Commentary: Remembering a Pioneer in the Cancer Wars
By John Carey
Two years ago, in a night seared into my memory, my wife, Agnes Loo, woke up in excruciating pain. We rushed to the hospital, where we eventually got the news that would shatter our lives: Stage IV colon cancer. The surgeon who sliced out her main tumors and stitched her intestines back together told us that the cancer was everywhere: liver, lymph nodes, ovaries.
Agnes had worked in a cancer lab. I'm a science reporter. We both knew her diagnosis was essentially a death sentence. Even with chemotherapy, we could expect she would live maybe a year.
But there was a slim hope, a new treatment designed to target cancer cells. Scientists had just reported that the drug, now called Erbitux, had knocked back tumors in late-stage patients, prompting front-page headlines. Thousands of desperate people were clamoring unsuccessfully to try it. Could we be among the "lucky" ones?
We learned that Dr. Leonard Saltz at Memorial Sloan-Kettering Cancer Center in New York was still recruiting a few newly diagnosed patients for a small trial using Erbitux in combination with his standard chemo regimen. One of his colleagues called it a "miracle" drug. But Agnes and I both knew that in today's world of cancer treatments, real miracles are rare.
Agnes -- the toughest and smartest woman I've ever known -- was ambivalent. She faced a dilemma familiar to many late-stage cancer patients. Her remaining post-surgery tumors were small, and she still felt O.K. So should we skip the trial and travel to the places she longed to visit -- Venice, Yosemite National Park, the Greek islands -- and accept the inevitability of her death? Or should she tie herself down to a punishing weekly treatment regimen in the hope of a miracle? What good would extra months be if they were spent fighting side effects, she argued.
In the end, her will to live won: We enrolled in the trial, and she began her aching battle with endless needles and IVs, nausea, diarrhea, fatigue, and rashes -- most of it caused by the chemo, some by Erbitux.
The news was good at first. The treatment dramatically shrank the tumors in her liver. Dr. Saltz told us he was thrilled, but he couldn't help Agnes overcome her disappointment. The reason was simple: As long as the lumps of cancer were still there -- however small -- she knew there would be no miracle.
In less than six months, in January of 2002, the cancer came roaring back -- as it did in the other patients we came to know in the trial. By mid-March, Agnes was on the brink of death. Ironically, it was an old-fashioned therapy, radiation, that brought us two extra months -- I called it her Indian summer. We hosted daily gatherings of friends, we visited the bluebells along the Potomac River, and Agnes greedily drank it all in. She even planned trips to California and to Italy, e-mailing for hotel reservations in Italian she continued to learn from tapes.
Those two extra months turned out to be priceless. I agonized over whether the ordeal of the trial was worth it, especially since Erbitux didn't even give us the full year we had expected. But Agnes reassured me that we had made the best decision we could -- and she hoped her experience might benefit others. We did travel to California, just two weeks before she stopped breathing on our living room couch. And as I promised I would, I went to Italy for her, alone.
Carey writes about science and medicine in Washington.