Arlene Delman - November 2012
Sometimes Arlene Delman still sees glimmers of her previous life when she
least expects it. Like when a stranger pays her a compliment on her hairstyle
at the grocery store which she adds, isn’t the first time, she can’t
help but feel good. “I never got this much attention with my real
hair,” she giggles. These moments of normalcy most resemble her
old life before she was diagnosed with pleural mesothelioma in October
2012. Now she admits to shedding more than a few tears when she removes
her wig at the end of the day. She has always been an attractive woman
with big twinkling blue eyes, but her vanity has been rendered insignificant
in the way she has tackled her treatment both aggressively and optimistically.
Prior to her diagnosis, Arlene had retired to lovely and quaint Grants
Pass, Oregon. She and her late husband Ivan had settled there to be close
to her son Roger and his family. Arlene had recently purchased a fixer-upper
home in Grants Pass and had invested a lot in upgrades. When her respiratory
symptoms from the summer before were not subsiding, she followed-up with
her doctor who recommended a CT scan. The scan revealed a mass and Arlene
was scheduled for a pleural biopsy in early October. She was shocked when
the results came back positive for mesothelioma..
Arlene and Kara
Grants Pass is far from any facility offering the specialized medical treatment
she would require so Arlene wasted no time researching specialists before locating
Dr. Robert Cameron, director of UCLA’s Comprehensive Mesothelioma Program. Arlene had
grown up in the Los Angeles Valley and remained very close to a married
couple she considered family. Arrangements were made for her stay with
her good friends Tom and Sherree Jackson in Simi Valley which is about
an hour north of UCLA
Arlene was relieved upon learning she was surgical candidate and underwent the
pleurectomy/decortication (P/D) surgery with Dr. Cameron in early December. Unfortunately, the pathology
slides taken from her surgery revealed her tumor was actually biphasic,
meaning it was both epithelial and sarcomatoid cell-type, the latter of
which is the much more aggressive cell-type. In Arlene’s case, she
had a perfectly split distribution, 50% epithelial and 50% sarcomatoid.
Both epithelial and sarcomatoid require distinct treatment protocols.
This presents quite a challenge to treat an already difficult cancer with
a particularly difficult presentation. In fact, Dr. Cameron told her he
hadn’t seen a 50/50 patient since 1986.
After Arlene recovered from her surgery, instead of undergoing radiation
treatment which is the typical multimodal treatment protocol for predominately
epithelial mesothelioma, she underwent chemotherapy to address the sarcomatoid
cell-type. She had her first round of Ifosfamide with Mesna and Doxorubicin
in late January with oncologist Dr. Melissa Cohen at a UCLA satellite
in Westlake. This is the type of chemo that caused Arlene’s hair
loss but otherwise, she tolerated it quite well which is rare for this regimen.
Arlene with her grandchildren
After her second chemo round in February, a CT scan revealed a small tumor
on Arlene’s aorta which most likely developed because it took her
treatment plan eight weeks to develop and implement after her problematic
P/D pathology results. In addition, her low white blood cell count was
a constant issue and caused delays in order to be addressed before treatment
Arlene continued to stay with her good friends the Jacksons while receiving
treatment in Los Angeles, give and take a few trips back to Oregon to
wrap up her affairs. She put her home on the market so she could make
the permanent move to Los Angeles close to her treatment. Her son Roger
and wife Kathryn also put their home on the market so they could all go
in on a house together and help take care of each other. Their wholehearted
embrace of uprooting their own family including two elementary-school
children to traffic-filed Los Angeles rendered Arlene tremendously grateful
for their sacrifice.
By May 2013, Arlene had received four rounds of the Ifosfamide chemo regimen
and was notified it did not work. An updated CT scan revealed two masses
in her rib area and multiple spotting in the pleural space, in addition
to the previously discovered aorta tumor. All the “starting and
stopping” in her treatment is the likely culprit for why her tumor
cells grew so quickly. Her physician team considered follow-up treatments
including radiation, cryoablation and even surgery but they were ultimately
all ruled out due to the precarious locations of her tumors. Throughout
this time, Arlene had to deal with the frustration of her health insurance
denying coverage for treatment they considered “experimental”.
She felt so desperate she even begged to pay out-of-pocket until she discovered
she didn’t qualify for the treatments anyway.
It’s now late August and Arlene’s last option is to undergo
two very aggressive courses of Alimta Cisplatin chemotherapy. She started
her first course last week and her final course is in September. She reports
that this regimen, surprisingly unlike her Ifosfamide reaction, has been
especially hard on her. She takes this as a sign that it’s working
harder and that she’s “now on the right path.” She feels
she needs this aggressive and proactive philosophy guiding her and essentially
making up for lost time.
This journey has taken its toll on Arlene both physically and mentally.
She continues to fight through every setback and obstacle with the love
and support of her family and friends. The Jacksons have tended to her
like a beloved member of their family. They have been to every single
doctor’s appointment with her, taking notes and asking the doctors
questions on her behalf. Arlene and her son Roger are currently in escrow
and will soon happily all be under the same roof. Her daughter Donna and
grandson also visit her every other week from Las Vegas.
Arlene may barely recognize her life since her diagnosis but she has coped
and embraced her situation with the kind of grace and positivity that
only someone with her strength could manage.
*** Posted on September 3, 2013 ***
An Update -- October 8, 2013
Arlene has updated us with very happy news indeed. In addition to finally
settling into the comfortable home she bought with her son and daughter-in-law,
the results of her recent CT scan were very promising. The results demonstrated
that her new chemo regimen has effectively shrunk both her epithelial
tumor cells and sarcomatoid tumor cells. She reports that Dr. Cameron
is “ecstatic” with the results and Dr. Cohen is just “beside
herself” with glee. Arlene continues to receive platelets on a regular
basis, consult with a pain-management specialist and cardiologist in order
to address ancillary conditions related to her mesothelioma.
Her unwavering positive attitude continues to make a huge difference in
her condition. After reviewing her chart, new doctors usually expect to
see a feeble sickly patient but are absolutely stunned when a bubbly woman
practically bounces right into the exam room. Arlene also has a deep sense
of responsibility regarding her role in the medical field. As Dr. Cameron
previously notified her, she’s his first patient since 1986 who
is purely 50/50 epithelial and sarcomatoid cell-type. Arlene believes
her medical trajectory is contributing to the current body of mesothelioma
research and may hopefully help someone in the future.
Given the good news, Arlene is taking advantage of this opportunity and
has many things scheduled to look forward to. Her son has planned a weeklong
surprise-destination trip coming up and she’s also looking forward
to visiting her daughter in Las Vegas for the week of Thanksgiving. According
to Arlene, she simply has too many things she still wants to do with her
children and grandbabies to let her condition get her down.
* * * Arlene Delman passed away on June 15, 2014 * * *