In 2013 Phil Hindt faced a life-threatening diagnosis: liver failure. Doctors told him he needed a transplant, which he received at a Bay Area teaching hospital on Thanksgiving Day, 2014.
But healing for the then 58-year-old aerospace designer would prove short-lived. The Grass Valley man has since endured more than his share of health crises, including metastatic colon cancer, but today is grateful for the bold work of May Cho and the UC Davis Comprehensive Cancer Center where he now gets care.
By the fall of 2016 Phil had regained his pre-transplant strength and returned to his normal activities and work schedule. Unfortunately, a routine colonoscopy revealed stage 3 colon cancer. Doctors at the Bay Area hospital treated him as aggressively as possible but were careful not to damage his new liver. They removed one third of his colon, then ordered a round of chemotherapy. Months later, however, scans showed a small tumor in his new liver, treated with microwave ablation. A few months later another scan revealed the cancer had spread further in his transplanted liver, as well as his lungs and lymph nodes. He went through more chemotherapy, which was not successful.
The good news, Phil said, was that an analysis of his tumors found that they would likely respond to immunotherapy, a new class of cancer treatments that allow a patient’s immune system to attack cancer cells. He felt hope it could be his cure.
The bad news was that a panel of specialists at his treating hospital told him it would be too dangerous for him to get immunotherapy since it had not been studied in patients who had undergone a transplant.
“They said immunotherapy could cause liver failure which could kill him,” said Phil's wife, Melissa. “We thought, what does he have to lose?”
"Chemo wasn't working for me, so I was willing to take the risk to undergo this new treatment − would sign anything to release them from liability,” added Phil. “The prognosis my oncologist gave me was only a handful of months.” Still the specialists declined to take the risk.
Phil was down to 130 pounds, so weak he was barely able to get out of a chair. The Hindts nearly gave up but then asked Phil's liver specialist to refer them to someone for a second opinion. The doctor found May Cho, an oncologist who specializes in the treatment of gastrointestinal malignancies including colorectal cancers at UC Davis Health.
Cognizant of the urgency of the request and impressed with the couple’s persistence, Cho quickly reviewed Phil’s case.
“Dr. Cho called us on Easter Sunday from Chicago,” Phil recalled. “She said yes, I’m willing to treat you.”
Cho took the chance, she said, because she knew that Phil was among the five percent of patients with metastatic colon cancer that is deficient in mismatch repair, a condition in which immune cells have infiltrated the tumors but cannot effectively fight the cancer cells.
“Immunotherapy takes the brakes off of the immune cells and lets the patient’s own immune cells attack the cancer,” Cho said.
These patients are good candidates for immunotherapy, which has revolutionized treatment of patients with some tumor types. Phil would get the treatment every three weeks for the rest of his life.
That handful of months have come and gone, and now more than five months into his treatment, Phil has a full head of hair, put on 25 pounds and has regained energy enough to work again. Tests show his continued improvement.
“After just one cycle of treatment, his labs were improving and scans showed the tumors were shrinking,” said Melissa Hindt. “Now, he’s out pruning trees and tossing rocks.”
Phil recently celebrated his 62nd birthday, his 4-year transplant anniversary on Thanksgiving Day, and looks forward to another Christmas with his growing family, including his two young granddaughters.
“It feels good,” he said. "We have hope again."
The couple credits Cho for what they perceived to be a decision to consider the risks, and ultimately make a compassionate choice to try immunotherapy.
“She’s one of our heroes,” said Phil. “The decision shows that UC Davis is not all about your batting average.”