Daniele, who lives in Milano, Italy, was diagnosed with stage II kidney cancer at age 46 in 2005. However, Daniele never let his diagnosis get in the way of how he lived life. You can read more about his incredible story of survival below:
Q: Tell me about your diagnosis.
A: I was driving back from a business meeting and while driving, I started to have a strong stomachache but I related it to the heavy business lunch I had. Once home, I lost blood while in my bathroom and so I moved to the nearest first aid hospital, where they thought it was due to kidney stones.
I did not give a lot of importance to the diagnosis but two days later, I had another case of hematuria, which was heavier than the last one so I proceeded immediately with an ultrasound scan which identified a 9 cm mass in my left kidney and then a CT scan which confirmed the presence of the mass and that the mass itself was vascularized. Based on the above results, it was decided to proceed with a nephrectomy of my left kidney.
No one in my family has never been affected by such disease, but my wife, who was beside me at all times since the initial crisis, experienced it in her family, and encouraged me to act. It was April 9th, 2005 when I had the first symptom. On May 3rd, 2005 I had my first operation.
My wife and I decided not to immediately inform our daughter, as she was just thirteen-years-old.
My wife supported me strongly as it was needed. Her support helped me speed up my decision on how to proceed as the hematuria was becoming heavier and heavier and the surgeons had doubts that my physical strength could have been dramatically reduced if the nephrectomy of the left kidney was postponed too long.
It is clear that the cancer affected my family, both my wife and my daughter, but I tried to not give too much importance to the disease.
Q: How did you feel when you heard the news?
A: Initially, I was trying to avoid to think that my life was over as I was not willing to consider the cancer I had dramatically lethal. When I learned from different sources, including the Kidney Cancer Association’s site, that the life expectancy for a person like me could have been not too long to live since the first surgery operation, I decided that I had to live independently from how long I was going to live, to continue my business activity and to continue to do the things which I liked such as traveling, scuba diving, skiing, following my cultural interest and enjoying life as I did in the past.
I never felt I was a person with no hope, I always felt as a person with a disease that has to live the same way I did before.
Q: What treatments did you undergo?
A: The first step was a radical left kidney nephrectomy in May 2005, together with a dissection of my hilar nodes.
Follow-up was negative until April 2007, when a pancreatic relapse was discovered. I underwent a distal pancreatectomy (with preservation of the spleen and of the splenic vessels); histology showed once again clear cell carcinoma.
I tried a chemotherapy drug, but the treatment was discontinued after just one week due to a severe allergic reaction. No further treatments were then planned.
In September 2009, a subcentimeter lateral renal nodule was discovered. Then, on September 16th, 2010, due to an increase in the dimensions of the nodule, and in the absence of other metastatic sites, a percutaneous radio frequency ablation of the nodule was performed without any biopsy.
Since June 2011, repeated CT scans showed another slowly growing nodule, localized at the upper pole of the remaining kidney (6 mm of major diameter), clearly away from the ablated area and by late 2011, three nodules, including the already indicated one, have been detected, two clearly away from the ablated area and one in the ablated area. In February 2012, I proceeded with an open- sky surgery operation with cyroablation of the three nodules without any biopsy.
By November 2012, a CT scan showed four nodules detected in my lungs, two in the lower part of the right lung, and two in each lung not very far away from the heart and aorta artery. I proceeded with a partial excision of my right lung and tomotherapy on the two upper nodules.
By late January 2013, a CT showed the situation was dramatically worsening with nodules again in the right kidney, pancreas and lungs, probably related to the weak immunity status of my body in consequence of the surgery operations I faced in 2012. I started with a low expectation of a successful drug treatment.
In consideration of the allergic reaction with the chemotherapy drug I initially used, it was decided that I try a chemotherapy drug instead.
The results were very positive. The targeted therapy drug reduced the volume of all the nodules, some of them disappearing and no new nodules appearing other than the ones present in the January 2013 CT scan.
I stayed on the drug for roughly two years. In March 2017, it was clear that the targeted therapy drug was poisoning my body and was not any more effective with treating the disease. I had the old nodules growing, mainly the one in the head of the pancreas, and new ones appearing in the liver.
The growth of the pancreatic nodule, other than blocking the common bile duct, with the result of a surgical operation to insert a stent in the same duct so to keep it open, was clearly a critical fact considering the possibility to have the nodules, by its growth, to infiltrate in the intestinal tissues and consequently a new tomotherapy treatment was organized on such nodule.
Once the tomotherapy treatment was over, I stopped using the targeted therapy drug and I started immunotherapy. This therapy, from August 2017 to February 2018, did not show the expected results of all the existing nodules at the first CT scan in November 2017. The CT scan in January 2018 showed no reduction of the existing nodules, but still with a limited growth, and luckily no new ones appeared in this period.
The immunotherapy drug drove my body to a dramatic situation with a continuous and very fast reduction of my weight and very bad vital parameters.
It was decided to terminate the immunotherapy drug. In February, I started with a different targeted therapy drug than the I tried initially. The following CT scan in June showed a reduction of the disease and the last CT scan of late October showed a terrific reduction in dimension of all the nodules still present in my body. The one in the pancreas, which was 4 cm in January 2018, is actually not bigger than 1.5 cm now, the nodules in my right kidney went down from 2 cm to 0.8 cm and the nodule in the liver that was 5 cm has practically disappeared.
Q: How did you cope with your diagnosis? Was there any practices or rituals you did on a daily basis?
A: I decided that my life was unchanged from a mental point of view and that the disease was not to affect my usual lifestyle.
Q: What advice would you give someone facing a similar diagnosis?
A: The way I coped with the diagnosis is to try to learn as much as I can on the disease, on the drug development, on specialists and always have a second, and in some cases, also a third opinion on how to proceed or where to go and who to contact.