Ted Canova: How do you think this man would battle cancer?
Steve Dombek: My sister would say, well you need an extra nine lives because you've used up all of yours running with the bulls and jumping out of planes and going down black diamonds.
Ted Canova: Hi and welcome to Right Here – a podcast from Texas Oncology who knows that family and friends are a huge part of cancer treatment, so being right here makes a difference. For expert cancer care, go to Texas Oncology.com. I’m Ted Canova.
Ted Canova: Like with so many cancer patients, having a plan of attack is half the battle.
Steve Dombek: My name is Steve Dombek and I live in Austin, Texas. And I am still fighting cancer still to this day.
Ted Canova: Before he was diagnosed, Steve was active and in good shape. He skied three times a year, played competitive soccer, and was diving all over the place playing sand volleyball.
Steve Dombek: I've been a positive person always looking for the good things in people and the good things in life.
Ted Canova: Steve also saw all the good things, all the great things, in his little girl, Cora.
Steve Dombek: That's the one that gets to me (laughter).
Ted Canova: Cora was six when Steve was first diagnosed.
Steve Dombek: She's kept me focused and kept me positive and kept me upbeat. From day one to present.
Ted Canova: Cora has presents of another kind. She’s positive, kindhearted, and loves to dance and sing.
Steve Dombek: She has been the light when it's dark. She has been the calm during the storm.
Ted Canova: The storm hit in 2015. Steve was 45 when he felt a pain in his right side, and like so many of us would, he brushed it off as a pulled muscle. But the pain kept coming back, knocking him out for a day or two. Five months later, Steve turned to his doctor, which led to an MRI.
Steve Dombek: And when they did the MRI, they found lesions on my liver. And when they found those lesions on my liver, they decided that they needed to do a biopsy of my liver, which came back inconclusive.
Ted Canova: So doctors ran a battery of blood work and performed a bone marrow biopsy, which detected not one, but two forms of cancer.
Steve Dombek: Once I heard it, I think I probably put on a front and acted strong. And then later I broke down and dealt with it. Every single thing goes through your mind. But you can't change what happened for the first 45 years. And you had to look at what the next hopefully 45 years will have in store for you. That's the way I had to think, that's the way I had to wrap my mind around it.
Dr. Jeff Yorio: I'm Dr. Jeff Yorio and I'm a Medical Oncologist at Texas Oncology in Central Austin.
Ted Canova: Dr. Yorio knew what a diagnosis like this would mean to Steve.
Dr. Jeff Yorio: Like anybody, you're sort of taken aback like, wait, what does this mean? I've got this disease. How did I get this? I've been healthy. I've been active. Why did this happen to me? And I think that's a common thing that a lot of our patients experience because they can't explain it, especially ones that have been really active and healthy otherwise.
Steve Dombek: Yep, I was like, and instantly the way my personality is, I had questions galore.
Ted Canova: Dr. Yorio gave Steve time to process the news and scheduled another visit to go over the best plan of attack.
Steve Dombek: I trusted him pretty much out of the gate. There's a lot of assumptions that's made when you're dealing with an oncologist that delivers this message and manages patients day in, day out, all day long. You have to relinquish your fear and give yourself to their knowledge and their expertise over the years. To be honest with you, it's something that I do really well but I have no clue about how to manage or deal with cancer at that time in 2015.
Ted Canova: Steve had a very rare blood disorder, typically seen in seniors and twice as likely in Black patients than in White ones.
Steve Dombek: You never want to be the one person that has the uniqueness. I was unique in the fact that I had two types, I had the rare blood disorder. And then I had multiple myeloma, which is usually on set for older individuals.
Dr. Jeff Yorio: He doesn't fit the perfect textbook person that gets a disease like this. He's a little bit of an abnormality as far as that what you would normally see which is most of our patients tend to be in their 60s, 70s, 80s, when they get diagnosed with this.
Steve Dombek: The first thing I did was I went on the internet, and I Googled. And don't do that. Because when I Googled it, it was not a positive outlook. It gave me years, not 10s of years. You know, I'm 45 years old, and it gave me two years, three years, so that was a little overwhelming and scary. And it made me mad, and I couldn't understand why. I didn't fit into those categories.
