Sylvia Crombert: A Spark of Life and Love
Born in Cuba, Sylvia Crombert speaks both English and fluent Spanish. While working near Boston in her early twenties, she met Gustavus Csorba, a good looking Hungarian who would become the love of Sylvia’s life. They married the following year and eventually settled on the west coast with their small daughter some time later.
Sylvia always enjoyed traveling and her small family did so extensively. Sylvia wanted her daughter to see the world as much as possible in order to develop a wide understanding of different cultures and to meet as many people as possible. She believes her own worldly experience through education in Cuba and in the United States along with her traveling has helped her journey of life. Sylvia retains this positive mindset despite her recent health problems.
Nobody wants the flu
Anyone who’s had the flu remembers the high fever and painful body aches. In the winter of 1998, Sylvia caught a bad case of the flu that she couldn’t seem to shake. Months later she still had pain in her muscles and decided to see her primary physician. He referred her to a rheumatologist who could not find anything specifically wrong, but prescribed prednisone for her pain.
Even though she felt better some weeks later, Sylvia had what she calls a “deep perception” that something was wrong with her body. She decided to make an appointment with an urologist who again found nothing wrong specifically, but decided to order a sonogram at a nearby hospital in La Brea, California. The sonogram revealed a solid mass in her kidney. An MRI confirmed a diagnosis of Stage 1 kidney cancer.
Concerned, Sylvia lost no time in seeking treatment with renowned Dr. Arie Belldegrun, Chief of the Division of Urologic Oncology at the University of California at Los Angeles, who surgically removed the affected part of her kidney. A biopsy taken during the surgery confirmed renal cell carcinoma.
With time, Sylvia recovered from the surgery and now her kidney cancer is in complete remission. But there was something else that was happening inside Sylvia’s body of which she was unaware. What she thought was just a persistent cough due to bad allergies would turn out to be much more.
Malignant pleural mesothelioma
Even though Sylvia has a long history of bad allergies, her cough grew progressively worse. In 2001, she decided to have a CT scan of her chest that revealed a small accumulation of fluid in her left lung, known as an effusion. Often effusions can be related to allergies, so her physician prescribed antibiotics. By 2002, her cough became uncontrollable, she felt fatigued all the time, and she started dropping weight slowly. Her allergy medicine was no longer controlling her symptoms.
She decided not to waste any more time and made an appointment with pulmonary specialist Dr. Michael S. Levin at UCLA in January 2003. Dr. Levin immediately recognized that there was something dangerously wrong with Sylvia and so in February 2003, he ordered an ultrasound guided thoracentesis and CT scans. He also referred her immediately to Dr. Wayne Hofstetter, a thoracic surgeon formerly at UCLA who has since relocated to the University of Texas MD Anderson Cancer Center in Houston, Texas.
On February 12, 2003, Dr. Hofstetter performed a Video-Assisted Thoracic Surgery (VATS) to determine what was occurring in Sylvia’s chest. He drained the fluid with a thoracentesis procedure to relieve pressure on her lungs and allow her to breathe better. He also performed a pleurodesis to insufflate her lungs with talc to prevent further fluid accumulation. Sylvia was kept in the hospital for five days recuperating from the procedure. A month later, a taken through a mediastinoscopy returned a diagnosis of a rare cancer known as mesothelioma caused by exposure to asbestos. The news so shocked Sylvia and Gustavus that they didn’t know exactly what to do next.
Due to insurance regulations, Sylvia had to obtain a second opinion. She went to the City of Hope Hospital in Los Angeles, California, to consult with physician Dr. Frederic Grannis. However, Dr. Grannis was not a mesothelioma specialist, so Sylvia decided to continue treatment at UCLA.
Back to UCLA
Sylvia returned to Dr. Hofstetter for treatment who suggested a multimodal approach to beating the cancer. Though many cancer patients begin treatment with chemotherapy, Dr. Hofstetter’s opinion was that the chemotherapy currently available was not a preferred method of treatment and had such a low response rate, that it should not be used as a first line of treatment.
