John Sherrick
Mr. Sherrick was in excellent health until January, 2000, when he grew
short of breath. In April, he developed severe pain in his abdomen. St.
John's of Tulsa admitted him emergently, but did not take any film,
and he was discharged shortly after admission.
Mr. Sherrick is not a complainer, and coped until September or October,
when he went to a Eufaula cardiologist, Dr. Petrasko, because of acute
shortness of breath. Dr. Petrasko performed a heart catheterization and
took chest films. His condition continued to deteriorate. He was referred
to a Muskogee pulmonologist, Dr. Lee.
Mr. Sherrick saw Dr. Lee one or two weeks before Thanksgiving. Dr. Lee
performed a right-sided thoracentesis, withdrawing two pints of very bloody
fluid. Dr. Lee wished to have him admitted for further diagnostic work-up,
but Mr. Sherrick waited until November 25, the Saturday after Thanksgiving,
at which time he was admitted to Muskogee Regional Medical Hospital. Another
three quarts of fluid were drained through a chest tube during his stay
there, which stretched until December 18.
On December 11, thoracic surgeon Dr. Rutlinger performed a right-sided
thoracoscopy with biopsy and talc insufflation. Dr. Rutlinger emerged
from the operating room and said that it was definitely cancer, a kind
of cancer known as mesothelioma. Pathology later confirmed the diagnosis.
Mr. Sherrick was referred to a Muskogee oncologist, Dr. Vasireddy. The
Tumor Board recommended that he seek treatment in New York City or Houston,
as Tulsa did not have the requisite expertise to treat the cancer. He
chose to seek treatment at M.D. Anderson because of its proximity. Mr.
Sherrick and his wife left for Houston January 8, and met with thoracic
surgeon Dr. W. Roy Smythe the next day. The Sherricks were very impressed
with Dr. Smythe's knowledge, compassion, and the care he took in communicating
the whys and wherefores of Mr. Sherrick' treatment options. The following
e-mails from
Dr. Smythe are published with his and the Sherricks' permission.
On January 27, 2001, Dr. Smythe e-mailed Carol Martin, one of the Sherricks' children:
Dear Carol,
Thank you for your correspondence. I am familiar with the ALIMTA drug.
It has shown some activity in mesothelioma, as well as a number of other
tumors. A great number of other drugs have also shown partial activity,
as has ALIMTA in this tumor. Unfortunately, absolutely no chemotherapeutic
agent has ever totally cured a patient with this tumor, and the response
to Alimta has been partial. If you wish to pursue chemotherapy, I would
strongly suggest that you consider one of the following options (if the
pathology results from the lymph node biopsy are negative, and the MRI
favorable):
(1) have the tumor removed surgically as we had discussed, followed by
inclusion in the Alimta trial if they will allow postoperative patients.
(2) have the tumor removed and speak with one of our oncologists about
our experimental drugs (we have a large number of new drugs on study now
here at Anderson, as many as any center in the worlk, some similar to
Alimta) - we allow postoperative patients in most of these trials. We
may also have the new form of postoperative radiation therapy we spoke
of to use in addition to or instead of chemotherapy. (3) you may forego
surgery and enter the Alimta trial, but I assure you that the chance of
Mr. Sherrick being alive in 5 years would be much lower than with surgery
with or without chemotherapy, although certainly with less short-term risk.
The only trial that has ever reported a good 5 year survival included surgery
in the treatment of these patients. If the biopsy results are positive,
the operation may be less effective, and we would need to discuss the
options at this point, carefully weighing risks and benefits.
I am a mesothelioma researcher, and have a basic science laboratory here
at Anderson dedicated to the treatment of this disease, I will try and
be as objective as possible with any questions you may have. Please feel
free to contact me at your convenience.
I hope that this is helpful, thanks again. - Dr. Smythe*
Dr. Smythe ordered a series of tests, including biopsies of Mr. Sherrick's
lymph nodes, in order to determine whether he could perform an extra-pleural
pneumonectomy (EPP), to be followed with chemotherapy and/or radiation
therapy. On January 30, 2001, Mr. Sherrick learned that his tumor had
invaded the lymph nodes, and that surgery was not an option. The Sherricks
were disappointed and at the same time relieved that they would not have
to make a decision regarding whether to undergo the rigors of tri-modal therapy.
