Sandy and Tom Hazen
Tom Hazen is a 58-year-old senior manager within the medical instruments
industry (specializing in dental, ophthalmic and surgical lasers) who
was diagnosed with right sided pleural malignant meso-thelioma by doctors
in Mission Viejo, California on May 17, 2000. Tom and his wife Sandy reside
in San Clemente in a beautiful custom made home within a gated community
on the beach. He lives a few blocks away from former President Nixon's
fabled "Western White House."
Life on the beach has been good. Tom is a tall slender man with an athletic
build who reminds me of a youthful Walter Matthau. He's both charming
and easy going -- at the same time, he has a razor sharp wit and an analytical
mind that searches for solutions like a moth to light. Sandy, as Tom puts
it, "is pure sweetness and light." She exudes good cheer and
optimism. She is the kind of person who breaks down barriers. Within a
few minutes, your guard comes down and you find yourself revealing personal
secrets and exchanging warm hugs.
Six months ago, Tom and Sandy would rise early in the morning and walk
along the beach to the San Clemente pier. A few times a week they would
play tennis. Tom enjoyed swimming at the community pool. They enjoyed
surf fishing and hiking. They knew their neighbors and liked them. Most
of all, they enjoyed the hearty and humor-filled company of their two
boys, David, age 29, and KT, age 31, who seemed to always be bringing
over their friends after a run, ocean swim or triathlon.
Hands-On Parenting
Tom and his sons, David and KT
Tom and Sandy's bond with their children rises above any "parent-child"
relationship. They play together like kids -- like friends. They genuinely
love each other's company -- an idyllic rapport that is the natural
result of Tom and Sandy's "hands-on" approach to child rearing.
Tom spent several hours every week coaching his boys in track and field,
baseball and soccer. In high school David was ranked as one of the top
pole vaulters in the nation and later went on to pole vault on the UCLA
track team. Tom was the Scoutmaster for a boy scout troop that included
KT and David, both of whom earned their Eagle Scout badges. Although Tom
has always worked -- he's a self-described "work-a-holic"
-- he always managed to find time for his kids, who in turn as adults
seem to always have time for their parents.
Tom earned his degree in Mechanical Engineering in 1963. After spending
the next seven years working in dirty, dusty industrial plants, including
the notorious Kaiser Steel Mill in Fontana, California, Tom realized that
he had higher calling. After putting in 60 hour weeks at the Kaiser Steel
Mill, at night he went to school at UCLA where he eventually earned his
MBA in 1971. For the next 29 years, Tom has been an executive senior manager
for various medical device companies -- a far cry from the oppressive
heat and swirling dusts of Henry Kaiser's Dark Satanic Mill. Tom left
the asbestos-infested mills, but millions of asbestos fibers went with him.
Early Warning Signs: Shortness of Breath and "Puny" Feeling
Sandy and Tom celebrating with friends after a triathlon, June 1998. Sports
have always been a way of life for the Hazens.
In early April of 2000, Tom and Sandy attended a birthday party for a
friend in Mexico. Tom began to feel "puny", a malaise which
he attributed to a virus. He stopped playing tennis. He began sleeping
more. He and Sandy began to walk more slowly for shorter distances. His
breathing became labored. He thought he had pneumonia. Tom had always
been robust. He did not even have a family doctor. So he spoke to his
next door neighbor, a medical doctor, who prescribed antibiotics.
On the sixth or seventh day after taking the antibiotics, he could no longer
climb the stairs to the patio on the roof of their two story house, where
Tom had spent many an hour formulating the business plan for a new company
he and his partners were starting. Tom, who knows his body like an Indy
Driver knows his race car, knew something was seriously amiss. Sandy called
her family doctor to set up an appointment for Tom. Tom resisted the temptation
to go to the hospital, but his shortness of breath became acute.
