Beating Back Esophageal Cancer
Not much gets Dimitri Dimitri down. And obstacles? No such thing.
Born in Iran, Dimitri came to the United States to study electronics in college, graduating with a degree from Cal Poly San Luis Obispo in1962. Within a week of graduation, he landed a job. Shortly afterward, he married his wife, Tammy, whom he first met in Iran.
Two decades later, after much hard work, Dimitri launched his own business, now a very successful venture that makes controllers for robots used in industrial automation. He had a lovely home and four successful children, all of whom worked in the family business.
His life, he said, was perfect.
Then, in October of 2008, he started to have trouble swallowing his food. Part of him, he said, knew something was very wrong. And it was.
Dimitri sought medical advice and doctors found a five centimeter tumor—about the size of a lime—in his esophagus. A biopsy confirmed he had a metastatic cancer of the gastro-esophagus junction.
His oncologist, Dr. Zev Wainberg, characterized his prognosis as “extremely difficult.”
“From what they were telling me, things looked pretty grim,” said Dimitri, 72, who lives in Chatsworth, within two miles of his business and the homes of his children. “I kept thinking to myself, ‘This is an easy one. I can beat this.’”
Daughter Monica Helm was less confident. And her online investigations into esophageal cancer only served to feed her fears.
“I knew he had a very aggressive cancer and that he may or may not have been a candidate for surgery,” said Helm, 40. “I was afraid the cancer would just keep getting worse and worse if they couldn’t remove it.”
A steadfast optimist, Dimitri held on to his positive thoughts and was determined to do whatever it took to beat his cancer. A consultation with a UCLA surgeon led to an appointment with Wainberg, an assistant professor of hematology/oncology at UCLA’s Jonsson Comprehensive Cancer Center who specializes in gastrointestinal malignancies and also conducts clinical trials testing new therapies.
Wainberg did not mince words, Dimitri said.
“The first time we met, he told me his experience indicated that the average survival for my type of cancer was about one year, even if I got the best chemotherapy available,” Dimitri said. “My answer to him was, ‘You may feel that way doc, but I don’t. I’m going to beat this and when I do, I’m going to be jumping up and down.’”
Wainberg’s response: “I hope you’re right.”
Dimitri was tested to see if his cancer had the HER-2 gene that is present in some breast and stomach cancers. But the gene, which makes an excellent target for therapy, was not present.
Wainberg then enrolled Dimitri in an UCLA investigator-initiated clinical trial that paired the chemotherapy regimen FOLFOX (5-FU, leucovorin, and Oxaliplatin) with the targeted agent Tarceva, an oral tyrosine kinase inhibitor that targets a growth factor driving the proliferation of the cancer. The trial, based on earlier research done in Jonsson Cancer Center labs, suggested that the location of Dimitri’s tumor at the junction between the esophagus and stomach might make him more sensitive to this combination.
There were about 40 volunteers in the study. Dimitri’s response, Wainberg said, was astounding.
“He has had what I can only call a miraculous response with a near cure of his cancer,” said Wainberg, invoking the “c” word that most oncologists are loathe to use.
Despite extensive genetic testing on Dimitri’s tumor, Wainberg has had trouble explaining why Dimitri experienced such an astounding response.
“Frankly, I wish I knew why this patient did so fantastically and why others didn’t achieve the same success,” he said. “We have sequenced his tumor and compared it to the other participants in the study, but no specific reason has turned up. I know there’s a reason. We just have to work harder to figure it out.”
The close-knit Dimitri clan was ecstatic that the one-two punch of the chemotherapy and Tarceva had proved an effective weapon against this aggressive cancer.
“Step by step, things kept getting better,” Dimitri said. “Then it got to the point where you couldn’t even see the tumor anymore. We couldn’t believe it.”
Dimitri was given chemotherapy every two weeks for almost a year, which he says he tolerated well. Every two months he gets an MRI to ensure the cancer has not returned. And he still takes the Tarceva every day in pill form, and while it does cause side effects, Dimitri is happy to be alive and well, three years after his initial diagnosis.
“It’s been a miracle drug for him,” Helm said. “I didn’t show it to him, but I was devastated when he was diagnosed with cancer. He was so strong the whole time. It’s like he willed his way out of this.”
As for Dimitri, he’s thrilled that things turned out the way he’d envisioned. He faced the cancer and fought it off. And while it may not have been as easy as he’d hoped, his battle has proven to be successful. He attributes much of his success to the outstanding support he received from his family.
“We hope the cancer doesn’t come back,” he said. “It’s an unknown quantity, really, whether it’s gone for good. But in my heart, I don’t think it’s going to come back.”
Life today for Dimitri has changed a bit. An avowed workaholic, he has ditched his 15-hour work days in favor of a more mellow existence. He’s still working in his company alongside his wife and children, but he says those roses he used to walk right past a few years ago—well, he stops and smells them now.
“The priorities are different now,” he said. “I have a different, calmer outlook on life. My focus is on the family.”
He also plans to travel more with his wife of 42 years. There are cruises to enjoy. And Africa beckons.
“I never really thought I would succumb to this thing. I always thought I would beat it,” Dimitri said. “That turned out to be true and we’re very grateful that we put ourselves into UCLA’s hands. I’m really glad I got into this study, and I would recommend that other cancer patients consider joining a clinical trial. Look at me. It saved my life.”
By Kim Irwin