Lymphoma, Breast and Prostate Cancer: Journeys of Courage

Frida Sklyar had been practicing for many years as a pediatrician in her native Russia when she had a small breast tumor removed in 1992 at the age of 71. However, her physician at that time did not order any follow-up
treatments with chemotherapy or radiation. A year later, Frida and her husband Ruvim emigrated to the United States to join their eldest son, who had settled in the Bay Area with his own wife and children three years earlier. At that time, their son had been receiving his medical care at the Palo Alto Medical Foundation's (PAMF) Sunnyvale Center, so he referred his parents to his (now retired) primary care physician there.

Over the next four years, medical exams revealed that Frida was suffering from an aggressive lymphoma and recurrent breast cancer, which had spread to her bones and lungs. PAMF oncologist Peter Yu scheduled chemotherapy for Frida to treat her lymphoma into remission and prescribed oral medications to slow the advance of her breast cancer. Today, with ongoing care from Dr. Yu, Frida is surviving in good health.

Frida's journey, although challenging, was not the end of this family's experience with cancer. In 2007, Ruvim was diagnosed with prostate cancer at the age of 89. Due to his advanced age, Ruvim was prescribed a regimen of hormone shots to extend his life.

In February 2008, the St. Petersburg Times, one of Russia's leading newspapers, reported on what top oncologists termed a "cancer epidemic." At that time, more than 2.5 million people in Russia had been diagnosed with cancer, resulting in 300,000 deaths annually. In 2008, the entire country of Russia had only 70 radiation therapy machines compared with more than 3,000 in the United States. Cancer is generally considered an untreatable illness in Russia, and people rarely seek diagnosis or treatment. In late 2008, however, a public education program was launched to encourage early detection and treatment, which prompted the Russian government to launch a nationwide program aimed at reducing cancer mortality rates.

Frida and Ruvim were both fortunate to be treated for cancer in the United States—particularly Frida. While breast cancer deaths in the United States have declined steadily since 1990, breast cancer deaths in Russia increased by 13 percent between 2000 and 2008. Each year, half of the 50,000 women in Russia diagnosed with breast cancer die from their illness. "I will always be grateful that my parents came to the United States when they did so they could have access to such wonderful care," their son said.

"Thanks to Dr. Yu and his colleagues, my parents can enjoy more years of their long life together and have the chance to see their three grandchildren embrace life as adults here in the United States."

A Tribute to a Beloved Father

Dr. Galina Balon has practiced as an internist at the former Camino Medical Group, now part of the Palo Alto Medical Foundation (PAMF), since 1994. Only five years earlier, she and her husband, also a physician, fled Russia as political refugees and arrived in the United States with their 2-year-old daughter and $300 to their name. Galina's father, Dr. Lazar Balon, and Galina's mother joined them in 1992. At that time, Lazar was 85 and left behind a distinguished career as a maxillofacial surgeon in Russia.

After serving on the front lines as a military surgeon during World War II, Lazar had become a dean of the School of Maxillofacial Reconstructive and Dental Surgery at the St. Petersburg State Medical University, Russia's oldest and largest medical school, where he taught for 50 years while continuing his surgical practice.

In 2005, Lazar was diagnosed by PAMF's Dr. Alan Chausow with primary effusion lymphoma (PEL), an extremely rare cancer that affects the pleural cavity surrounding the lungs. PEL is generally resistant to chemotherapy and has a very poor prognosis. Galina and her husband Vladimir, an anesthesiologist, immediately began seeking out any available research on PEL, reaching out to colleagues around the world.

"Nobody really knew how to treat this lymphoma, so we were on our own," Galina said. She took a family leave from her own practice and enlisted the help of PAMF oncologist Peter Yu to help develop a treatment plan for her father. Dr. Yu created a new combination of chemotherapy drugs and began a six-month journey for Lazar through multiple infusions and blood transfusions.

"I spent such precious time with my father during those months," Galina said. "He was always so busy with his work when I was a child. We sat together for hours sharing stories and memories, and the infusion center became a happy place for both of us."

In October 2005, tests revealed Lazar was cancer free, and it seemed that Dr. Yu had worked a miracle. Two months later, however, something totally unexpected occurred. Lazar was diagnosed with an advanced stage of chronic hepatitis B, which had gone undetected since he contracted it
performing surgeries on the Russian battlefields 60 years earlier.

"The chemotherapy drugs were so strong, they apparently activated the dormant virus," Galina said. Less than three weeks later, her father died of acute liver failure. It was January 2006, just three months before what would have been his 100th birthday. In 2008, Galina and her husband made a gift to honor the memory of her father and to pay tribute to Dr. Yu. A plaque bearing the name of Dr. Lazar Balon now hangs in the waiting area of the infusion center at PAMF's Mountain View Center.

"My father would have been so proud to see his name on this infusion center," Galina said. "It was where he spent some of the last and happiest days of his life."
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