May 08, 2025
Provided Image/Rick O'Keefe
Rick O'Keefe, right, and his fiance, Elly Rumbach pose at the top of the 'Rocky steps' outside the Philadelphia Museum of Art. O'Keefe came to Philly to have a cancerous tumor removed from his horseshoe kidney by Temple Health's Dr. Daniel Eun.
Rick O'Keefe had no idea he had a horseshoe kidney or, like most people, what a horseshoe kidney even was.
But after breaking his clavicle playing tennis in May 2023, scans revealed cancer in his collarbone that had spread from his kidneys. O'Keefe also learned that he had a congenital condition that causes the kidneys to fuse into a horseshoe shape.
O'Keefe, 53, had had none of the complications that can arise from the condition, such as kidney stones and urinary tract infections. Horseshoe kidneys are still a bit of a mystery to medical providers, their cause unknown. Only about 1 in 500 people have them.
"I was just shocked when I found out," O'Keefe said, not just that his kidneys were fused into a horseshoe shape but that he had metastatic renal cell carcinoma.
O'Keefe, an avid tennis player in Little Rock, Arkansas, said he and his family cried when they found out his diagnosis. "But that was it. It was just like, 'You've got to keep on going.'"
That is precisely what O'Keefe has done. A righthander, O'Keefe taught himself to play tennis left-handed, earning the nickname "Lefty" among his circle in the United States Tennis Association in which he is an avid competitor.
O'Keefe and his fiance, Elly Rumbach, also researched the best places to have the tumor removed from his horseshoe kidney. They discovered Dr. Daniel Eun, chief of robotic surgery at Temple University Hospital, one of the foremost experts on performing unusual urologic cancer and reconstructive surgeries.
"I see a lot of weird kidney conditions," Eun said – cases that other physicians refer to him because of his experience.
O'Keefe had been on oral chemotherapy medication for about 1 and 1/2 years in part to shrink the tumor so he could have surgery. On March 13, which also happened to be Worldwide Kidney Day, Eun successfully removed O'Keefe's tumor and separated his fused horseshoe kidney into two.
"I find horseshoe kidneys fascinating," said Eun, who estimated that he has operated on 25 to 30 of them. "I look at weird conditions as opportunities to learn from the patients, because there's only so much that a textbook can tell you."
O'Keefe's case presented significant challenges, partly because the tumor was "smack in the middle" of the fused kidneys, Eun said.
Also, unlike typical kidneys that have one main artery providing the large amount of blood needed to clear waste and excess fluids from the body in the form of urine, O'Keefe's had three sets of vessels. If Eun had tried to remove the tumor all at once, it would have caused excessive bleeding from both sides, he said.
"The error in cases like these is that if you don't catch up with the bleeding, you could end up rupturing the tumor … which would be terrible for the patient," Eun said. "You could create a … situation where the tumor seeds in multiple places, and that could be a death sentence in some situations."
So, Eun took O'Keefe's surgery in steps.
First, he detached the tumor from the left side of the kidney and repaired it. Then he did the same procedure on the right side. Eun was able, in this careful fashion, to remove the entire tumor.
The day before his surgery, O'Keefe, his fiance and his 82-year-old mother June visited the Hecht Tennis Center at the University of Pennsylvania. A coach there, who overheard their conversation, was impressed that O'Keefe had become a lefty. He invited O'Keefe to play with some Penn students. So O'Keefe hit the court the evening before entering the hospital.
He was discharged less than 24 hours after his surgery and was up and touring Philadelphia. O'Keefe, Rumbach and June logged about five miles a day across the city over the course of that March weekend.
They visited Reading Terminal Market, toured the Federal Reserve Bank of Philadelphia and hit the "Rocky" steps at the Philadelphia Museum of Art.
"I tell everybody that was my favorite vacation, going to Philly. It really was," O'Keefe said.
The support of his friends, his tennis buddies, his family – and his 10-year-old dog Tippy – have been instrumental in keeping his spirits up during his treatment, O'Keefe said.
Back in Arkansas, O'Keefe is undergoing radiation.
He sees himself as the "lucky person who got cancer who is fit and active and who can fight it."
"You can't mope," O'Keefe said. "It doesn't do any good."
