After thirty years of faithful service in the United States Navy, Captain
Albert Carpenter retired on July 1, 1973. During his thirty years of service,
Capt. Carpenter fought in and survived three wars. As a trained soldier,
he was prepared for many battles and he learned to never retreat. His
military training had instilled in him the discipline to solve problems
and calmly face hardships head-on. Unfortunately, three decades of sacrifice
and exemplary service could not prepare Capt. Carpenter for an extended
battle with mesothelioma.
In September of 1997, at the age of 77, Capt. Carpenter began to feel increasingly
tired. He also noticed a slight pain in his chest and progressive shortness
of breath. His voice became hoarse and he felt like he was suffocating.
Over the next two months, his shortness of breath grew worse.
Albert Carpenter finally went to the emergency room at the National Naval
Medical Center in Bethesda, Maryland for treatment of his symptoms. A
chest film showed a large left pleural effusion. On November 8, 1997,
Capt. Carpenter was admitted to the Naval Medical Center and underwent
a thoracentesis which resulted in the removal of 1500 cc's of fluid.
The fluid was sent to the pathology lab for cytological testing. The fluid
tested positive for mesothelioma. A CT scan of the chest revealed pleural
based nodules in his left chest cavity with minimal mediastinal adenopathy
(swelling and morbid change in the lymph nodes).
Capt. Carpenter was then referred to a cardiothoracic surgeon for a biopsy.
On November 21, 1997, Dr. John S. Thurber performed a left chest thoracoscopy
with pleural nodule biopsy and a talc pleurodesis (a procedure in which
sterile talc is introduced into the chest to produce adhesions to prevent
pneumothorax [the collection of air or gas] and effusions). Dr. Thurber
saw multiple nodules on the visceral and parietal pleura and also on the
left hemidiaphragm. The nodules were diffuse and widespread throughout
the left chest. Dr. Thurber also found a large amount of bloody serosanguineous
fluid (containing serum and blood) which he suctioned and sent to cytology
and microbiology for examination. The pathologists examined the biopsy
tissue and diagnosed malignant pleural mesothelioma, epithelial subtype.
To conclude the surgery, the doctors suctioned off Capt. Carpenter's
chest and inserted a talc slurry poudrage (application of an irritating,
but otherwise nontoxic, powder to the pleural space of the lung in order
to produce pleural adhesions). About five grams of talc were insufflated
into Capt. Carpenter's chest.
The tissue and the evacuated fluid were then evaluated and the pathologists
at the Armed Forces Institute in Bethesda confirmed the diagnosis of malignant
pleural mesothelioma. Capt. Carpenter was discharged on the sixth post-operative
day and referred to oncology services for evaluation and future treatment options.
The doctors classified Capt. Carpenter's tumor at Stage II. They did
not recommend radiation therapy or any surgical options, such as a radical
pneumonectomy. Capt. Carpenter decided to undergo experimental treatments
at the Lombardi Cancer Clinic in Washington, D.C. These treatments included
Gemzar (gemcitabine HCL) and Taxotere. He was later enrolled in a clinical
program using
CPT 11
.
The doctors at Lombardi were very straightforward with the Carpenters.
The Carpenters understood that there was no magic cure. Chemotherapy drugs,
although state of the art, were experimental. They also understood that
the natural course for untreated mesothelioma patients was dismal. By
this time, Capt. Carpenter had lost nearly thirty-five (35) pounds from
his six-foot three-inch frame. He now weighed a slight 145 pounds. When
Capt. Carpenter was released home, he rigorously complied with his chemotherapy
treatment schedule for five weeks. A CT scan taken on February 9, 1998
showed that the tumor had increased in size around the lung and there
was a pulmonary embolism (obstruction of the pulmonary artery) in the
right pulmonary artery. Capt. Carpenter returned to the Naval Hospital
in Bethesda where he was treated for the embolism.
On March 17, 1998, Capt. Carpenter began experimental chemotherapy using
CPT 11. Prior to administering the chemotherapy, Capt. Carpenter had extensive
testing to evaluate the condition of his kidneys and bladder, which were
found to be healthy. At the Naval Hospital, Capt. Carpenter began an infusion
regimen which involved the insertion of a port near his clavicle. He wore
a cassette containing the CPT 11 around his waist which was connected
by an IV line to the port. The CPT 11 was slowly infused over a twenty-four
(24) hour period. Every day, Monday through Friday, Capt. Carpenter went
to the Naval Hospital to have the cassette refilled.
One month after beginning the CPT 11 chemotherapy, a CT scan was taken
which showed that the tumors were neither smaller nor larger. Unfortunately,
six weeks later another CT scan showed that the tumors had indeed grown
and that the tumor or "rind", as it was described, had completely
encased the left lung and large airway. The doctors at the Naval Hospital
recommended the termination of the CPT 11 regimen. At that time, Capt.
Carpenter was having difficulty breathing. The doctors recommended two
(2) weeks of radiation therapy in hopes of reducing the tumor and enhancing
Capt. Carpenter's breathing. The Carpenters agreed. Capt. Carpenter
received twelve (12) treatments of radiation therapy which helped his
breathing.
A short time later, in late May early June of 1998, Capt. Carpenter learned
of another experimental treatment that was being offered at the National
Cancer Institute. The treatment was to be Taxol by infusion cassette and
PSC 8-33 by pill. He scheduled an evaluation on August 22, 1998. Unfortunately,
Capt. Carpenter passed away on August 20, 1998, just days prior to his
appointment.
Throughout Capt. Carpenter's illness he attempted to maintain his daily
routine, just as he did when he was in the Navy. Each morning he arose
at 5:00 a.m., ate breakfast, read the paper and attended to personal and
business matters. He ate lunch at noon, and filled his afternoons with
exercise, doctors appointments, reading and/or gardening as time and weather
allowed. Before his illness, Capt. Carpenter often performed volunteer
work in the afternoon. Dinner was promptly at 7:00 p.m., followed by social
activities or quiet time with Renee. He would retire each evening at 10:30
p.m. Capt. Carpenter followed this rigid schedule until the day before
he passed away.
His widow, Renee Carpenter, is deeply proud of the way her husband marshaled
all of his resources to fight for his life. Renee states, "My husband
was, I thought, incredibly brave in the way he faced his illness. He never
complained, he never gave up hope, and he fought to the end."
Capt. Carpenter served his country in the Navy from 1943 to 1973. As an
experienced soldier he fought many battles, but the toughest one may have
been his battle with malignant mesothelioma. According to Renee, in his
final days, Albert's main concern was for the welfare of his wife
and children. This is not surprising, as his entire life was dedicated
to serving others. He always put his country and family first.
**
POSTED OCTOBER 15, 1998
**