Doctor and stage 4 stomach cancer survivor thankful for clinical trial at UT MD Anderson

As an emergency physician who comes from a family of health care workers, Derek Cooney, M.D., has dealt with his share of challenging situations. But he says he never could have prepared for receiving a stage 4 stomach cancer diagnosis at age 48.

“It was pretty devastating,” Derek says of his diagnosis. “After I got over the initial shock, then anger, I immediately thought, ‘Thank God it’s not my wife or kids.’”

Starting stomach cancer treatment

Derek had a history of gastroesophageal reflux disease (GERD) and indigestion, and he’d taken medication to keep it stable for years. But when he was unable to eat or drink one day, he visited the emergency room at the hospital where he worked in upstate New York.

Doctors ran diagnostic tests and did a biopsy. A few days later, he was diagnosed with diffuse gastric adenocarcinoma, a fast-growing type of stomach cancer.

He sought treatment at a local cancer center with a doctor he trusted. A laparoscopy revealed that the cancer had spread to his peritoneum, making it stage 4. So, he started an aggressive treatment protocol that began with four rounds of FLOT chemotherapy, a combination of four drugs: fluorouracil, leucovorin, oxaliplatin and docetaxel. Then he would have a gastrectomy with hyperthermic intraperitoneal chemotherapy (HIPEC) followed by another four rounds of FLOT. 

“My doctor encouraged me to get second opinions and assured me that he’d maintain a cooperative relationship with the doctors wherever I decided to go,” Derek recalls.

So, Derek and his wife, Norma, also an ER doctor, sought second opinions at other centers, including UT MD Anderson. They asked about new treatments or available studies. But they kept hearing that there were no clinical trials available and that Derek was already on the most aggressive treatment.

“The statistics online were disheartening, but I explained to my four kids that I’m pretty young for this disease and there have been a lot of medical advances since those numbers were produced,” he says. “As doctors, Norma and I have seen so many patients overcome the odds. We believed I could, too.”

Opportunity to join a clinical trial at UT MD Anderson

Derek had his first appointment at UT MD Anderson on Oct. 3, 2024.

“It’s such a busy place, but I got a very warm welcome from the staff,” he recalls. “When we came through the door, I felt like a VIP. Everyone was phenomenal, and things ran so smoothly.”

Gastrointestinal medical oncologist Jaffer Ajani, M.D., explained that while they didn’t have any specific clinical trials for the cancer at the time, a team of experts would review his case.

Derek returned to New York a little disappointed but still optimistic. The cancer was responding well to chemotherapy, so he completed another four rounds.

Shortly after finishing chemotherapy, he caught pneumonia. While in the ICU, he got a phone call from Brian Badgwell, M.D., a surgical oncologist at UT MD Anderson who specializes in stomach cancer.

“The doctors at UT MD Anderson had reviewed my case, and Dr. Badgwell had a clinical trial I qualified for if I was interested,’” Derek says.

Badgwell explained that the clinical trial was similar to Derek’s current treatment plan, but it added another type of chemotherapy drug called paclitaxel delivered directly to the peritoneal cavity and an additional opportunity for cytoreductive surgery earlier.

“I knew there had been progress in using intraperitoneal chemotherapy to treat other types of cancer, so I was very interested,” says Derek. “I was at UT MD Anderson within two weeks.”

Successful treatment for stage 4 stomach cancer

Pulmonologist Carlos Jimenez, M.D., examined Derek’s lungs to make sure he wouldn’t have any increased risks during surgery.

Once cleared, Badgwell surgically implanted the intraperitoneal port and removed superficial lesions in Derek’s abdomen.

Derek then completed three cycles of paclitaxel, getting infusions every two weeks.

On Jan. 28, 2025, Badgwell performed a total gastrectomy with cytoreductive surgery and HIPEC. Derek healed for a month, then completed three more cycles of paclitaxel. Badgwell removed the port in April.

At his first follow-up in June, scans showed no evidence of disease.

“There are some key people in life that you’ll always remember, and Dr. Badgwell is one of those people for me,” Derek says. He’s still taking care of me even after the surgery, and Dr. Ajani supports me on the medical side. That matters to me as a patient. My family and I are forever grateful for my care team at UT MD Anderson.”

Continuing to get the most out of life 

Derek had planned to start a fellowship in interventional pain management in August 2024. Naturally, his cancer diagnosis that July delayed those plans. But he was determined.

“I was doing so well with the chemotherapy that I decided to enter the match,” he says. “I had faith that I was going to beat cancer.”

And he did. He completed the fellowship this past.

“I knew I was going to become a pain management doctor, and facing cancer was just one more thing I needed to make sure I was going to be a good one,” he says. “It’s also made me set more realistic lifestyle expectations for myself – like getting more sleep and taking vacations.”

Facing a stage 4 cancer diagnosis isn’t easy, and Derek gives a lot of credit to Norma for caring for him throughout treatment.

“If you spent 15 minutes with Norma, you’d understand why I did so well during treatment,” he says. “She’s an unstoppable force and exudes positivity.”

And he’s eternally grateful for UT MD Anderson.

“As a doctor myself, I understand that medicine is a science, but it’s also an art,” he says. “There’s room to treat every patient as an individual. UT MD Anderson does that extremely well, and I’m living proof of that.”

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