Six feet two inches tall, husky at his "fighting" weight of 235
pounds, with the large, meaty hands and leathery skin of a life-long Texas
farmer, 68-year-old Aloys Fuhrmann fills the doorway as he lumbers into
the room. The son of a farmer, he has himself farmed for the last fifty
years where he was born, in Gainesville, Texas. He speaks with a faint
hint of a German accent, a dialect acquired from his forebears and the
insular German-American farming community in which he was raised.
Aloys married Marge in 1962. Together they raised six children; all six
live with
their families within a five-mile radius of their parents' farm. Aloys and
Marge instilled in their children principles of hard work and appreciation
for a job well done. They led by example. Marge ran the household, herding
the kids, keeping house and feeding some formidable appetites throughout
the day. Aloys worked the farm up to 12 hours a day, always six days a
week. His son Kevin works the farm with Aloys full-time. His two other
sons work as public school teachers and also work the fields, which are
filled with Fuhrmanns come harvest-time.
Farmers, teachers -- the Fuhrmanns fall within that class of unseen American
working-class heroes who give so much more to society than they ask for
or receive in return.
Aloys and Marge keep the Sabbath holy, leaving the week's hard labor
behind for the Lord and family. After mass, Aloys and Marge are joined
at their farm by their children and grandchildren for Sunday get-together.
They pray gratefully over the farm-fresh food, their livelihood, a reminder
our prayers should always include the farmers, ranchers and fishermen
who feed us. After dinner, conversation often turns to the rich history
of Notre Dame football; the Fuhrmanns are true fanatics. When Aloys is
unable to pick up Irish away games on his house radio, he can be seen
taking a lunch break on the hood of his pick-up, where the reception of
the truck radio is better.
Aloys' Biopsy Scars
As a farmer, Aloys knows that all of his hard work can only affect but
not control the outcome. He lives and dies with the weather, which can
be particularly hard in Texas. Drought or deluge at the wrong time can
kill a crop. Maybe it's years of pondering the hot sky which gouged
the crow's feet at the corners of his eyes; maybe it's laugh lines
from the weather's pernicious turns of cruelty and kindness. He embraces
the weather, tries to understand it, and definitely respects it. He tries
to prepare for the weather's vicissitudes.
He did not pay similar attention to his health, and there was no cause
to. Aloys has always been a strong, healthy man who brushed aside ills
that hinder other men. He does not smoke; never has. Nothing could have
prepared him for the cataclysmic news which came out of the blue in August, 2003.
In May of this year, Aloys first began to notice that he was short of breath
and unusually fatigued. When he could not complete a full day in the field,
he began to think maybe something was wrong. In July, he attended his
son Linus' wedding. During the reception, Aloys felt a tightness in
his chest and decided to schedule an appointment with his family physician.
The next week, Aloys met with his doctor, who thought Aloys might be suffering
from the flu, or an inflammation in his throat. Aloys' complaints
of chest pain persuaded his doctor to make a referral to a cardiologist.
The cardiologist took a sonogram of Aloys' throat and tested him for
Lyme Disease and for the West Nile virus, but could not find anything
wrong with Aloys. The cardiologist asked Aloys to return in two weeks
for additional blood tests. Up to this point, Aloys had yet to have a
chest film taken.
Aloys with sons Linus and Glenn
About one week later, Aloys awoke in the middle of the night with a sharp
pain in his chest. He could not breathe. He was rushed south down Interstate
35 to Denton Regional Medical Center, where he was quickly admitted. A
chest film was taken which revealed a right-sided pleural effusion. On
August 7, Aloys underwent a thoracentesis. Nearly 2000 ccs of fluid were
removed. A pathologist at the Anatomical Medical Laboratories in Denton
examined the fluid and found no evidence of a malignant process.
On August 12, Aloys underwent a thoracoscopy. Several tissue samples were
removed from the right middle lobe. A chest tube was also inserted. During
the procedure, his surgeon left the operating room and told the Fuhrmann
family that what he had observed in Aloys' chest was "something
I have never seen before" and that the surgery was going to be longer
than he anticipated. The procedure lasted almost three hours.
The specimens were again examined by pathologists at the hospital. The
doctors initially considered a poorly differentiated squamous cell carcinoma;
however, since the lesion was so close to the pleura, mesothelioma and
poorly differentiated adenocarcinoma needed to be excluded using special staining.
The specimens were sent to ProPath Laboratory in Dallas, Texas for special
immunohistochemical staining. The pathologists at ProPath diagnosed malignant
epithelial mesothelioma.
Aloys and Marge Fuhrmann
Aloys was first informed by one doctor that the diagnosis was not cancer,
but unfortunately, approximately fifteen minutes later, a second physician
came into his room and frankly told Aloys and his family that he had a
rare and incurable cancer. According to Aloys, "everyone told me
it's just a real bad cancer, and it's not easy to treat at all".
