The doctors guess it will be at least five to seven years before ALA gets through the whole approval process.