2 Million Dogs – The Blog

Cancer. Touches. Everyone.

Posts Tagged ‘Dr. Steve Withrow’

22 Stones

Posted by Erich Trapp on January 7, 2011

This blog is re-posted from Luke’s original post of January 4th, 2011.

"Kthnxbye"

Don’t know where I left off last with Murphy’s condition but Christmas week we reached critical mass. He was struggling and I wasn’t sure if he’d make it.

I didn’t think the massive radiation doses administered over three days would alleviate his airways quickly enough for him to breath sufficiently which is why I explored radical ideas like inserting a shunt or stent.

But the radiation did work and it didn’t take the two weeks that was speculated. By Christmas day Murphy was playing with Hudson for the first time in weeks and it was a very special day. That’s a photo of Murphy taking off with his X-Mas booty that I entitled, “Kthnxbye”.

We were blessed with a mostly uneventful week following Christmas during which I turned 40 and then the Earth added another year to the 4.54 billion and change it has under its belt.

I say mostly because Murphy has had nosebleeds and down days but he’s still markedly better than two weeks ago. However, that radiation was so effective so quickly suggests serious side effects are in store. Already Murphy’s losing fur on his head and around his eyes that never fully re-grew from the first round but we knew that hitting the tumor hard would be risky.

We are due to return to CSU this morning for a clinical evaluation to assess whether he’s a candidate for adjunct chemotherapy though my mind’s pretty much already made up since the ‘wait and see’ approach after radiation last August was a complete failure. Had I run parallel courses then we may have been in a different place now.

Which is perhaps the lesson for the week. When it involves cancer always assume the worst and choose the most aggressive form of therapy. I’m listening to The Emperor of All Maladies on CD now (which I highly recommend) and while it’s chocked full of interesting metaphors I’m a movie kinda guy.

While writing this blog The Terminator came to mind when Reese is trying to convey the seriousness of the situation to Sarah Connor. “It can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity or remorse. And it absolutely will not stop. Ever. Until you are dead.”

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Notes on Murphy

Posted by Erich Trapp on December 21, 2010

From 2 Dogs 2000 Miles, Tuesday, December 21, 2010.

Dictating my thoughts for the oncologists at CSU, others who have dogs with nasal adenocarcinoma, and in the interest of science.

Over the weekend Murphy’s ability to breath through his snout has diminished significantly. It seems this new tumor is spreading quickly. We hope the radiation will stop this growth almost immediately. In layman’s terms here’s how it works:

Cancer cells are referred to as ‘immortal’ because they divide unabatedly. The first one, not sure what scientists call it; perhaps the parental or originator, has a gene that for some reason is turned on telling it to start dividing. That one cell becomes two which becomes four, etc. until you have a tumor mass consisting of millions of cells. Radiation therapy attempts to interfere with the tumor cells’ ability to continue mitotic division thereby stopping growth. The cells that can’t divide eventually die off.

Back to Murphy. Even if this massive three day dose of radiation halts tumor growth, it’ll still be restricting airflow in the interim. We’ve already discussed a surgical option in Dr. Withrow’s words taking a roto-router and cleaning the tumor out but that presents some serious problems.

That got me thinking this morning. How can we improve breathing through his snout without surgery and how do we do something like this in humans? Well we know that when people have clogged arteries we place a stent in them permitting improved blood flow. Plus, stents are now drug delivery systems so this might be a way to administer chemo directly into the tumor site.

Must discuss this with Dr. Withrow…

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Murphy’s Treatment Plan

Posted by Erich Trapp on December 19, 2010

From Luke’s blog post:

If you’re offended easily, please read no further. Don’t know what sort of graphic language will be expressed in this post and I have no intention of editing it.

A lot of you know me from our walk from Austin to Boston http://2dogs2000miles.org/  and some of our new friends don’t. Then, I was walking in memory of Malcolm whom I lost to cancer. Now I’m just a father who’s desperately trying to save his other boy’s life from this dreadful disease. I’ve made the decision to make a documentary of this latest chapter of our lives and I’ll post more about this as it develops.

It’s already a hard time of year from me since it was this time in 2005 when Malcolm was struggling and the metastatic tumor in his lungs was overtaking him. But this isn’t about me so let me bring you up to speed about Murphy.

I posted about his prognosis. We don’t understand why the first round of radiation failed… I have a theory but for now it’s academic and we can’t afford time for talk. The tumor has reached critical mass and if allowed to grow any further, it’ll shut off his ability to breath through his snout. If that happens he’ll have no quality of life.

The recommendation of the oncology team at CSU is that we have to act immediately and hit it hard with everything they’ve got. Their radiation plan is 30 grays administered over three days, the maximum tolerable dose.

After that we’ll look into chemo as an adjunct therapy. Thanks to everyone who posted to our wall about human cancer drug trials – Erich is compiling a list from your links so I can send emails out to the principal investigators.

The potentially catastrophic downside to this plan is there’s a 5% chance Murphy will succumb to massive radiation alone in a few weeks or months.

“What’s your decision?” Dr. Withrow asked me Friday.

Having sat through 30 minutes of if, ands, and buts – all I could think about was Star Trek. Strange since I’m not a Trekkie but when he said the first round of radiation merely stunned the tumor, I thought of the phaser and it’s two settings: Stun and Vaporize. At least that’s how I remembered it since the last time I saw an episode was probably in the 80s. Perhaps we didn’t hit it hard enough the first time and the Variant Trilogy machine was on the wrong setting.