Crisis Prompts ER Visit
On May 1, 2000 at 8:30 pm Tom acknowledged that his condition had become
critical. He was feeling chronic pressure and pain. His heartbeat became
irregular -- a fact which Tom kept secret from his wife in order to spare
her the added worry. He and Sandy rushed to the South Coast Medical Hospital
in Laguna Beach. On arrival at the hospital he calmly advised the doctor:
"I think I have a collapsed lung." The ER doctor first diagnosed
arrhythmia. He ordered a chest film which showed a pleural effusion and/or
soft tissue mass that was pressing against his chest wall, mediastinum
and pericardium. The film also confirmed a partially collapsed lung.
One hour later, the ER doctor drained the pleural effusion, withdrawing
3.5 liters of fluid. A radiologist looked at the film and his differential
diagnosis included mesothelioma. Tom was admitted to the hospital. When
the ER doctor explained his findings, he did not mention cancer or "mesothelioma."
However, Sandy interpreted the findings to raise the possibility of lung
cancer. She asked the doctor about "the 'C' word" and
the ER doctor said this could not be ruled out without more diagnostic testing.
Doctors asks about Asbestos
On May 2, 2000, Tom had a CT of the chest, which showed extensive diffuse
mediastinal swelling with encroachment of the trachea, along with extensive
soft tissue density in the pleural cavity. That evening while Tom was
in his hospital bed, Dr. Jungwirth explained that Tom had a pleural based
tumor and "inflamed lymph nodes." He asked Tom if he had ever
worked around asbestos.
Son David Hazen clearing the bar at the prestigious Sunkist meet. 'We
spent hours perfecting David' s mother. tom had never met him before.
sandy said later that she felt sorry for dr. jungwirth, who had to deliver
this very bad news. this is typical of the hazens:their first concern
is always the health and welfare of those around them.
Dr. Jungwirth ordered additional tests to rule out the possibility of a
primary site elsewhere in the body. He referred the Hazens to Dr.Chino,
a cardio-thoracic surgeon, who he thought would want to take a tissue
biopsy and perform a talc pleurodesis to prevent future effusions. The
Hazens went home, dazed, but not confused. The tests indicated a cancer
of the pleura. With the help of their friends, the Hazens set out to learn
more about what they were dealing with and more importantly, how to beat it.
Mesothelioma Suspected
The word that kept coming up in their internet search was "mesothelioma",
an asbestos related tumor of the pleura that usually presented with a
pleural effusion and shortness of breath. Tom and Sandy poured over the
grim survival statistics and prayed that they would dodge this bullet.
Sandy had begun marshaling her "prayer warriors" together in
an effort to beseech God to spare Tom from this hideous tumor. She asked
her friends to "pray like mad." The Hazens hoped for the best
but prepared for the worse. They made an appointment that week with their
family lawyer to create a living will and trust.
On May 9th, the Hazens met with an oncologist, Dr. Nagasawa. Sandy asked
him about mesothelioma. Dr. Nagasawa said mesothelioma was a possibility,
but they needed a tissue biopsy. The plan was for Dr. Chino to perform
another pleuracentesis, remove a tissue sample through an open lung biopsy,
and insufflate the pleural space with talc in order to prevent future
effusions. He also arranged to have the specimens assayed in order to
determine which types of chemotherapy drugs may provoke a response in vitro.
Dr. Nagasawa was reluctant to definitively diagnose mesothelioma. Tom asked
him point blank if indeed he did have mesothelioma, what was the prognosis?
Tom's practice in business and life has always been to identify the
worse case scenario and then plot a course to carefully avoid it. If he
had mesothelioma, he wanted to know the odds, so that he could configure
a way to beat them.
Dr. Nagasawa said the tumor appeared to be stage IV because of lymph node
involvement. Dr. Nagasawa would not address the question directly. He
instead explained that for lung cancer patients the first attack was chemotherapy.
If the tumor responded, the median survival was 6 months to 2 years. If
no response, the survival was 3-4 months. Dr. Nagasawa ordered more CT
scans of the pelvis and stomach, which were negative for a tumor metastasis
or primary.
Sandy recalled later her emotional state after meeting with Dr. Nagasawa:
"It was like, 'get the shovel,' your husband has three months
to live."
