My toe hurt, but it really was kidney cancer and I only had four days to live

About five years ago, Richard Bernstein began experiencing mysterious pain in his right toe.

“I went to my podiatrist,” the 62-year-old Montvale, NJ resident told the Post. “I thought I broke my toe, but he couldn’t find anything wrong.”

Two years later, the pain crept into his ankle, so he saw a sports doctor, who thought he had stenosis – a narrowing of the spaces in the spine that is sometimes treated with physical therapy.

Her foot and ankle pain continued, slightly affecting her mobility. Then, in March 2022, his right leg noticeably swelled up. He went to his GP, who gave him an abdominal scan during his examination. The doctor immediately sent him to see Dr. Michael Grasso, director of urology at Phelps Hospital, who delivered some disturbing news.

“He told me I had four days left to live,” Bernstein recalled.

Richard Bernstein had pain in his toes for years but learned it was kidney cancer when he was told he had four days to live.
CT scan of Richard Bernstein's torso revealing his kidney tumor and tumor thrombus
Bernstein’s CT scan of his chest, revealing his kidney tumor and tumor thrombus.
Courtesy of Northwell Health

Abdominal scan showed the married father-of-one had a large cancerous kidney tumor and a tumor thrombus that had grown in 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 that he, along with cardiothoracic surgeon Michael Hemli and vascular surgeon Alfio Carroccio, could perform a complex procedure to remove the tumor.

But preoperative tests revealed more pressing medical issues. Two of Bernstein’s major coronary arteries were 99% blocked and his liver was failing because the malignancy was impeding its function.

Urologist Dr. Michael Grasso, cardiothoracic surgeon Dr. Jonathan Hemli and vascular surgeon Alfio Carroccio operating on Bernstein in a 12-hour procedure
Urologist Dr. Michael Grasso, cardiothoracic surgeon Dr. Jonathan Hemli and vascular surgeon Alfio Carroccio operating on Bernstein in a 12-hour procedure.
Northwell Health

“He was walking a thin tightrope,” Grasso told the Post. “You have two situations where life ends in a very short time, happening simultaneously.”

The trio of surgeons had to both remove the tumor and perform a bypass. The procedure lasted nearly 12 hours and was something of a medical symphony.

The kidney, surrounding tumor and fat, and tumor thrombus were removed from Richard Bernstein
The kidney, surrounding tumor and fat, and tumor thrombus were removed from Bernstein.
Northwell Health

First, they had to “control circulation” by cutting off blood flow without damaging 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 because the bleeding is torrential,” Hemli said. “We want to completely stop traffic.”

While the body was undergoing the two-hour cooling process, Hemli and his team performed the coronary bypass. Then the trio set about removing the kidney and tumor.

“We opened the vena cava, and they opened the heart on the right side [and] released the tumor. I freed it from below, pulled the snake out, and they fixed the vena cava and started warming it again,” Grasso said.

The “snake” – meaning the tumor and tumor thrombus – he was referring to was about a foot long and weighed almost 2.5 pounds.

Richard Bernstein with his wife Ann and daughter Emma
Bernstein with his wife Ann and daughter Emma.
Courtesy of Richard Bernstein

“I can’t say I fully recognized the complexity when I walked in, although Grasso told me it was complex. I couldn’t do much about it and [that attitude] allowed me to pass,” Bernstein said.

According to Grasso, the pain was manifesting in Bernstein’s foot, ankle and leg due to a venous blockage.

“The vena cava was blocked. There was pressure in his lower extremities,” Grasso said.

Kidney cancer notoriously presents late, when the tumor has progressed. Signs can be vague, such as back pain, although the presence of urine in the blood is another indication.

Bernstein said he had a small lump on his chest which his doctor dismissed. However, he feels lucky.

“If my whole leg hadn’t swelled up, I would have dropped dead,” said Bernstein, who after the operation was sedated for about three days. After a week, he left Lenox Hill for rehab at Phelps Hospital, where he strengthened his strength. He now walks unaided and is slowly regaining the 30 pounds he lost.

Doctors think they removed all of his cancer, so he doesn’t need to undergo any further treatment. He is now focused on recovering from intense surgery.

“I’m still suffering from a bit of a haze,” said Bernstein, who now tells people with vague symptoms not to ignore 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 the search,” he said. “Trust to your feelings about your own body.”

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