I don’t know how much time passed after he asked the question – all the options and the probabilities of their outcomes cycled through my head like a centrifuge.

“What are we going to do?” he asked again.

“Let’s kill this mother f***er.”

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Murphy — Preliminary Analysis of PET scan

Posted by Erich Trapp on December 16, 2010

Luke posted this to the 2 Dogs 2000 Miles blog 12/16/10.

It’s almost certain Murphy has new tumor growth in two areas one of which is causing breathing problems. Dr. Withrow is still consulting with the radiation team and we’re meeting back at CSU at 9am. As of yesterday afternoon we discussed putting a scope up there and biopsying the new tissue just to be sure but the PET scan really wiped Murphy out and I’m unsure about performing the procedure today.

If there is new growth this is where it becomes problematic. From my understanding when we finished up the first round of radiation in September the game plan was let’s take a look at it in four months and if the tumor’s still there let’s hit it again until we shrink it completely or it can be removed surgically.

But re-radiating the tumor can have some potentially deleterious side effects. Hopefully we’ll know more in a few hours…

ADDENDUM –

Luke posted videos of Murphy’s scan to his blog. I am not able to load them here, so please see Luke’s blog here to view the videos.

These videos are from my consult with the radiation oncology team at CSU this morning. The news was devastating even though I felt something was wrong a few weeks back. I haven’t watched them and don’t know if the dialogue is audible. I’ll try to post later tonight to let everyone know where we’re at but I just don’t have the strength for explanation and elaboration right now. All I want is to be with my boy.

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Murphy Update

Posted by Erich Trapp on December 14, 2010

Luke posted this blog today, Tuesday, December 14, 2010.

Murphy hasn’t had a CT scan yet. Dr Withrow wanted to do a thorough physical first and during the exam he palpated a nodule in his lymph node which they aspirated. It’s unlikely this type of cancer spreads to the lymph system but we want to be sure.

He also wanted to biopsy the tissue that Murphy sneezed up Sunday morning which can only be described as fleshy gray matter, pictured nearby. (Very sorry for the graphic nature of the photo but welcome to my world.) Is this the byproduct from radiation, debris from the destruction the cancer has caused in his nasal passage, or evidence of new tumor growth? We don’t know yet.

On the upside, Murphy’s blood work came back normal although he’s slightly anemic, probably due to his nose bleeds, and his chest films were clear.

A CT scan is scheduled for Wednesday morning while we’re awaiting the results of the lymph aspirate and the biopsy.

That’s all I got right now…

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Happy Birthday, Malcolm by Luke Robinson

Posted by Erich Trapp on November 2, 2010

Malcolm

Malcolm would’ve been 13 Sunday. I didn’t realize it until now that his birthday comes on the eve of Pet Cancer Awareness Month.

A year or two ago I might have said that was curiously coincidental but I’ve witnessed way too much in my travels and I know otherwise now.

Last night I was fortunate enough to listen to Dr. Steve Withrow‘s talk about his lifelong work in comparative oncology. The title of his presentation tells all, “Some Science. Some Stories. Some True.” It was both enlightening and invigorating, and I hope every one of you has the opportunity to hear him speak some day.

One of the most interesting points he made was that despite breakthroughs in understanding and technological developments, “The dumbest cancer cell is smarter than all of us.” My father, a nephrologist, used to talk to me at length when I was young about the amazing complexity of the human body and the intricacies of its individual yet interconnected systems. A few months back in a blog about Murphy I described cancer as nature’s perfect enemy. It uses that complexity against its victims.

Dr. Withrow also talked about his efforts in convincing the National Institute of Health of the importance of studying cancer in companion pets. In his words, “NIH never questioned the science but the relevance and the ability to extrapolate it into humans.” Comparative oncology or translational studies are not even a rounding error in the billions of dollars spent on cancer research in the U.S. every year.

Public perception is still another problem and one I can speak about personally. While on our cross-country walk I was invited to a number of human cancer rallies and at every one, I was introduced as the ‘Dog Cancer Guy’ or on a few occasions the ‘Dog Cancer Boy’ which made me sound a little like a circus act. Don’t get me wrong; I was grateful for every opportunity we had on the road to share our story, but most of my time at those events was spent on, “Yes, dogs get breast cancer, too, and by working together we may find a common link or a key.”

It’s important this month, Pet Cancer Awareness Month, to keep in mind exactly what we’re up against —  the greatest epidemic facing companion pets, limited government funding for research, and even public perception.

That’s why participating in the 2 Million Dog March this November 7th is so imperative. We’ve got to send a message to the media that this isn’t just an “Aww, puppies” story, and to the general public that the only way to eradicate cancer in both pets and people is through partnership.

We’re not going to get 2 million dogs to walk in the 12 cities this year or any where close to that but it’s the start. You know, when Malcolm’s cancer spread to his lungs he had hard days, and when he struggled, I whispered to him, “We don’t give up, we don’t give in until the end, my friend.” That’s where ‘puppy up’ came from…

I miss you Malcolm. puppy up!

To participate in a puppy up walk near you, please follow this link.

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