Veteran St. Louis firefighter Salvatore (Sam) Licata thought he had strained a muscle in June 2006 while on a call. As he bent to lift a patient who had fallen between her bed and the wall, he felt pain in his upper back.   

The tingling and numbness that developed in his lower body progressed until he couldn’t feel a touch, but he kept expecting it to get better. He was fortunate that when his wife’s orthopaedic surgeon asked about the Licata family during an appointment for a hand ailment, she mentioned Sam’s back pain and numbness.   

Her doctor, Martin Boyer, MD, immediately went down the hall to tell Jacob Buchowski, MD, MS, about the symptoms, and Buchowski asked Sam to come in to be seen. Admitted directly into Barnes-Jewish Hospital, Licata had a round of MRI scans that revealed a tumor on his kidney and metastasis to his lungs and cervical spine.  

“I had no idea that I had cancer,” Licata says. “It turns out that I would have been paralyzed if the spine tumor had gone untreated for just one more week.”

Buchowski believes that a tumor-weakened vertebra led Licata to break his back when he bent to lift the patient he was helping, and that event triggered the cascade of care.  Buchowski performed surgery on Licata’s cervical spine several days after he was admitted.  During the five hour surgery, the cancerous vertebra was removed and the spine was reconstructed using a cage, screws and rods all the while preserving complete function of the spinal cord. 

Two days later, the cancerous kidney was surgically removed. Licata continues to undergo weekly chemotherapy treatments for the metastatic lung cancer, sees his oncologist every six weeks, and gets an annual follow-up by Buchowski. He says he experiences some stiffness after working in the yard for extended periods, but overall, he gets around well.  

Now 44, Licata says Buchowski’s educated, quick reaction to the tiny clue Boyer gave him “not only kept me from being paralyzed but saved my life. I was much sicker than anyone knew.”