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Department of Internal Medicine

Department of Internal Medicine

Maintaining an Optimistic Spirit

Like most salespeople, Jeff Prola is an optimist by nature. It's a good thing he believes in positive thinking, or he might not have agreed to participate in the clinical trial that saved his life.

In December 1994, Prola made an appointment with his family physician. He had a strep throat and had been feeling very tired lately. His doctor ordered a full physical, and the lab work revealed an extraordinarily high white-blood count, with numbers off the charts. Initial indicators pointed to non-Hodgkin's lymphoma. Although worried, Prola was pretty upbeat about his prognosis - a 95 percent cure rate. But further tests changed the diagnosis to a carcinoma, giving Prola a 50 percent chance of being alive after five years.

His condition was much more serious. A biopsy followed. "What I actually had was nasopharyngeal cancer," says Prola. "My chances of surviving were now only 5 percent to 15 percent. I had run the full spectrum of emotions. I was devastated.

Prola was referred to UC Davis' Frederick J. Meyers, chair of the Department of Internal Medicine and a leading oncology expert. Meyers examined Prola, listened attentively to his story, and had him meet with a UC Davis ear, nose and throat specialist as well as a radiologist and a surgeon. Prola's options were not good. He had an unusual tumor at the back of his throat, which was technically inoperable because it was too close to his brain and spinal cord. The doctors could try radiation therapy, but the likelihood of a cure was not encouraging, and the cancer would probably return.

Meyers offered another alternative. Since the 1980s, researchers had been treating this type of cancer by giving patients radiation therapy and chemotherapy at the same time. A number of small, exploratory clinical trials had been conducted, and UC Davis was in the midst of a 15-year trial that would hopefully prove definitive for widespread use of the new protocol. "The preliminary trials indicated that combining anti-cancer drugs (chemotherapy) with radiation provides a real knock-out punch," explains Meyers. The cancer cells cannot repair themselves with the dual treatment."

However, this extremely aggressive therapy was not without risk of side effects, including dehydration, weight loss, nausea, and mouth sores. "I told Jeff that the treatment would knock the heck out of him," recalls Meyers. "And although the combination approach was based on good laboratory data, the results were unpredictable. There were no guarantees." Prola was somewhat overwhelmed with stress after many diagnoses and months of worry, but he had tremendous faith in his new physician. "I asked him what he would do if his son faced this kind of cancer," says Prola. "He told me he would recommend the clinical trial."

Prola elected to try the new treatment. In making his decision, he relied on the data and his confidence in Meyers. The early results of the trials were promising - a better than 50 percent cure rate," explains Prola, "so I decided to take my best shot." Moreover, he had been impressed from the outset with Meyers' caring and concern. "Fred has a tremendous humanistic quality, and I knew he cared deeply about me both as a person and a patient," says Prola. "In the end, it boiled down to a matter of trust in my physician.

My gut told me to go with the clinical trial." Participating in the trial not only gave Prola a chance for a better cure, but made him a medical "pioneer," helping to confirm whether the new treatment would produce better outcomes than standard therapy. "Mr. Prola's story exemplifies the benefits of the collaborative, translational research that is the mark of the internal medicine department," notes Meyers. "We apply what is first tested in the lab and then validate the idea in the clinical trial. We are committed to making this our way of improving therapies and quality of life for our patients."

Beginning in May 1995, Prola endured 40 days of radiation and eight months of chemotherapy. He admits that the treatment was pretty horrendous, but as of his last MRI in June 2000, there was no residual cancer. And the prognosis looks good. "Jeff had a previously uniformly fatal cancer," says Meyers, "but the new protocol was effective, and now he is cured. We were delighted to return him to his family and the community."

Like other cancer survivors, Prola wakes up every morning with renewed appreciation for life. He is grateful to UC Davis for the opportunity to take part in a clinical trial that made all the difference. "I can't say enough about this institution," he declares. "The best place to be acutely sick is in a teaching hospital." And while he's still an optimist, Prola knows it took strong faith in God and in himself, his family, and his doctors to survive. "You've got to be mentally tough to beat cancer," he says. "And you can't be afraid to make a decision that's in sync with your head and your heart."