Grateful to be back on the job

A demolition foreman treated for pancreatic disease by the 'pros' at UC Irvine is able to provide for his family once again

The local doctors who sent Joe Alfaro by ambulance to UC Irvine Medical Center said he needed to see "the pros, the specialists" who would know what to make of the mysterious mass visible on a scan of his pancreas.

Only a few days earlier, Alfaro and his construction crew had been working at the medical center in Orange, setting up cranes and heavy equipment. The next thing he knew, he was receiving intravenous fluids to nourish him and keep his kidneys from failing in a fifth-floor room of the very building he had been working on.

Alfaro could hear the distant thudding of heavy equipment when a team of UC Irvine physicians surrounded his hospital bed and told him the tests were definitive: He had a rare cancer on his pancreas. This neuroendocrine tumor was the cause of the vomiting and bowel problems that had begun plaguing him a few months earlier, finally causing him to collapse, unable to hold down a sip of water or a grain of rice.

"I was told that I potentially had a year to live, that we had to act," said Alfaro of that day in early June 2005. "I was 33 and I just couldn't believe what was happening to me, physically, emotionally and financially. I'm a field supervisor, the guy making it happen. Then not to wear my boots or hard hat again, that was hard."

Surgery, the physicians said, would be tricky because of the tumor's nearness to major arteries, the liver and small intestine. Dr. David Imagawa, a UC Irvine hepatobiliary and pancreas surgeon, put the father of three boys on a trial chemotherapy drug.

"The drug was like stopping a freight train," Alfaro said. "It was the greatest relief, and my illness never came back."

A few months later, Dr. John A. Butler, an endocrine surgeon at UC Irvine, removed the Anaheim man's parathyroid glands, which were producing the chemicals that had triggered the tumor's growth on the pancreas.

There were tumors on the parathyroid glands too, but they were benign. "Dr. Butler did such a wonderful job," Alfaro said. "You can't even see the scar."

Alfaro has multiple endocrine neoplasia syndrome, a genetically transmitted disease that affects about one in 20,000 people. It produces a flood of hormones that cause nausea, vomiting, severe diarrhea and fatigue. Luckily, Alfaro's tumor is slow-growing, said oncologist Dr. Randall F. Holcombe, director of clinical research at the medical center's Chao Family Comprehensive Cancer Center, the only Orange County institution designated as a comprehensive cancer center by the National Cancer Institute.

"It's still a cancer, but it has been controlled by the injections he gets monthly," Holcombe said.

Should the chemotherapy stop working, surgery would likely be the next step. In the meantime, Alfaro is religious about eating healthy, exercising regularly—playing baseball with his sons and riding his bike—and praying.

He's also back in his cherished role as provider for his sons and wife, Laura, who works with elderly patients at a convalescent home. He still remembers the day in May 2006, when Holcombe asked if he felt strong enough to return to work.

"I jumped up and hugged him," Alfaro recalled. "I held onto the note he wrote like it was my first driver's license. I took it to my boss. ‘Oh my God,' he said, ‘I have this big job for you, are you ready?' I told him, ‘Let me have it!' "

On May 11, 2006, Alfaro was back at the medical center, once again supervising demolition crews to help build what is now UC Irvine Douglas Hospital. Once a month, like clockwork, when his shift was over, he'd take off his hard hat and get his injections.

"I still come faithfully for my appointments," said Alfaro, now 38. "I feel better than ever and I'm so thankful for my great doctors. They never gave up. I tell everybody who has an illness, I go to UC Irvine. They take care of you there. These doctors are the greatest."