At the moment that Dr. Andrew Pippas, morphed from being my friend to becoming my medical oncologist, I already knew several things about him. I first met him in his cramped little office across the street from Doctors Hospital, well in advance of the construction of the John B. Amos Cancer Center.
I was there to welcome him to town. Our conversation drifted to men’s clothing. I recommended Chancellor’s as a good place to go. We talked about his family and that he had just arrived here from Lakeland, Fla. I found him to be quick-witted, very intelligent and he seemed to always order his thoughts before he opened his mouth to speak. Over the years I’ve know him, he’d occasionally disappear from the small space his body occupies and appears to be lost in thought, pondering some angle, some formula or another way to get at something on which he’s been working. Like a well-dressed mad scientist in a bow tie, he leaves no stone unturned in his quest to heal those of us sick people who are glad to be in his care.
These few days since my last posting on this blog have found me on a soul-wrenching journey. Our lives have gone on: doctor visits, dinners with family and friends, quiet conversations with family, the business of running two print magazines while launching three digital versions of both of them, church (although I skipped today to have some quiet time just for myself), board work, tractor time, an event with my parents — all against the ever present backdrop of cancer and a big decision that needs to be made.
As you know, Jill and I just returned from an 11-day journey out to Houston, Tex. to the M. D. Anderson Cancer Center. Out there we found out a couple of things we already knew and one thing we were surprised to hear. The cancer that has invaded my body is trying to kill me, but thankfully it has brought a slingshot to the gun fight. But instead of the one tumor that we knew I had on my left adrenal gland, we found out that I have two more small ones in the upper pole of Strainer, my right and only kidney.
There is a surgical option that should be exercised after a period of systemic treatment. I have always been told by Dr. Pippas and other medical oncologists whose opinions we’ve sought: “Treat a local problem with a local treatment. Treat a systemic problem with systemic therapy.” We’ve got a systemic situation now, and although surgery is still on the table, we need to blast my system with cancer-killing therapy to beat down what is there and destroy any cells that may be trying to get a toe hold someplace else.
TKIs and anti-angoiogenic drugs are the chosen systemic route these days for clear cell kidney cancer because they can shrink tumors and lessen a patient’s tumor burden in advance of surgery. I believe there are 7 of them: sunitinib (Sutent), pazopanib (Votrient), everolimus (Affinitor), axitinib (Inlyta), sorafinib (Nexavar), temsirolimus (Torisel) and bevasizumab (Avastin). These drugs have two things in common: their toxicities are legendary and they cannot cure kidney cancer. The 8th approved therapy is called Aldesleukin (IL-2). It has one thing in common with the other seven: its toxicities are legendary. AND, +/- 7% to 10% of the time, it can also cure (provide a durable, lasting remission from) kidney cancer.
If you search HDIL-2 on this blog, I’m sure you’ll find a double handful of references and the discussion that if this cancer forces me to a systemic therapy, high-dose interleukin-2 will be the one I choose. I know that I’ll be walking unarmed and naked into a wall of flames, but I’ll be walking toward the only thing that can give me my life back and provide a tiny hope for my greatest wishes: to live to be old with Jill Tigner, to see our sons happily married and to hold a lapful of grandchildren.
Andy Pippas called me this afternoon and we talked about things. The bottom line: I am not going to dick around with a drug that has not got a chance to cure me. Not now, anyway. I may have to take one of these 7 drugs some day in advance of another surgery. But, I may be one of the 7 percenters, who can get enough remaining life out of HDIL-2 to ether be done with this shit or to live long enough for something more profound to come along.
So, I sent Dr. Dan George an email today and asked him to make a place for us at Duke University Hospital in his world-class HDIL-2 treatment program. My hair is on fire, my eyes are red, I’m locked and loaded and I’m going in. Unless something in my scans or labs makes me ineligible for this treatment, we’re choosing to ride the only horse that can take us all the way to the finish line.
This decision had been difficult to make and has taken days of discussion with Jill and many emails with the doctors who are involved with my case. I am tired of thinking about it now. We know what we’re going to do and we’re ready to get about it. Here is some information on Aldesleukin if you need some specific things to pray for on our behalf. This is going to be worse than 100 miles of cobblestones in a Belgian bike race. But, with enough people cheering us on, we’ll get through it.
I’ll post here when I hear from Dr. George. Please keep us in your prayers.
Neil says
Dear God,
All those things I was discussing with you last week – well, forget it. I’m good. Please apply any positive vibes reserved for me to my friend Mike. He needs ’em more.
Thanks
Jennifer says
Go in with both guns blazing, Mike! And all the while, tell cancer to you-know-what itself….
Will be thinking of you during this battle.
cyndy says
we’re with you Mike…all the way!
Carol Ann says
I will continue to pray for you and to spread the word to get as many people as we can to send their prayers for you and your doctors.
Patti Trotter says
As always, you, Jill, boys and John and Ann are in my prayers. We lifted you up in prayer today at church. You are such an inspiration, Mike.
Grandin Eakle says
I love you Mike….. You have such a way….. You had me hooked into the SERIOUS business before you…. Your choices made with Jill and much thought…. You had me engaged in the seriousness of what the systemic treatment will be…. I was totally enrolled in your decision process and searching for any stone you may have left un-turned…. Just as I was reaching the decision that you have given this good and thorough thought and I was beginning to think of how to word my support in your decision and all the SERIOUSNESS that brings…. with a furrowed brow I was finishing the last few deep and near solemn words in your last paragraph and THERE IT WAS!…. Those 16 words that broke the wrinkles in my brow and turned my expression to a smile the way you do so often, “This is going to be worse than 100 miles of cobblestones in a Belgian bike race.” How can I continue to dwell on serious things after that!!!!!! Thank you for sharing your experience with us all in a way that we can give thought to what lies ahead and still smile in the present moment!!! YOU my friend are nut sometimes!!!! Keep loving and lugging along ONE DAY AT A TIME!!!!!! We are here with you and Jill!!!!! – Peace out- G
jim thompson says
Mike, you are a special person and our thoughts and prayers will be with you and your troop of warriors as you win this battle. Jim T.
Marquette says
You don’t even have to ask for the prayers. You don’t have to ask for the good thoughts. You don’t have to ask for anything other than just say, “Y’all?” And it will be given. In abundance. By all of the many many many people you have loved and laughed with and given to and partaken with and we will be there, all the way, praying, cheering, thinking, laughing, crying and simply BEING with you Mikey. You are such a warrior, my brother, you mean too much to too many – those future grandchildren included — to not be anywhere but here, for a very long time. You’re a good poker player. We’re ‘all in’ with you. Love you Mikey.
Betsy and Jack says
We just wanted you and Jill to know, Mike, that you are often in our thoughts and . every . single . day . in our prayers. We, like so many others, are cheering you on from the sidelines as you run this race with the endurance only God can give.
We love you both!
Stephanie Downs says
Mike and Jill-
Most of us that read your blog can’t even imagine what you are going through and the tough decisions that you are having to make. Just know that we are here supporting, praying and cheering for you daily!
Stephanie
janet p says
I did IL-2 with Drs. George and Morse last year. Although it didn’t work for me, I never wanted to have any regrets that I didn’t treat my RCC as aggressively as I could. IL-2 is tough but doable. All the effects you have as you are going through it will go away in time. The worse for me was the itching. Sounds crazy but it was horrible. All side effects can be handled and I felt well taken care of Duke. And the view from the 9th floor are spectacular. You’ll get through this and I pray it works for you.
Pam H says
I’m hoping you hit a home run!!