Ted Canova: Steve wondered if his disease was genetic.
Steve Dombek: The first thing I thought was could my daughter get some of this. Whenever you get cancer, you might be predisposed genetically so I don't believe that they ever made the conclusion that it was genetic. I was just unlucky. I was just unlucky.
Ted Canova: But how would he tell Cora, who at the time was just six? He knew he couldn’t protect her with lies. So, Steve reached out to experts who helped him navigate the conversation.
Steve Dombek: The best recommendation I got was a kind of a cool way with Legos and making a person's body and then putting red on there and then putting yellow ones that take the red out, meaning I was going to yellow was the drugs to help pull the red off of my body and out of my body.
Ted Canova: Steve had a lot to live for and was ready to take on cancer.
Steve Dombek: I wanted to get after day one, I wanted to give me the play on let's go, let's get this done. I'm gonna knock this thing down. I was like, bring it on. Let's go. Let's figure out what the deal is, and the plan of attack was because I had such unique types of cancer blood disorders.
Ted Canova: To begin, Steve received chemo once or twice a week for a few months. But his cancer was more complicated, he had, in essence, a dual disease. While he had multiple myeloma in his bone marrow, he also had another kind of blood disease called systemic mastocytosis, which was driving most of his symptoms.
Dr. Jeff Yorio: And when you have a disease like systemic mastocytosis, that is essentially your whole body having this constant allergic reaction all the time to lots of different sorts of stimuli and it makes you feel really bad.
Ted Canova: Steve’s symptoms got worse. So, Texas Oncology doctors, working together, recommended the next treatment.
Steve Dombek: Dr. Yorio recommended I talk to Dr. Matthews in Dallas. And I went up and he did his own bloodwork, he did his own biopsies with a combination of the ones that I'd had previously. And said that I was a candidate for a bone marrow stem cell transplant.
Dr. Jeff Yorio: The goal of the stem cell transplant is to one, be able to use some really intense type of chemotherapy treatments that essentially wipe out somebody's bone marrow, it's like totally emptying out their bone marrow and it's such an intense dose of chemo that most peoples’ bone marrow on their own would never recover, it would never come back, it wouldn't grow back.
Ted Canova: In layman’s terms, the bone marrow stem cell transplant is like hitting control, alt, delete on your computer. It reboots you. With a stem cell transplant, Steve gets a new immune system that can start to regrow, replacing his system with cells that don’t have cancer.
Steve Dombek: It's basically taking you down to you have zero cells being produced and hopefully kills that. And then with the donor cells, and I was fortunate, that was my sister. To start from scratch. And it's very unique in the fact that I, my blood type changed, I had to get all my baby shots. They always call it your birthday, so whenever you get your stem cell transplant, that's your new birthday. And my sister would say, well, you need an extra nine lives because you've used up all of yours running with the bulls and jumping out of planes and going down black diamonds and all of that.
Ted Canova: You heard that right. Steve has run with the bulls in Pamplona, Spain seven times before cancer. It would seem cancer was no match. What was a match was his sister, who donated her stem cells to Steve.
Dr. Jeff Yorio: He's always been super upbeat. I think he started to feel better. And so, I think he was encouraged by that. He's one of those that I think hid it well, he's this super strong guy, I'm gonna keep marching forward I'm gonna get through this. And that's always his personality.
Ted Canova: Steve’s life turned upside down. He traveled to Dallas and remained there for three months for the transplant and heavier doses of chemo.
Steve Dombek: It's rough. It's a lot. And I do it again, I do it again. And I don't want to ever, but it's something you can work through.
Dr. Jeff Yorio: The idea that you've got this healthy guy in his 40s, he's got a young daughter, and he's always been, 120% his whole life, and now he's got this disease and you're faced with your own mortality to some extent, and, what's going to happen to his daughter? What's gonna happen to his family? What is he going to be like, in five years, 10 years down the road? Those are all the things that are running through his mind, as you're going through this treatment, it's scary, there's a lot of unknown.
Ted Canova: Luckily, Steve’s stem cell transplant was successful.