Instead, he recommend Sylvia undergo first a lung-sparing surgery to remove all visible tumor inside the chest in a procedure known as a pleurectomy with decortication (P/D). This surgery usually lasts between 4-8 hours and removes the pleura or lining around the affected lung but leaves the lung health and intact. Dr. Hofstetter contrasted this surgery with the other radical surgery known as an extra-pleural pneumonectomy (EPP) which would remove her entire left lung in an effort to contain the asbestos and growing tumors inside her chest. Much debate between these two surgeries exists and it is best to discuss a patient’s options with his or her thoracic surgeon, yet research suggests that the EPP does not effectively contain tumor growth nor does it show better survival results than the P/D.
Sylvia believes that “UCLA is at the cutting edge of treatment.” So on April 2, 2003, she underwent a left pleurectomy with decortication, dissection of involved lymph nodes to determine the extent of the cancer, and a resection of her diaphragm that Dr. Hofstetter reconstructed with Gore-Tex, a fabric best known for its use in waterproof and breathable fabrics.
Sylvia was released from the hospital the next week and gradually regained her strength. By May she felt strong enough to begin the second phase of treatment in Dr. Hofstetter’s protocol--radiation at Long Beach Memorial Medical Center in Long Beach, California. Dr. Joel Cherlow tailored her radiation treatment and conferred throughout her treatment with Dr. Michael Selch, radiologist at UCLA and with Dr. Hofstetter. Sylvia is grateful that Dr. Hofstetter took such an interest in each phase of her treatment.
However, she did not recover as easily from radiation as she did with surgery. Appetite loss compounded by occasional nausea caused her to drop down to 85 pounds. Sylvia largely subsisted on soup. During this time, she often felt very hot, a possible side effect from the radiation. She sought relief through cool showers which usually made her feel better and lifted her spirits, too. After her successful radiation ended, Sylvia slowly gained the weight back.
In April 2005, approximately two years after her P/D surgery with Dr. Hofstetter, Sylvia began taking interferon, an injection she took daily to boost her body’s own natural immune system. Her husband administered her shots, but the interferon also made her nauseous. By October 2005, she couldn’t even think about food, so her new thoracic surgeon, Dr. Robert Cameron, Director of the Mesothelioma Program at UCLA’s David Geffen School, decided to end that treatment.
Sylvia’s most recent CT scan taken on August 31, 2007 was negative for any signs of mesothelioma. She is currently receiving no treatment for her mesothelioma. Sylvia keeps her conviction that God has granted her the opportunity to see many places and meet many people. She is grateful to have found all her doctors at UCLA. Sylvia sees her new physician Dr. Cameron every six months now and says “he is brilliant and kind and always does his best with me.” Dr. Cameron shows his patience and diligence in answering her questions which she writes down in her notebook. “He is a compassionate physician,” she remarks, and acknowledges that “maybe there are other surgeries in other places that are good too, but I have UCLA in the area and there is nothing better.”
Inner Peace
Today Sylvia still struggles periodically and occasionally feels pressure in her back and chest which she relieves by sleeping or sitting with many pillows. But she puts everything in perspective and weighs the good with the bad. Given the chance to do it again, Sylvia wouldn’t do anything differently and Gustavus completely agrees.
Currently, Sylvia continues regular check-ups with Dr. Cameron who monitors her CT and PET scans. She is considering interferon injections again. Satisfied with the treatment she has received at UCLA over the past decade, she firmly believes she could not have gotten anything better anywhere else in the nation.
Sylvia finds that surrounding herself with beauty allows her to obtain an inner peace, tranquility, and serenity. She enjoys music, reading mysteries, and uplifting books. She strongly believes that her inner peace allows her body to better recuperate. She meets every day with acceptance, one day at a time. She considers herself a spark of life and love to guide and comfort others.
If you have been diagnosed with mesothelioma and would like to speak with Sylvia M. Crombert, please contact the Pacific Heart, Lung & Blood Institute for an arrangement.