On February 2, Dr. Smythe e-mailed Carol again, regarding the next step:
Dear Carol,
Thanks for your note. It has been a pleasure, I assure you, to care for
your father. There are a number of staging systems for this tumor, and
many of them don't agree with one another. I would say that he is
stage III of a possible IV, and this means that he is in a "medium"
stage range. His quality of life will depend greatly on whether or not
he responds to chemotherapy (tumor shrinks) or if his tumor stablizes
(growth stops for a time). As I had mentioned earlier, unfortunately,
cure with chemotherapy alone is virtually unheard of.
Ida and John Sherrick
What the family and your father should focus on now is to try to be optimistic
regarding the therapy, and if that therapy is not incredibly successful,
to have as a goal that he enjoy as much quality of life as possible in
the time that he will have left. We will certainly hope for improvement,
but again, if this is not possible, we have an entire department here
at Anderson - The Department of Symptomatic and Palliative Care, that
will help with pain, comfort and home care issues.
Dr. Kies is a very good clinical oncologist, and I know that you will like
him. He can elaborate, as time goes by on the answers to many of your
questions, some of which are not answerable at present. Although it may
sound trite, you really have to take a "one day at a time" attitude
at this point. I will keep you in my thoughts and prayers, and will always
be accesible if you have a question or concern.
Take care,
Dr. Smythe
On February 6, 2001, Mr. Sherrick met with Dr. Kies, an oncologist at M.D.
Anderson. Dr. Kies felt that Mr. Sherrick's condition was too weakened
to withstand chemotherapy, including that offered in clinical trials.
The Sherricks are following Dr. Smythe's advice to take it "one
day at a time."
Mr. Sherrick stands six feet, four inches tall. He weighed approximately
238 pounds before falling ill. He currently weighs 180 pounds. He understands
that the tumor extends around his right lung. He senses that the fluid
is returning despite the talc pleurodesis. He currently takes 60 milligrams
of MS Contin (a morphine-based drug) every eight to twelve hours for pain
relief. Carol writes:
His health is continuing to weaken. He now only walks with a walker and
only from his chair to the bedroom. We are no longer taking trips outside
the house. This disease is a very mean type of cancer. It seems when this
cancer makes a change it is a BIG change . . . it doesn't gradually
move into a different physical state, it JUMPS. One day we can walk without
assistance, the next day it's a total assist.
Before he fell ill, Mr. Sherrick played the harmonica in church and other
gatherings. He can still make the harmonica sound like the plaintive wail
of a passing train, but the few moments effort leaves him short of breath.
A deeply religious couple, the Sherricks have placed their faith in God.
Our thoughts and prayers are with this wonderful couple.
*
The inclusion of Dr. Smythe's correspondence does not imply that the
University of Texas, The University of Texas M.D. Anderson or any of its
staff endorses this law firm or any other law firm. We wish to thank Dr.
Smythe for allowing us to reprint his letter.
*** POSTED MARCH 5, 2001 ***
An Update -- March 23, 2001
from John's Daughter, Carol
1. Dad has lost down to 170 lbs.
2. Medications
a. 60 mg MS Contin every 8 hours
b. 1-2 tsp Morphine/Sulfate 10mg/5ml every 1-2 hours for break through pain
c. Megace for appetite
3. He is loosing control of his right foot/leg
4. He walks only with a walker from bed to his chair and back
5. He has NO appetite
6. His urine output is decreasing
7. He now sleeps in a hospital bed.
8. He is complaining of more intense pain and in different areas.
9. Constipation is always a problem.
10. He is beginning to have short term memory losses.
We think the cancer is probably into the endocron system now. Last week
he had a spell of his body going into a self medicated state of natural
chemicals that kept him out for about 36 hours. His body temp dropped
to 94.2; his heart rate went up to 110+; his respiration dropped to 8
per minute. We really didn't think we would make it through the weekend,
but he did.
He's very weak. It's hard to get him to eat. We have good days
that we are thankful for and bad days that we endure.
Mr. Sherrick passed away on April 26, 2001