The Kindness of Strangers

Patient Perspectives Dominic Fiorentino

August 16, 2018

Plainsboro man with kidney cancer rebounds with excellent care and support from other survivors.

Dominic (Dom) Fiorentino, 28, was experiencing back pain. An acute care physical therapist, he assumed it was work-related and went to his employee health center for relief. Unfortunately, after X-rays, an MRI, orthopedic consultations and physical therapy, pain relief and a diagnosis remained elusive. Frustrated, Dom changed to a less physically demanding job as a physical therapy case manager in hopes of minimizing the pain.

Finally, Dom visited his primary care physician. Thinking it might be a gallbladder issue, Dom’s physician scheduled an abdominal ultrasound, which revealed a cancerous tumor on Dom’s kidney. While he was relieved to have answers, Dom was understandably afraid. He shared his concerns with a co-worker, who connected him to two people who’d had similar diagnoses.

Seeking Advice

One of them was Toms River resident Jeff Rowe who, like Dom, was 28 and worked in rehabilitation. Jeff learned of his tumor by chance when nurses he worked with at Ocean Medical Center urged him to see John DePalma, D.O., a nephrologist affiliated with Ocean who is highly experienced in managing hypertension, about his high blood pressure.

Dr. DePalma recalls, “I ordered a cardiac test and an ultrasound of Jeff’s kidneys, since high blood pressure can damage blood vessels in the kidneys and affect their function. The ultrasound revealed a cyst on Jeff’s kidney.” After a subsequent CT scan, Dr. DePalma diagnosed Jeff with renal cell carcinoma. He recommended Jeff see Pierre Mendoza, M.D., a urologist and director of Robotic Surgery at Ocean, who advised Jeff to have the tumor removed via robotic surgery.

Because robotic surgery is less invasive than traditional surgery, it leads to less pain post surgery, a shorter hospital stay and a quicker recovery. After his procedure in March 2017, Jeff returned to golf and training in Brazilian jujitsu with minimal downtime. Jeff recommended Dr. Mendoza to Dom. “He’s the best and proved it in the operating room and with the care I received post surgery,” Jeff says.

Dom decided to see Dr. Mendoza for a second opinion. In the waiting room, he noticed a HealthViews story on the wall about a patient of Dr. Mendoza’s, Megan Cotta, 27, who’d had a diagnosis similar to Dom’s. He considered it a sign: kidney cancer is rare for someone in their 20s and now he knew of two other young patients with the disease who’d been treated by Dr. Mendoza. After the appointment, Dom agreed to undergo surgery and also reached out to Megan for advice.

Successful Outcomes

In September 2017 at Ocean, Dom underwent a robotic partial nephrectomy on his kidney to remove the tumor. Dr. Mendoza operates at Ocean because it has the latest advancements, including the da Vinci® Surgical System. He has the most extensive robotic surgery experience in the area and finds performing robotic partial nephrectomy particularly rewarding.

“Not only is the surgery curative, it preserves the portion of the kidney without the tumor, which allows for a lower chance of decreased kidney function later in life. I feel very fortunate to have had training and experience to provide this service to the patients of our community,” Dr. Mendoza says.

During his hospital stay, Dom relied on his wife, Shradda, and his mother for emotional support, and he was also visited by all the kidney cancer survivors he had reached out to for advice. Jeff provided support in an additional way, acting as Dom’s rehabilitation aide. “I’m overwhelmed by the goodness of strangers,” Dom reflects. “I almost feel like all of this was meant to be — the way these kind people came into my life. I am especially grateful to Dr. Mendoza, who in my eyes saved my life.”

Taking everyone’s advice, Dom took it slow during his recovery. Today his cancer is in remission and he is back at work, spending time with his wife and family and getting back to his love of travel. This spring, Dom and Shradda celebrated their 10-year anniversary in Europe.

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