Dr. Chino Performs Talc Pleurodesis
On May 11, the Hazens met with Dr. Chino, the surgeon. He explained that
he would perform the talc procedure. They did not discuss the option of
surgically debulking or extricating the tumor. Without using the words
expressly, Dr. Chino's take home message was that the tumor was inoperable
-- at least by him. Dr. Chino was respectful and honest, but the news
was brutal.
On May 12, Tom was placed under general anesthesia and Dr. Chino performed
the pleuracentesis, talc pleurodesis video-guided bronchoscopy and open
lung biopsy. The tissue and fluid were submitted to the pathologist. The
next day, Dr. Chino advised the Hazens that based on the tumor's appearance
and diffuse nature he thought Tom had malignant mesothelioma.
Local Surgeon Recommends Dr. Sugarbaker
Dr. Chino candidly admitted that he did not have the expertise to operate
on the tumor and recommended that they contact Dr. David Sugarbaker in
Boston, who was world renown for his tri-modal therapy approach to treating
mesothelioma patients. Dr. Chino said that the removal of the lung and
pleural cavity was a radical procedure that carried a 30% risk that the
patient would die on the operating table. Dr. Sugarbaker's mortality
numbers were 5%.
To put those numbers in perspective, during his deposition, which was attended
by twenty (20) lawyers, Tom testified: "This means that of the 20
lawyers in this room, using a local surgeon six of you would die on the
table, but if you were operated on by Dr. Sugarbaker, only one of you
would not make it."
On May 17, 2000, the pathologist used immunoperoxidase stains to rule out
adenocarcinoma and confirm the diagnosis of malignant mesothelioma. Dr.
Nagasawa called that day to inform Tom and Sandy of the diagnosis.
Tom, like all athletes, is very in tune with his body. He knows when he's
on, and when he's off. I asked him at his deposition if he could feel
the tumor. "Yes. It was pushing against my heart. I could feel it
growing. Did you ever see that movie with Sigourney Weaver? Alien? Where
the alien bursts through the guy's chest? That's what I felt like,
like there was an alien inside me, moving, and I had to get it out."
Tom was adamant about going to Boston without further delay to cut the
beast out.
Preparations for Dr. Sugarbaker
The Hazens contacted Dr. Sugarbaker 's office and arranged for an appointment
in Boston on June 6. Sandy assumed the task of amassing all the records
and films and tissue blocks. Additionally, they arranged to complete further
tests, including blood work, an MRI and an echocardiogram (ECG). The ECG
showed that Tom's heart was strong. The MRI was less optimistic.
Sandy recalled: "We looked at the MRI and it scared us to death. We
could see how the tumor was wrapping around the lung and pushing the heart
over to the left. It was bending the trachea like a garden hose."
On the positive side, the MRI ruled out that the tumor had spread beyond
the pleural cavity. Dr. Jungwirth compared the MRI to the CT film from
a month prior and noted some growth. The Hazens did not sleep that night.
Sandy's own stress began to build. She and Tom had been married for
over 30 years and she had always felt like her flesh was his and vice
versa. She had begun to have chest and lung pain. She kept thinking about
all those years when Tom worked at Kaiser Steel and she would beat the
dust out of his work clothing. She had a chest film taken, which thank
goodness was clean. She also noted a numbness and tingly sensation in
her left arm. She had an EKG, which was normal. Sandy's symptoms were
caused by the stress from knowing that her husband -- her soul mate, best
friend and life-line -- was living with a terminal cancer.
The Extra Pleural Pneumonectomy
When Tom and Sandy flew to Boston, they had been warned that Dr. Sugarbaker
is very much in demand and has a long waiting list. The typical interval
between the initial consult and the operation was several weeks. Tom understood
this but did not flinch, as if he enjoyed the challenge of convincing
a prestigious doctor to make an exception to the rule. He also knew that
"with God, all things are possible." Tom met with Dr. Sugarbaker
on a Tuesday and sure enough Dr. Sugarbaker agreed to change his schedule
in order to accommodate Tom.
