A routine colonoscopy screening in March 2025 at MedStar Health brought Donnie Estevez, 58, of Newburg, Maryland, face-to-face with a dire diagnosis he hadn’t seen coming.
“It was new territory for me. I’ve been fortunate to have good health throughout my life with no medical issues,” Donnie says. “Going into that colonoscopy, I had no symptoms to hint at what was ahead of me.”
During the colonoscopy, Umed K. (UK) Shah, MD, a gastroenterologist affiliated with MedStar St. Mary’s Hospital, identified an easy-to-miss abnormality “peeking” from behind Donnie’s appendix. A biopsy indicated an aggressive, rare form of cancer known as goblet cell carcinoma (GCC), which primarily occurs in the appendix and affects only about one out of every 2 million people. It is most common in individuals ages 50 to 60.
Minal Shah, MD, a MedStar Georgetown Cancer Institute medical oncologist at MedStar St. Mary’s Hospital, and one of our colorectal surgeons, Tushar Satish Samdani, MD, evaluated Donnie following the colonoscopy. They recommended standard colon cancer treatment: diagnostic scans to identify the extent of the cancer and surgery to remove Donnie’s right colon, appendix, and lymph nodes (a hemicolectomy). Chemotherapy was also a possibility following surgery, depending on the stage of his cancer.
But Donnie’s case was about to become far more complex.
An unexpected turn
When Dr. Samdani began Donnie’s surgery, he saw that the cancer had spread into the thin membrane lining the abdomen. He quickly consulted our system chief of surgical oncology at MedStar Health, Timothy Kennedy, MD, who practices at MedStar Georgetown University Hospital, for his expertise in treating rare abdominal tumors. On Dr. Kennedy’s recommendation, Dr. Samdani halted surgery.
“This type of cancer is an unusual and distinct combination of two common cancers that affect the appendix—neuroendocrine tumors and adenocarcinomas. As with other cancers, the chances of recovering from GCC depend on how far it’s advanced at the time it is diagnosed.
Because this cancer is so rare and, in Donnie’s case, so advanced, we had no large-scale clinical trials to guide us with treatment insight,” Dr. [Minal] Shah explains.
The advanced stage 4 GCC diagnosis devastated Donnie and his family. “It’s hard to imagine going as Donnie did from a routine screening test and no symptoms to receiving such a grim diagnosis of a rare form of cancer with limited life expectancy,” Dr. [Minal] Shah says.
A difficult road, carefully navigated
Fortunately, MedStar Health’s network of cancer specialists was available to Donnie. During a consultation with Dr. Kennedy, Donnie and his family learned that an advanced treatment option called hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) had shown positive results for GCC tumors.
After the initial shock of his diagnosis faded a bit, Donnie took control where he could throughout his complicated medical journey. Along with his wife Vicky and their daughter Rachel, he researched recommended treatments and asked questions.
“I was hearing that I didn’t have all that much time left,” Donnie says. When Dr. Kennedy described HIPEC as a heated chemotherapy wash that is circulated through the abdominal cavity “like a mouthwash gargle that destroys cancer cells, I was all for it.”
Dr. [Minal] Shah coordinated the next stage of Donnie’s treatment carefully with Dr. Kennedy to prepare for CRS and HIPEC. She started six months of aggressive chemotherapy for Donnie at MedStar St. Mary’s. A diagnostic laparoscopy would indicate whether chemotherapy had successfully shrunk the tumors.
Living life with purpose, cancer free
Once his laparoscopy, scans, and cancer biomarker blood work came back negative, indicating a positive response to chemotherapy, surgery was rescheduled to remove Donnie’s colon, appendix, lymph nodes, and any tumors left in the stomach lining. Pathology from the surgical specimen showed only a small amount of viable tumor left behind, according to Dr. [Minal] Shah. “This was a very good result. It was a successful, potentially curative surgery. I was thrilled to see he responded so well,” she says.
Donnie returns regularly for routine check-ins with our MedStar Georgetown Cancer Institute team at MedStar St. Mary’s to monitor his progress. At this point, he counts his care team there as friends. Recently, a circulating tumor DNA blood test confirmed that no cancer DNA fragments are present in his body. He is now considered cancer free.
“Everything is worth the fight,” Donnie says. “My motto was and still is ‘stay positive and move forward.’ I am not looking back.”
Now, Donnie takes each day as it comes, with his goals firmly fixed on the future. When he isn’t working as a program manager for a local land surveyor, Donnie devotes his time to his favorite activities: playing golf, shooting pool, and spending time with family, especially his 9-year old grandson Will.
“Without the excellent care I received from all of my physicians, my story would have ended differently,” Donnie says. “Dr. [Minal] Shah and her team were so proactive and supportive. I never felt like I was facing any of it alone. My experience is a reminder of how timely intervention, expert coordination, and steady physician support can change the course of a life.”
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