Grateful to be back on the job

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 demolition crew had been at the medical center in Orange, setting up cranes and heavy equipment. Now, in a fifth-floor room of the very building he had been working on, he was receiving intravenous fluids to nourish him and keep his kidneys from failing.

Alfaro could hear the distant thudding of machinery when a team of university physicians gathered around his hospital bed and told him the tests were definitive: He had a rare cancerous growth on his pancreas. This neuroendocrine tumor was causing the intestinal problems that had plagued him, 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,” says 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 demolition 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 proximity to major arteries, the liver and the small intestine. Dr. David Imagawa, the medical center’s chief of hepatobiliary and pancreatic surgery, put the father of three boys on chemotherapy injections.

“The drug was like stopping a freight train,” Alfaro says. “It was the greatest relief, and my illness hasn’t come back.”

He has multiple endocrine neoplasia syndrome, a genetic disease that affects about one in 20,000 people. It causes the endocrine glands to overproduce certain hormones, often resulting in nausea, vomiting, severe diarrhea and fatigue, as well as the development of tumors – like the one on Alfaro’s pancreas.

A few months later, Dr. John A. Butler, chief of surgical oncology at UC Irvine’s Chao Family Comprehensive Cancer Center, removed Alfaro’s parathyroid glands, which were producing chemicals that had contributed to the cancerous mass.

There were tumors on them too, but they were benign. “Dr. Butler did such a wonderful job,” Alfaro says. “You can’t even see the scar.”

The tumor on his pancreas is far more difficult to reach. Luckily, the drug has halted its growth, says oncologist Dr. Randall F. Holcombe, director of clinical research at Chao, the only Orange County institution designated as a comprehensive cancer center by the National Cancer Institute.

“It’s still a cancer but has been controlled by the injections he gets monthly,” Holcombe says.

If the chemotherapy stops working, pancreatic surgery probably would be the next step. In the meantime, Alfaro is zealous about healthy eating, regular exercise – playing baseball with his sons and riding his bike – and prayer.

He’s also back in his cherished role as provider for his children and wife, Laura, who’s employed at a convalescent home. He still remembers when Holcombe asked if he felt strong enough to return to work.

“I jumped up and hugged him,” Alfaro says of that day. “I held onto the clearance 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 the demolition crews making way for what is now UC Irvine Douglas Hospital.