On June 14, 2000, Dr. Sugarbaker removed Tom's lung and the 1-2 inch
tumor that completely encased it. He also removed portions of the diaphragm
and the pericardium (heart sac). Dr. Sugarbaker used a gore-tex patch
to sew the diaphragm back together and to hold the heart muscle in place.
Nature abhors a vacuum, and without the patch in place, there is a risk
that the heart would collapse into the void left in the right chest cavity.
Dr. Sugarbaker advised that he had removed all visible tumor and he did
not see any evidence that the tumor had invaded the stomach. He also said,
with the conviction of a doctor who has spent the last decade operating
on hundreds of mesothelioma patients, "I hate this tumor." Tom
thanked Dr. Sugarbaker for "saving my life."
Tom and Sandy understand that the operation was not a cure. Tom acknowledges
that "undoubtedly" there are millions of malignant mesothelioma
cells still circulating in his lung cavity. The good news is that his
lymph nodes were negative for tumor invasion. Tom is now preparing for
the next round, which involves chemotherapy and radiation. He will likely
participate in the Phase III trial using gemcytabine/cisplatin.
Living with One Lung
We take for granted that when we inhale our oxygen is distributed equally
among both lungs. I asked Tom what it was like to suddenly live with one
lung, knowing that the other one would never "grow back." He
testified: "It presents a whole new set of fears. What if I get a
cold? A virus? Pneumonia? What if the tumor comes back? Can I go out?
I have been sleeping in a recliner. I'm not ready to sleep in our
bed on my back. I worry about my body getting enough oxygen constantly.
I asked Dr. Sugarbaker if there was any book out there about how to live
on one lung. He said there is no manual, no easy answer. You just have
to keep moving."
"It is not for me to Judge."
Despite his physical chaos and turmoil, Tom Hazen still casts a certain
serentity in his manner. He is a religious man who does not allow anger
to saturate his soul. At the same time, he cannot understand why the asbestos
companies continued to make and market a product that they knew posed
a serious health risk to millions of workers. As an Executive Vice President
of Operations of a company that manufactured laser eye equipment, Tom
always understood that it was his legal and moral duty to thoroughly investigate
the possible health risks of his products before putting them on the market.
"I have killed projects that I thought were dangerous, leaving millions
of dollars on the table." For him, in a similar circumstance, it
was not difficult to put health and happiness over profits.
But Tom's voice lacks the trembling fury of the righteously indignant.
"If I could face the CEOs of the asbestos companies in my living
room and look them in the eye, I would not judge them. It is not my place
to judge. I believe they will be judged by an authority far greater than
myself."
Although Tom's body has weakened, his spirit has grown stronger. He
may not have the slender athletic build he had 8 months ago, but he has
his honor and his dignity, both of which have grown stronger. Most of
all, he has the serentity of knowing that his wife Sandy, his sons KT
and David, and the hundreds of friends whose lives he has touched with
his kindness and mercy, will be with him, every step of the way.
Tom's prayer group also includes the many asbestos company defense
lawyers who cross examined him. In 13 years, I have never seen so many
defense lawyers linger so long after a deposition just to shake Tom's
hand and offer their solace, respect and prayers.
*** POSTED AUGUST 2, 2000 ***
An Update, August 29, 2000
I presented them with the Yellow Jersey from the 2000 Cascade Cycling Classic. 8/4/00
An Update, October 23, 2000
Tom and Sandy are big fans of Lance Armstrong, who survived cancer and
came back to
win the Tour de France twice. Lance's book has been a big inspiration
to the Hazens.
I recently saw Lance at a book signing event and he offered encouragement
to the Hazens.
October 10, 2001
Building A Brighter Future for mesothelioma Patients
Sandy Hazen and Dr. Robert Cameron are pleased with the progress that MARF
has made so far, but understand that much more work needs to be done.
Ms. Hazen, who lost her husband Tom to the tumor on December 23, 2000,
has contributed $25,000 to the
foundation. Dr. Cameron continues to devote his career to improving and extending
the lives of mesothelioma patients from around the world.