OF NOTE:  PHLBI IS EXTREMELY GRATEFUL TO TONY AND JANET CHOMO FOR THEIR NUMEROUS DONATIONS TO SUPPORT DR. ROBERT CAMERON’S MESOTHELIOMA RESEARCH EFFORTS AT THE PUNCH WORTHINGTON RESEARCH LABORATORY AT UCLA, FUNDED BY PHLBI.

Tony Chomo and his wife, Janet, moved from Massachusetts to California in 1977. The day finally came when Tony, a career maintenance worker and licensed plumber, had all he could take of the brutal East Coast winters. The family, now consisting of four grown children and nine grandchildren, settled in Simi Valley.

In August 2006, Tony was involved in a motorcycle accident. But, his injuries seemed minor, and Tony went home. One month later, he found himself having a hard time breathing normally.  Tony went to the emergency room at Northridge Hospital. An EKG ruled out a heart attack, but fluid was found surrounding his lung, and was drained.  Tests on the fluid revealed abnormal mesothelial cancer cells, and Tony was diagnosed was malignant pleural mesothelioma.

A friend told Tony about Dr. Robert Cameron at UCLA’s David Geffen School of Medicine, and Tony met Dr. Cameron in October 2006.  For Tony, the eternal optimist, the family provider, the rock of stability who could nonetheless let loose on the open road atop 1200cc’s of  motorcycle muscle, the options seemed slim, until Dr. Cameron talked about treating mesothelioma as a chronic condition which Tony would have to deal with the remainder of his life—like high blood pressure or diabetes. The focus became choosing a treatment that would hopefully extend his life and allow him to maintain his quality of life. 

Dr. Cameron: “I told Tony that his disease appeared to be limited just to that part of the chest and did not have obvious spread to his lymph nodes. He was a good candidate for the pleurectomy with decortication procedure done, so I recommended that.”  Tony had the pleurectomy with decortication surgery on January 9, 2007.  Dr. Cameron, removed all visible tumor attached to Tony’s chest cavity and organs. Tony required ten days of recovery in the hospital.  Tony responded reasonably well.  Many people have problems with abnormal heart rhythms, pain, coughing up phlegm, and that kind of thing. But he seemed to get through that reasonably well.  He’s a pretty strong person. Then Tony did radiation on the body. What’s really tricky about radiation is that you technically want to radiate every place where the tumor was present. But that involves every single surface of the lung, the diaphragm, the middle of the chest and the ribs. That’s a big area. Also, the lung itself is very sensitive to radiation damage. So you have to have a lot of fancy treatment planning to be able to deliver radiation to all those areas and yet not hurt the lung.”

Tony is proud to say he has not taken any prescription pain medication since February 2007. He feels soreness and occasional numbness at the incision site but manages it without medication. In June 2007 he finished radiation with Dr. Michael Selch at UCLA. By July 2007 he started the next phase of treatment, daily injections of interferon alpha. Initially he felt tired and fatigued from the injections, but this has since improved.

In November 2007, Tony grew concerned when a CT scan revealed possible fluid in the lower left lung.  However, tests determined it was not fluid development, but rather air that had accumulated, resulting in a partial collapse of one lung.  Inflammation due to radiation was still visible, but this has since improved, as well. There is currently no sign that the cancer has spread.  Tony has monthly comprehensive blood tests along with scans and the Mesomark blood test every three months.

Tony tries to go on walks two to three days a week to stay active. He tires easily and notices significantly decreased breathing capacity. He loves riding his motorcycle with his buddies whenever he gets a chance and has gone on several bike rides with a friend in the mountains and in Ojai.

A Loving Couple

Tony and Jan continue their active and adventurous lifestyle. They own Harley-Davidson and Suzuki motorcycles and enjoy taking the motorcycles on tours and trips. Prior to becoming motorcycle enthusiasts, they owned boats and would go scuba diving. A seasoned dirt bike rider, Tony enjoys the thrill of showing his grandchildren how to ride off-road.  And, no job or occupation is as dear to Tony as the role of “Grandpa” and babysitter.  The Chomos’ home is constantly filled with the laughter and chatter of rambunctious youngsters.

Prior to his diagnosis, Tony had no plans of retiring, but since his surgery and radiation, Tony made the decision to cut out work completely, which was one of the hardest adjustments. Tony’s life has changed, but he faces those changes with fortitude and optimism. His surgery has given him the precious gift of time, which he lovingly spends with his children, grandchildren, and great-grandchildren.

OF NOTE:  The Pacific Heart, Lung & Blood Institute would like to express their heartfelt thanks to David and Pilar Vanderhyde for their gift of $100,000 in support of mesothelioma research at the Punch Worthington Research Laboratory, funded by PHLBI.

Diagnosis and Treatment 

David Vanderhyde was diagnosed with pleural malignant mesothelioma (epithelial type – epithelium are tissue membranes that line the internal organs),  in October 2006, and  was instructed by his oncologist to begin chemotherapy right away.  A month later, he began the standard regimen of Alimta with Cisplatin, however, his oncologist included a non-standard targeted therapy drug as well called Avastin (Bevacizumab), which is not a chemotherapy drug but rather an anti-angiogenesis therapy.  Anti-angiogenics are drugs that inhibit blood vessel formation, and blood vessel formation is critical for tumors to grow — it’s like their food supply.  Research has shown that in some instances, Avastin may prevent blood vessel formation in some types of tumors.

