A Walk in her Flip Flops — El Centro Mayor Shares Story of Kidney Cancer

Story by:

• Michelle Brubaker- [email protected]

Published Date

October 09, 2024

"I was going to do whatever it took for a successful outcome, and I knew having the next chapter of my care at an academic medical center would be the best way to do that."

Marroquin received an appointment with Ithaar Derweesh, MD, professor of urology and radiology at University of California San Diego School of Medicine and urologic oncologist at UC San Diego Health.

"He immediately put me at ease. I felt I was in the most capable hands," said Marroquin.

After a thorough exam and conversation, Marroquin was scheduled for surgery.

Derweesh leads the surgical arm of the multidisciplinary program at the Urologic Cancer Clinic at UC San Diego Health. The clinic offers innovative approaches and personalized treatment options for patients, like Marroquin, who received a partial nephrectomy, or removal of part of the kidney.

UC San Diego Health is one of the most experienced medical centers in the world in performing partial nephrectomies. More than 70% of patients treated for kidney cancer at UC San Diego Health receive a partial nephrectomy.

Partial nephrectomy is a more difficult surgical procedure but it is preferred when possible as it preserves kidney function. Preserving kidney function can lower a patient's chance of chronic kidney disease, bone fractures, osteoporosis and cardiac events.

"We removed an approximately six-centimeter tumor from Sylvia's right kidney, as well as about a third of the kidney using a robotic-assisted, minimally invasive approach," said Derweesh, UC San Diego Moores Cancer Center member.

"The surgical pathology showed the tumor was Stage 1 cancer and low grade with no indication that cancer cells were in the surrounding tissue. We carefully monitored Sylvia with quarterly CT scans."

"I was relieved the tumor was gone, and I could move forward with my life, but cancer is a word you never want to hear, no matter the stage," said Marroquin.

Her diagnosis and treatment never stopped her from fulfilling her civic duties.

"During my recovery from surgery, I still attended city council meetings and community events. People that knew of my situation would ask why I wasn't home resting. I would tell them because I wanted to feel normal," said Marroquin.

That normalcy was rattled in early fall of that same year. A follow up scan showed something suspicious. The cancer had returned and spread to her right kidney, liver and lungs. It was Stage IV.

Marroquin credits her strong family support as to what got her through her kidney cancer diagnosis and treatment. From left to right: Marroquin's mother, Aurora Marroquin, Sylvia Marroquin, Laura Johnston, her sister, and Lauren Johnston, her niece. Courtesy of El Centro Mayor Sylvia Marroquin

"Dr. Derweesh called me to share the news. He was so compassionate and took immediate action. I had an appointment with a medical oncologist the very next day. I am forever grateful to him," said Marroquin.

"I was determined to fight and win. I immediately started telling myself it was going to be okay. I kept my faith and continued using distractions with work and my family to get me through those initial, difficult days."

Marroquin met with Rana McKay, MD, professor of medicine and urology at UC San Diego School of Medicine and medical oncologist at UC San Diego Health.

"My sister was with me through my entire journey. She came to every appointment. She is in the medical field and was committed to helping me kick cancer's butt. Dr. McKay welcomed me and my sister with open arms as soon as she walked in the room. She gave us the confidence we needed," said Marroquin.

The specialized team at the Urologic Cancer Clinic at UC San Diego Health work closely together to develop new techniques to treat kidney cancer and shrink large tumors with targeted treatment.

"We understand how leveling a cancer diagnosis can be for a patient, especially news that the cancer has returned and spread. Patients come to UC San Diego Health for comprehensive care, and we care for the entire patient. We have our finger on the pulse of all the groundbreaking treatments of today and tomorrow to help us best care for our patients," said McKay, also a UC San Diego Moores Cancer Center member.

"What sets us apart in the region is that we are integrally involved in the design and execution of leading- edge clinical trials that bring the next generation of treatment strategies directly to our patients. Integrating clinical trials into a patient's treatment plan is critical to providing care that has the greatest potential to positively impact long term outcomes for patients."

Immunotherapy is an area of cancer research that has continued to show tremendous promise by harnessing the body's own immune system to treat cancer. It has been proven to be transformative in the treatment of lung cancer, head and neck cancer, bladder cancer, kidney cancer, skin cancer, Hodgkin lymphoma, as well as colorectal, cervical and uterine cancer.

"Immunotherapy has become a standard of care for patients with kidney cancer," said McKay.

In this particular case, the best treatment option was deemed to be a clinical trial, and Marroquin decided to enroll.

The trial involved patients either receiving the standard of care of immunotherapy alone or immunotherapy combined with a novel, oral drug. The trial was being coordinated through the National Cancer Institute through the Alliance for Clinical Trials in Oncology Cooperative Group. Marroquin received immunotherapy via infusion every three-to-four weeks and took the oral drug daily.

"Clinical trials are a beacon of possibilities and offer new treatments for patients who may have few options," said Diane Simeone, MD, director of Moores Cancer Center at UC San Diego Health. "We offer a unique and rich scientific environment. We have so many talented clinicians that deliver state-of-the art cancer care for our patients. We are focused on developing the next generation of novel therapeutics to treat cancer in more effective ways. In any patient, their best treatment option may be a clinical trial."

As an NCI-designated Comprehensive Cancer Center, Moores Cancer Center is among the top 4% of approximately 1,500 cancer centers in the United States, and one of only 57 Comprehensive Cancer Centers in the nation. Approximately 43,000 patients with cancer are seen at UC San Diego Health annually. Patients have access to physicians who provide personalized care and are setting treatment standards nationwide for more than 200 types of cancer.

Marroquin did experience side effects, including sores on her feet that required some adjustments to the medications she was receiving as part of the trial.

"I walked like a turtle wearing flip-flops for a bit. Even though it was not easy to walk, I continued to function as normal. I went to work, meetings and all my other activities. I am not complaining though, those days in my soft flip-flops were worth it when I received my results after the trial."

After being part of the trial for approximately two years, a scan showed Marroquin had a complete imaging response, which means there was no indication of cancer.

"I could not believe the drastic result of my treatment. I consider it a miracle," said Marroquin.

Topics covered:

• Cancer
• Clinical Trials
• Patient Care

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