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Jim Dykstra recalls a long and successful 26-year career working in the HVAC field for the city of Phoenix. Stationed at the Sky Harbor International Airport, Jim frequently worked with boilers and other systems that required regular maintenance and updates. Unknowingly at the time, his day-to-day tasks frequently exposed him to asbestos within the building itself, as well as the products he was working with.
After a testicular cancer diagnosis in 2011 leading to chemotherapy and surgery treatments, his doctor noticed growths in his abdomen during a CT scan. In 2013, Jim was diagnosed with peritoneal mesothelioma and has been undergoing treatment ever since. This August will mark six years of battling the cancer.
A History of Asbestos Exposure
Jim grew up in a military family, often moving around before settling in Phoenix, Arizona. As an adult, Jim started his own career in the HVAC industry, stationed within Phoenix’s Sky Harbor International Airport.
“While there, I worked within buildings that were full of asbestos but was unaware of that. In Terminal 2, there were two Cleaver-Brooks Boilers that required refactoring periodically, which as a worker I did as assigned,” Jim recently explained to Mesothelioma.com. “Terminals 1 and 2 had asbestos all over the place and have had abatement done to them. Terminal 1 was torn down in the late 1980s to the early 1990s.”
Jim explained other parts of the airport also had large amounts of asbestos throughout. “There is a red brick building called FAA North that they had to move all the functions to a new building due to the extensive amount of asbestos. Afterwards, the city just closed the building and wouldn't allow anyone to enter.”
Unfortunately, the asbestos removal came too late to prevent Jim’s exposure. While asbestos use in the United States slowed down by the 1980s and 1990s, the mineral is still not banned and many past uses of the toxin remain. Without a full ban and the safe removal of old asbestos materials, thousands of workers and the general public are at continued risk of exposure.
Receiving the Mesothelioma Diagnosis
Jim initially went in for a routine CT scan about one year and a half after his diagnosis and treatment for testicular cancer. The scan showed some growths in his abdomen, though initially, his oncologist was not concerned. After another six months, Jim’s scans showed more growths.
“My doctor went three months for another scan and, you guessed it, there were more of the tumors and the older ones were bigger,” Jim recalled.
After that scan, he went in for a CT-guided biopsy in July 2013 to determine what was causing these growths. However, the doctors had difficulty attaining a tissue sample for analysis. Jim recalls, “The surgeon tried seven times in and out of the machine, and finally he gave up, stating ‘It’s like hitting a superball in jello.’”
Jim returned for another biopsy in August and the surgeon was able to take two samples for study. Jim remembers the surgeon telling his wife, “I am not sure what it is, but he is full of it.”
Following the biopsy, Jim and his wife learned he had epithelioid peritoneal mesothelioma. Epithelioid cells are the most commonly diagnosed in mesothelioma, and are noted as growing more slowly and reacting more favorably to treatments than other cell types. Peritoneal mesothelioma indicates cancer in the lining of the abdomen. It is the second most common form of the rare cancer and, in recent years, patients have seen improved survival rates with new treatment options available.
Jim’s Mesothelioma Treatment Journey
After his diagnosis, Jim’s doctors explained his best treatment option would be to undergo cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment works by first removing all visible tumors and then circulating a heated chemotherapy wash throughout the abdomen to kill any remaining cancer.
After he recovered, Jim next underwent 30 sessions of radiation therapy for the tumors the doctors were unable to remove in the liver. Shortly afterward, he underwent four cycles of chemotherapy, which consisted of cisplatin and pemetrexed (Alimta®), followed by another two cycles of carboplatin and Alimta. He finished these rounds of treatment in June 2014.
“Afterwards, I went back to my original oncologist who was testing me with the SMRP blood test. All was good until late 2018, when my SMRP blood test showed an increase in numbers from 0.9 to 1.4. That is when PET scan showed new growth, and in May I started back with chemotherapy,” Jim told Mesothelioma.com.
His treatment consisted of carboplatin and pemetrexed (Alimta) plus bevacizumab (Avastin®), with Neulasta® Patch until August 2018. At this time, his doctors updated his treatment plan to just pemetrexed (Alimta) plus bevacizumab (Avastin) until February 2019. Jim had two tumors that were not reacting to treatment, so his oncologist recommended he have cryoablation of the liver to treat those tumors that were not a candidate for surgery. In October 2018, the cryoablation was a success.
Jim was then able to start undergoing immunotherapy treatment with Keytruda®, which he is still being treated with today. If the Keytruda should stop working, Jim explained that his tumors are positive with the BRCA-2 mutation, which opens the doors for several other experimental drugs. Most recently, the FDA-approved NovoTTF-100L could be a potential option for Jim, when the FDA removes the freeze on it and allows patients to use it for peritoneal mesothelioma.
Next month, Jim will have been battling peritoneal mesothelioma for six years and has learned a lot through his journey.
He told Mesothelioma.com, “My advice to anyone who is diagnosed with mesothelioma is:
- Have a good frame of mind always. Don't allow yourself to get into "the dark funk.”
- Always have a sense of humor. I say, "I have to have humor because I already have a tumor.”
- Trust in your doctor. If not, find another one.
- Have faith in God or whoever is your spiritual guidance, family, friends and most importantly, yourself.
- Lastly, be strong and remember you are not alone in this fight.”