Dr. Jeff Yorio: All indicators were that he's had a really nice response to the transplant and, and had put him into a remission
Ted Canova: Remission is the first victory.
Steve Dombek: I was feeling awesome, I felt great. I felt this is it. This is what I needed. This is what I've been striving for. But it's mental work and physical work
Dr. Jeff Yorio: As an oncologist, the mental aspect of a disease like this becomes a big part of what we have to deal with side effects that these drugs or the cancer itself does to people, the mental aspect of it is just huge, and it's hard.
Ted Canova: Steve continued to make progress, Cora got older, and his follow-up doctor visits went from twice a month to every other month. But remission doesn’t always last. And about four years after his stem cell transplant, Steve, showing no symptoms, was found to have a recurrence of his multiple myeloma, and started treatment again in April 2021.
Steve Dombek: I was I was like not again.
Dr. Jeff Yorio: The tough part is a disease like multiple myeloma. it's rare that it completely disappears forever.
Steve Dombek: That's when I was pissed. That's when I was like, what are we going to do? I want to get this out of me. Let's so that's when we went to a treatment process of back to chemo 21 weeks every week, 21 weeks every other week. And then once a month until to present it's not there. It's not showing up but we're just maintenance chemo every month… if it's keeping me here it's keeping me with my daughter, once a month is nothing I can cope with once a month
Dr. Jeff Yorio: Multiple myeloma is a chronic process. I always try to tell people, this is a marathon there might be times where we coast, and we don't have to do much. And then there's other times where we got to put the gas on and do something about it, because it's going to start to cause problems. And that's tough when you're feeling pretty well, and, and you're like, wait a second, you're seeing all these numbers, but I feel great. Why am I getting back on treatment? And so that's a hard, that's a hard thing to swallow.
Ted Canova: Steve learned to not face the rollercoaster alone. Dr. Yorio introduced him to the Flatwater Foundation, a nonprofit in Austin that helps patients, and their families, face the mental aspects of cancer.
Steve Dombek: They help individuals and family members cope with a cancer diagnosis to help find their flatwater. And that's navigating to therapists that have knowledge on how to help, as well as paying for their therapy. And to date, they've raised enough money to pay for 57,000 hours of therapy for individuals and families.
Ted Canova: And Steve takes part in these fundraisers, paddleboarding the 21-mile trek, get this, standing up without sitting, falling or kneeling.
Dr. Jeff Yorio: Steve's 120%, I think at all times. And so he got involved with this organization, at first for himself and for his daughter. He just grabs the bull by the horns and keeps going forward and says, okay, not only am I going to do this, I'm going to be the, the number one fundraiser for this organization. I'm going to, be at every event, I'm going to get to know every single person that's involved with this organization, and I'm going to make this organization better because I'm in a place where I can do that as a patient and as somebody who hopefully people can relate to better than even a lot of others. It was like a calling for him
Steve Dombek: Dr. Yorio means everything to me. He knows me. He knows he's working with me. We're like a team, even though I'm the one with cancer. My goals are to eventually not have to get chemo and not have to do as many pills that I take a day. And we're working together as kind of like a team. He's the leader of the team, and Dr. Yorio and I are just working through this process together and pulling it off his expertise.
Dr. Jeff Yorio: Steve, I'm always amazed by your passion. Your optimism in life your way you've turned a disease like this into a positive for yourself, and the way you influence others is amazing. Keep it up. He's one of those where I'm always happy to see Steve in the office because keeps me going to the next patient.
Ted Canova: Steve continues to respond well to treatment and there’s no evidence of disease. The hope is for that to continue for a long, long time. Up next, a busy mother of two faces breast cancer and how it challenged her identity.
Next Guest: Every morning I woke up after I shaved my head, and I would touch my head and when I looked in the mirror I looked like a person with cancer and that was really hard.
Ted Canova: This inspiring story in our next story when we meet Heather. We hope you enjoyed Right Here – a podcast from Texas Oncology who knows that family and friends are a huge part of cancer treatment, so being right here makes a difference. For expert cancer care, contact Texas Oncology.com. I’m Ted Canova. See ya next time.
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