Michelle Bono displays the stars and stripes championship jersey she received for winning the match sprints title at the USA Cycling Masters Track National Championships. Bono won the title just 14 months after being diagnosed with pancreatic cancer. - Baron Sekiya | West Hawaii Today
Winning When It Really Counts - Bono Raced Against Time To Beat Pancreatic Cancer
by Brendan Shriane
West Hawaii Today
Thursday, October 30, 2008 10:25 AM HST
Michelle Bono's been through a lot this past year.

She fought through pancreatic cancer, receiving almost a lethal amount of chemotherapy and racking up more than $130,000 in medical bills. She lost her business and put her house up for sale.

But she still came out on top at September's USA Cycling Masters Track National Championships.

"I should be dead right now," said Bono, who was diagnosed with an 8-centimeter-wide, nonfunctioning, islet-cell neuroendocrine cancerous tumor in July 2007.

Bono, 46, however, didn't take the diagnosis lying down.

"I handled it like a race — I told them, 'Give me my goal' — I kind of think they thought I was nuts," she said.

But she thought: "Here's the time I need to beat."

In August 2007, Bono went to M.D. Anderson Hospital in Houston, where her doctor, Douglas Evans, told her she needed to undergo chemotherapy for a long period of time to shrink the tumor enough to make it operable.

Click Photo to Enlarge
Bono, who went through four chemotherapy treatments over 12 weeks to help reduce the size of an 8-centimeter-wide cancerous tumor, expresses her feelings about cancer on her socks. - Baron Sekiya | West Hawaii Today
She told the doctors who were administering her medication that she wanted to go through the chemotherapy quicker than anyone else.

She was fortunate that the type of disease she had was less deadly than the more common type of pancreatic cancer — adenocarcinoma. According to the American Cancer Society, an estimated 29,000 Americans are diagnosed with that form of the disease each year, and 28,000 die from pancreatic cancer.

Bono's neuroendocrine cancer represents 5 percent of pancreatic cancer diagnoses. The cancer develops more slowly, and patients have a better prognosis.

"Your chances are better," Bono said.

But her cancer had spread.

Bono had forwarded her CAT scans to a fellow bicyclist, Mike McHugh, who is also a general surgeon who specializes in colon cancer surgery in San Diego.

"I saw cancer with evidence of spread," McHugh said.

He said the cancer was present in the pancreas, spleen and lymph nodes.

Drug cocktails, matzo ball soup

"I'd seen tumors like that before — I knew what to do, I just didn't know what to do in Hawaii," said McHugh, who did the only thing he could do: help her get into M.D. Anderson.

It was there where Bono was told the fastest anyone had ever gotten through chemotherapy was four treatments over 12 weeks with a 70 percent reduction. She went through chemotherapy in three treatments over nine weeks with a 68 percent reduction.

Despite such great progress, Bono's surgical crew, expressing concerns about never operating on a patient that had completed three treatments, made her go through a fourth treatment.

It wasn't easy, physically or mentally.

"I just got through it," said Bono, who prepared for chemotherapy by cutting her hair short, realizing she might lose her curly blond locks. She donated her hair to Locks of Love to help other cancer patients.

Then there was the drug treatment, which attacked the body of the finely tuned athlete, who'd won numerous cycling and powerlifting awards.

"They hit me harder because of my conditioning — they hit me harder than they had hit anyone with chemo. My dosages were higher," Bono said. "I called on the third day of my first round, crying 'uncle' but I didn't have enough side effects, so they kept everything up."

To make it so she could take the chemotherapy, she took pain blockers, which dropped her blood pressure considerably, making mundane tasks difficult.

"It would probably take me three minutes to walk 30 feet," she said. She fell down in a Whole Foods in Houston, but she was doing better than some of the other patients, who she said ended up in the hospital during her treatments.

She didn't work out for months because the chemotherapy drugs attack growing cells.

All in all, Bono lost a total of 15 pounds — she said she's still down 10 pounds.

A Houston-based charity, Aishel House, kept her going throughout her time in Houston.

"These people housed me, clothed me, fed me — I had my own apartment (provided by Aishel House, but a) minimal amount of money," Bono said of the Jewish charity that provides assistance to patients of all denominations that are undergoing long-term treatment in Texas. "I could have never done it without them, because I would go four days without eating."

She said the group's organizers would send their daughter with soup to get her to eat and keep up her strength.

"Even during chemo, matzo ball soup was really good," Bono said.

She said she owes a deep sense of gratitude to the charity, which featured her on its most recent fundraising video.

