If Jon Stewart was the famous face of last week's hearing to ensure 9/11 first responders keep getting health care, Luis Alvarez was its soul.
Strikingly gaunt, ashen and frail, the retired New York Police Department detective told lawmakers he felt compelled to testify even as he prepared for his 69th round of chemotherapy the next day.
“I should not be here with you, but you made me come,” Alvarez quietly told a House subcommittee.
“I have been lucky enough to have the pain and suffering of 69 rounds of chemo and countless other treatments and surgeries," he added. The regimen — as brutal as it had been — had bought him time with his family that many other stricken responders weren’t able to get, Alvarez explained.
His gut-punch testimony, delivered before a hushed chamber, ended in a standing ovation from the crowd. Last Wednesday, the bill to ensure that the 9/11 victim compensation fund doesn't run out of money passed a key hurdle in the House.
But on Tuesday, Stewart was back in the headlines after responding directly to Senate Majority Leader Mitch McConnell, who wondered why Stewart got "all bent out of shape" over funding for 9/11 first responders and insisted "we will take care of" them.
"They're suffering and dying and in terrible need. You'd think that'd be enough to get Congress's attention," Stewart said during an appearance on "The Late Show with Stephen Colbert" on Monday.
Who is Luis Alvarez?
Alvarez, 53, and his family did not respond to a TODAY request for an interview made through his attorney. But previous media coverage shows he is a former U.S. Marine and NYPD bomb squad detective who reportedly has “10-44” — NYPD radio code for a suspicious package — tattooed on his hands.
When terrorists flew planes into the World Trade Center on Sept. 11, 2001, he raced to the scene and worked at Ground Zero for weeks afterward, searching roof tops for victims, his family told the New York Daily News.
In 2016, Alvarez was diagnosed with colorectal cancer that had spread to his liver, his son told the paper.
It was one of thousands of cancer cases linked to the aftermath of the 9/11 attacks. First responders breathed in pulverized dust that contained cement, asbestos, lead, glass fibers, dioxins and other chemicals after the towers collapsed.
Of the 2,753 people who died at the World Trade Center site that day, 343 were firefighters and paramedics. More than 150 have died since, Dr. David Prezant, chief medical officer of the New York Fire Department, told NBC News last year.
Alvarez has had surgeries to remove parts of his colon, gallbladder and liver, his son said.
'Pain and suffering of 69 rounds of chemo'
It’s uncommon for a patient to undergo chemotherapy for as long as Alvarez has, but it likely means the regimen continues to help keep the cancer under control, said Dr. Nikhil Khushalani, an oncologist at the Moffitt Cancer Center in Tampa, Florida. Khushalani is not treating Alvarez, but commented in general.
“It’s certainly more on the rarer side. It’s not unheard of — it’s perfectly reasonable to do as long as the patient is tolerating it well, but more importantly, deriving benefit from it,” Khushalani told TODAY.
How much chemotherapy a patient can tolerate depends on what type of cancer he has and what type of treatment is being used. Some chemo drugs can only be given for a finite number of times because the cumulative dosing can damage the heart or other organs, Khushalani said. Other drugs are much better tolerated by the body and can be continued for much longer.
In a stage 4 setting — when the cancer has spread from the original tumor site, as in Alvarez’s case — doctors try a treatment until the cancer cells find a way to become resistant to the drug, or the patient develops more side effects or has plateaued in his response.
“It’s in the rare circumstance such as this that his oncologist probably feels that he is benefiting from the treatment and he’s tolerating it reasonably well and therefore he is continuing,” Khushalani said.
“That often becomes a shared decision between the treating physician and the patient.”
For Alvarez, the endless treatment has meant more time. "It is my goal and it is my legacy to see that you do the right thing," he told lawmakers.