ANTI-ANGIOGENIC DRUGS:  Anti-angiogenics are drugs that inhibit blood vessel formation, and blood vessel formation is critical for tumor to grow — it’s like their food supply. 

After his six rounds of chemotherapy, PET scans revealed that the chemo was effectively reducing the size of the tumors in David’s chest.  His oncologist extended treatment for two more rounds, but without Cisplatin, due to a bad reaction after round six.  David finished in May 2007, and starting researching mesothelioma treatments on the web.  After noting repeated references to the expertise and skill of Dr. Robert Cameron, Executive Medical Director of Pacific Heart, Lung & Blood Institute, David made an appointment with Dr. Cameron.

Dr. Robert Cameron performs Pleurectomy with Decortication

Dr. Cameron informed David that while chemotherapy helped reduce the size of his tumors, a surgical procedure to remove the remaining tumor, known as a Pleurectomy with Decortication (P/D), might both extend his life and give him a better quality of life. 

Dr. Cameron’s ”Less is More” approach to surgery:  Perform Pleurectomy with Decortication, and resect (remove) the pleural lining around the lung, without disturbing tumor-free organs inside the chest, as opposed to the radical, highly invasive Extrapleural Pneumonectomy, a surgery that removes the entire lung, part of the membrane lining the thoracic wall, the diaphragm and the pericardium.

On June 7, 2007, David underwent the eight hour procedure with Dr. Cameron.  Once inside, Dr. Cameron saw tumor growing around the heart, so the lining of the pericardium (heart sac) was also resected. 

Approximately three weeks after his surgery, David was feeling so good, he took a long walk along the Santa Monica Pier.   Later that night he woke up with a fluttering heart and high blood pressure.  Doctors put him on Lopresor to restore his normal heart rate. 

In July 2007, David inhaled for a deep cough to clear the phlegm causing his scratchy throat.  Phlegm occasionally occurs after surgery for mesothelioma patients and can range from moderate to severe congestion.  David coughed with such force that he opened the surgical stitches on his left side.

David’s wife Pilar immediately drove him to a nearby San Diego emergency room where doctors attempted to put steristrips over the wound.  Within minutes of leaving the ER, David could feel the strips loosening, so the Vanderhydes drove straight to UCLA. 

At UCLA, doctors found an infection had developed, so they couldn’t re-stitch his side.  Instead, David had a “wound vac” attached to his side for over four months.  A “wound vac” gently and continuously drains the open wound so that it can heal quickly — without the machine, healing could have taken up to a year. Pilar became an expert at packing the wound with sponges, then bandaging the top until it eventually healed.

David continued his regular visits to Dr. Cameron who recommended radiation with Dr. Michael Selch, also at UCLA.  David’s PET scans in November 2007 showed good results, though David was concerned about the four month delay in radiation due to the blown stitches.

David completed his radiation, then began nightly injections of interferon alpha as maintenance therapy beginning April 24, 2008. David usually keeps a very positive attitude and outlook on all aspects of life, however, while he was on interferon, he noticed that he felt extremely fatigued, which caused depression. He did not want to get out of bed. David found it difficult to summon the optimism he often relied upon during his treatments.

Depression and fatigue are common side effects associated with interferon alpha. Usually these symptoms (and possibly flu-like side effects) disappear after a few days. David continued the interferon treatments, but after three weeks of worsening depression and fatigue, David and Dr. Cameron decided to stop the drug. Two days later, David noticed that he was feeling better and was a little more upbeat.

In October, 2008, a CT scan revealed some micronodules in David’s right lung, however, after four rounds of chemotherapy, Dr. Cameron says the nodules look fainter, and may be receding.

When David is finished with chemotherapy, he is going to try the interferon injections again, but at a lower dosage. 

“Never Surrender”

Despite the hardships during treatment, David plans to set an example by continuing to fight the good fight and never surrender.  He often says he can’t wait to share his story about being a 10 year survivor!  He hopes to inspire others to donate their time and money to the efforts of the Pacific Heart, Lung & Blood Institute, as “[they] believe in trying to find a cure for this so-called incurable disease.”

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Pilar Vanderhyde’s Tips for stress reduction: 

*Draw on your personal relationship with God, in whatever form you perceive God to exist.

*We watched a video called ‘The Secret’, which is all about positive thinking, and positive thinking is why David is alive today.  A thoracic surgeon in San Diego told us that David’s cancer was inoperable, and there were no options.  We decided to do some research on our own, and an interesting thing happened: Dr. Cameron’s name kept coming up, not only on the web, but also from the daughter-in-law of a friend, an attorney, and other oncologists.  Be sure to explore your options, even if someone tells you “nothing can be done.”

  *Find things that make you smile, and, if you really like the rain, like I do, make a fool out of yourself and go dance in the rain…