On a clear day in Central Park, if you watch for long enough, you might spot Kieran Kelly and his horses. Originally from the Irish seaport town of Sligo, Kieran has worked for many years as one of New York City’s 68 licensed carriage owners and drivers.
The same qualities that make Kieran a good horseman—his patient and steady spirit—enabled him to endure nearly two years of searching for a diagnosis. With each passing week, the tumor in Kieran’s abdomen grew bigger: imperceptible, then unavoidable. By the time Kieran received surgery at Columbia, the mass weighed nearly sixty pounds.
Kieran, 58, was diagnosed with liposarcoma, a cancerous tumor that develops in fat tissue. His condition is rare, but his story will be familiar to many: a long search for diagnosis, taking two years and a succession of different doctors and healthcare institutions. Unfailingly tough, Kieran was able to withstand the growing discomfort for a long time—but when the tumor threatened to take his livelihood and life, he needed specialized care.
The Search for Answers Begins
Like many rare diseases, liposarcoma—a cancer affecting an estimated 5,000 people in the US—can be hard to pin down. Its symptoms take many forms, and they can be subtle and common to other conditions: abdominal pain, fatigue, nausea, weight loss. While the tests have improved in recent years, thanks to broader progress in cancer immunotherapy and genomics, diagnosis can still be evasive.
In late 2021, Kieran started to suspect that something was wrong. He could feel a hard mass growing in his stomach, with an onset that was at first subtle—small enough to be “maybe just a beer belly”—but slowly becoming obvious. Kieran started to notice other symptoms, too. His lower body was swelling with edema, as fluid built up in his legs and feet. Sometimes it was difficult to breathe.
After a few weeks, Kieran and his partner Alanna, also a carriage driver, went to urgent care near Kieran’s home in Queens. But after the examination and ultrasound, Kieran was sent home: the doctors had found nothing. “We let it go at that point because they didn’t really refer us to anyone,” remembers Alanna. But the mass in Kieran’s abdomen kept growing.
Pushing Through the Pain
For months, Kieran powered through. “I kept going to work as much as I could.” He claims that the discomfort wasn’t too bad—Alanna, familiar with Kieran’s pain tolerance, suspects otherwise—but his symptoms were starting to interfere with his active life.
Eventually, Kieran’s edema had gotten so severe that he was not able to put on his socks. The growth in his abdomen was making it difficult for him to get in his carriage to work. People were beginning to notice: “They would joke with him, [saying] he looked like a pregnant woman in the last trimester—but with twins or triplets,” Alanna remembers. Meanwhile, the rest of Kieran’s body was growing thin from malnourishment.
The next awakening came with a visit from a friend who worked in a Staten Island emergency room. Seeing Kieran’s state, she urged the couple to seek a second opinion: “If you don’t get this checked out, he’s going to die.”
Persistence, Self-Advocacy, and a Lifesaving Plan with Dr. Yoon
Kieran and Alana decided to try again—but it would still take months and several more doctors before they had an answer.
The next provider still couldn’t determine what the problem was, and Kieran’s care was disorganized. He was twice sent to have fluid drained from his abdomen (a procedure known as paracentesis), with repeated mixups about where he was supposed to go, when, and why. After all of it, the biopsy came back negative for cancer: a common issue with liposarcoma, which is rare enough to evade standard oncological diagnostics.
Like many patients searching for a diagnosis, Kieran and Alana had to do their own investigating online. “I started doing all kinds of research [to figure out] what this could possibly be,” Alanna recalls. “Just reading and reading and reading.”
Their persistence paid off. Finally, seeing yet another provider, the couple got the “first clue” about Kieran’s condition. Kieran remembers the doctor looking at him aghast: “He said, ‘Oh my god, who left you like that?’” Suspecting liposarcoma, the doctor referred Kieran to specialized care. By then, the mass had overwhelmed most of Kieran’s body, coming very close to his vital organs. A surgery would be long and dangerous.
Finally, Kieran and Alana met S. Sunghyun Yoon, MD, Chief of the Division of Surgical Oncology at Columbia and an international expert in the treatment of gastrointestinal and abdominal tumors.
Together, they made a plan. Dr. Yoon would resect the tumor—including a partial removal of Kieran’s large intestine and kidney—and take care to protect Kieran’s heart, with a restructuring and repair of the major veins. The surgery could take as long as twelve hours. By this point, Kieran knew that the treatment was his only chance. “I can’t live like this,” he remembers thinking. “I wasn’t afraid to die. I wasn’t afraid to have the surgery. I was gone that bad.”
While they hoped for the best, Kieran and his loved ones prepared for the worst. Kieran’s sister Mary flew in to be with him; his friends asked him if he wanted to be buried in New York or taken back to Ireland. When it came time for Kieran to enter the operating room, he and Alanna said goodbye: “Both of us felt like we were never going to see each other again.”
For nine tense hours, Alanna waited for updates, looking at Kieran’s anesthesiology chart for real-time clues about how the surgery was going. Finally, she got the call from Dr. Yoon: Kieran was out. The tumor removed from his abdomen weighed 59 pounds.
A Remarkable Recovery
When he woke up, Kieran remembers asking for a cup of tea—and being afraid to look down at his abdomen, now free of the tumor. He stayed in the hospital for nine days, regaining his strength with help from Columbia’s care team.
Astonishingly, Kieran didn’t have much pain; the real struggle was reintroducing food. “I was so hungry,” Kieran remembers. But after several days, he was already beginning to walk again—and, before he knew it, he was healing at home. His sister Mary stayed with him for three months, feeding him. “I couldn't stop eating,” Kieran recalls. “I could eat and eat and eat.”
Now, Kieran is back to his old active self. He’s working every day of the week, having fixed up his carriages and his entire stable. He also regularly helps his friends repair their houses. “He’s super physical and a great horseman,” says Alanna. “He’s back to his full and wonderful self.” Just a year after his surgery, Kieran experiences no pain and needs no medication.
While Kieran’s story is one of patience, it’s also one of perseverance and initiative. Despite their long road to diagnosis and care, Kieran and Alanna didn’t give up—and they trusted their instincts and the people close to them. The targeted, lifesaving care that Kieran needed was out there. To anyone going through a similar search for answers, Alanna advises: “Just keep going. Just keep up the fight.”
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