Sunday, February 20, 2005

Fighting the Good Fight

Over the past week, nearly 24 hours a day, I have stood by my brother Charles’ bedside in a VA (Veterans Administration) hospital called John L. McClellan Memorial Veterans Hospital in Little Rock, Arkansas. In July of 2004, Charles was diagnosed with throat cancer. That cancer had a hideous and horrific sounding name of Squamous Cell Carcinoma and the family was devastated.

Over the months I have observed Charles decline in health from an approximate 160 pound healthy man to a 94 pound skeletal wraith barely making a huddled mass under the rough government issued hospital blankets. In fact, it is hard for me to focus enough to even consider the husk of a human lying there as being the same person I know as my younger brother.

Charles is an Air Force veteran and thus qualified for treatments through the VA. He was a part of a phase II experimental protocol clinical trial that consisted of large doses of a three drug chemo cocktail and 35 consecutive days of concentrated radiation treatments… the last two weeks of which were two-a-day treatments. The treatments were considered the best hope of beating the Stage IV cancer even though it was unknown if he would survive the treatments themselves. The last radiation treatment was just before Halloween of 2004 and the following December he was declared “cancer free” after his CT scan. Charles and the family were elated and whispers of a miracle circulated even though there were some who felt uncomfortable with such a pronouncement.

Charles struggled with recovering from the treatments and continued to lose weight and fight dehydration and malnutrition and trying to control his pain. Several more stays in the hospital to keep him hydrated finally led to one night when he burst a blood vessel in his throat and found himself once again back in the hospital with complications. Emergency surgery to cauterize the wound ended up revealing that there was what looked to be new tumors and the nightmare deepened.

That brings us to this week and the long hours I’ve spent at his bedside as we all wait for what is to come next. A two inch tumor as been discovered behind his nasal passages and is pressing dangerously against his brain cavity. He has partial paralysis of his face and right eye. It is unknown if this is new cancer or a metastisization (to spread to another part of the body, usually through the blood vessels, lymph channels, or spinal fluid) of the old tumor. He has already undergone another round of standard chemo and they are pumping him with steroids and electrolytes to prepare him for radiation in hopes of reducing the tumors in size and thus relieving the pressure on his brain.

He will be treated at CARTI with the rare and famous Three-dimensional (3-D) conformal radiation therapy. This treatment is an innovative high-technology radiation technique. Computer simulation produces an accurate image of a tumor and surrounding organs so that multiple radiation beams can be shaped exactly to the contour of the treatment area. Because the radiation beams are precisely focused, nearby normal tissue is spared. CARTI is one of only four locations in the United States that has the equipment and technology to do this sort of treatment. I believe this is also called Tomo-Therapy (also read this and this) and is considered a second great hope for those who have a recurrent cancer or one too large to remove with a gamma knife treatment near the brain.

All of this is a severe over simplification of what is going on with my brother and what he is facing in his battle with this insidious disease. I thought that maybe putting some sort of verbal “face” on it here may help me to cope with what’s going on. It doesn’t. The tears and fears are all still here in my heart.

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