"It restores your faith that there are people out there that all they want to do is acts of kindness to bring themselves closer to God," she said. "They don't expect anything in return."

It was worth it, though, as her tumor shrunk considerably, and what was originally to have been a six-hour operation was cut down to two.

"They awarded me the gold medal in surgery," Bono said.

She had the body and tail of her pancreas removed — she still has the head of the organ that makes insulin and enzymes that help digest food in the small intestine. She also had her spleen and some lymph nodes removed. The surgery has affected her body's ability to digest food.

"A bad date to me now is dinner," said Bono, who said her pancreas does produce some enzymes, but she takes more to help her body process food, especially fats and proteins, adequately.

"You know what? Big deal, I'm here," she said.

Bills, bills, bills

Then the medical collections bills came. Because her caregivers were "out of network," her health insurer wouldn't pay for much of her care.

She said one doctor she visited on Oahu after her surgery didn't even know the names of the chemical agents that were used in her chemotherapy — drugs Bono said could easily be looked up on the Internet.

Her health insurance paid 30 to 40 percent of the $200,000 bill — leaving her on the hook for $130,000 to $140,000.

She said her health insurance company, Summerlin, refused to negotiate with M.D. Anderson on a single patient contract.

She shut down her business, Diamond Auto Sales, partly because of her bills. Her house in Keauhou is up for sale.

Summerlin didn't respond to phone and e-mail requests seeking comment in time for this story.

Back in Hawaii

When Bono made it back to the Big Island, she quickly got back into the swing of things — riding her bike, lifting weights and paddling for Keauhou Canoe Club.

She even competed in a seven-mile race from Keauhou Bay in an OC-2 canoe with Keauhou coach Cheryl Villegas in March. They finished first in their division.

"She's an animal," Villegas said. "She's an inspiration to me.

"I don't know how she does it."

After riding her bike around town and on Queen Kaahumanu Highway, Bono thought her riding was getting back up to speed, so she enlisted the help of Kailua-Kona's Jim Jennings, who once motor-paced her by riding his motorcycle while Bono trailed behind in his draft to train for speed.

Jennings motor-paced Canadian Peter Reid when he won one of his three Ironman triathlon world championships. Most recently, Jennings worked with American triathletes Chris Lieto and Luis De La Torre. Lieto placed 28th at the Ford Ironman World Championship on Oct. 11, while Kailua-Kona's De La Torre was 103rd.

"Her miles per hour were right where they were before — which I thought was amazing," Jennings said after riding his 600 cubic centimeter Honda scooter with her trailing. "She still had the zip in the legs — it was like (her cancer) had never happened."

On to nationals

That performance in mid-August convinced Bono she could compete if she went to the Track Nationals, which took place Sept. 2-7 in San Jose, Calif.

The financial support of fellow paddler Kaeti Ecker, who had air miles; another friend, who had a car and a place to stay in California; and her coach, Eddie Borysewicz, who had a tour bus going to the competition, convinced her she could afford to go.

"It wasn't about me, it never was," she said. "When I came back, I said I wanted to be an inspiration to others because I wasn't supposed to be alive."

In her first race, Bono was 2 seconds off her national record time, going 500 meters in 40.94 seconds and finishing second.

After a couple of days off, she won the 200-meter time trial in 13.49 seconds. Bono said the 200 counts as a national championship but was used for seeding in the match sprints, a double-elimination sprint event.

In the match sprints, she dropped her first race after being jostled by her opponent. That normally wouldn't have been a problem for Bono, but because she had lost so much weight during her cancer treatments, Bono wasn't able to pour on the closing speed she used to have.

"I put the power down and I was still in the same place, and just then it hit me that I'd had cancer," Bono said.

Her coach, Borysewicz, took her aside and gave her some sprinting tips, and they seemed to work. Bono turned it on the rest of the way, placing first in her next five races to win the match sprints stars and stripes national championship jersey.

"It's amazing that she can come back from that extensive of a disease," said McHugh, who had seen how large her tumor was just a year before.

'Live each day to its fullest'

While Bono hasn't lost her competitive spirit, she has come away with an increased appreciation of life.

"Everyone needs to live each day to its fullest — joy, ecstasy, tell the people you love you love them before the sun goes down," she said. "Don't hold grudges. Life is too long for pettiness and too short for love and kindness.

"All those little things — 'You said this, you said that' — are so meaningless. If people would live their lives like that, whether they got cancer or not, the world would be a better place."