The Fuhrmann family was shocked and devastated. The next day, while still
admitted, Aloys consulted with an oncologist who informed Aloys that surgery
was not an option. Rather, Aloys' best chance was the current "gold
standard" chemotherapy for mesothelioma, Alimta with Cisplatin.
Meanwhile, the Fuhrmann children went on the Internet to learn more about
mesothelioma, treatment options and treaters. They discovered Dr. Roy
Smythe at the M.D. Anderson Center in Houston and contacted his office.
Dr. Smythe wanted to see Aloys immediately for evaluation and possible
surgical intervention. After careful consideration, Aloys decided that
even if Dr. Smythe felt surgery was in fact possible, he preferred to
take Alimta.
On September 3, Aloys began treatment with Alimta in combination with Cisplatin
at Denton Cancer Center. The initial treatment left Aloys nauseous and
weak for days. He said "for ten days or so you just feel terrible,
you can't hardly eat anything, your stomach is upset -- it's just
real bad."
He receives one treatment every three weeks and has since completed his
eighth treatment. A CT scan was taken in January that showed no tumor
activity. Although still nauseous for days after a treatment, Aloys, his
family and his doctors are pleased with the progress of the treatments
Since his diagnosis, Aloys has been unable to work in the fields. "It
is one of my favorite things, working on the farm. I was planning to help
on the farm like I had my whole life. I felt I could go another ten years
or more without no trouble". He has hired several people to assist
Kevin with the upcoming harvest. Normally, just Aloys and Kevin could
handle the harvest. Aloys says he can no longer operate the combine because
"it just wears me out." Aloys is terribly disappointed and depressed
about not being able to work: "It is something I really, really love
to do. It is just killing me to sit here when I know there is so much
work to do. I'm trying to look to the future, but I don't know
what to look for. You can't look, you just can't look with this
thing in my chest."
He is also unable to spend time with his grandchildren. He used to play
ball with them, take them fishing or just drive around the farm. It is
a rite of passage for the grandkids to learn to operate the combine at
a certain age with Aloys as their teacher. The kids are patiently waiting
for their grandfather to get well so they can climb up next to him in
the cab and participate in the harvest, as all Fuhrmanns do. We will keep
you posted on the progress of this larger-than-life Texan.
Fuhrmann Family
*** POSTED FEBRUARY 16, 2004 ***
An Update -- 8/25/05
I am Aloys Fuhrmann's daughter, and we are so thankful for the information
on the Roger Worthington website. I hope that by updating my father's
profile, maybe some other patient or family will find some useful information.
On Sept. 3, 2003, my father began the Phase III clinical trial of Alimta/Cisplatin
every 3 weeks. After a few treatments, the CAT scan revealed shrinkage
of the tumor and my father's symptoms had tremendously improved. He
experienced nausea and weakness for about a week after each treatment.
He took 9 treatments of this combination then was changed to Alimta alone
for 3 more treatments due to tingling in his feet and ringing in his ears
caused by the Cisplatin. It was decided by his oncologist that it was
time for a treatment break. This was in May of 2004.
My father was able to really enjoy the break. He worked hard on the farm
everyday doing his usual physical labor. He always had a smile on his
face and a positive attitude. In July 2004, he started to feel minimal
shortness of breath and reported it to his doctor. It was time for a follow
up CAT scan anyways which revealed growth of the mesothelioma tumor in
the right lung and indicaton of a lymph node being affected by the disease.
Although this was disappointing news, my father simply told the doctor
to do what she could and he would do the best he could.
From July 2004 to September 2004, it was decided to give him a combination
of Alimta/Gemcitabine. Again after some treatments, the CAT scan showed
shrinkage. He continued on this treatment with stable disease. The treatments
caused his blood counts to drop sometimes to dangerous levels. He took
many Neupagen and Aranesp shots to offset the effects of the chemo. He
couragously and positively continued until the oncologist felt she had
maximized the combination and began another treatment break on September 27, 2004.
During this time, we had been looking into other clinical trials that he
may be able to participate in. We became especially interested in an immunotoxin
therapy for mesothelioma with Dr. Raffit Hassan at the NCI in Bethesda,
Maryland. We liked the idea that the treatment had been fairly easily
tolerated and it was a one time treatment with a minimal hospitalization.
After much consideration, consultations, testing, and planning, my father
traveled by plane, for the first time in his 69 year life, to the NCI
in January 2005. On January 17, he began the treatment. He was hospitalized
for one week. He experienced the expected side effects of shortness of
breath, temperature, and retention of fluid. He was able to return home
and after about a week, he started to feel like he was recuperating. We
made plans for a follow up appointment at the NCI in one month.
On February 14 we made our return trip to the NCI. Dr. Hassan was so attentive
and kind. All of the follow up tests looked good with the exception of
the left lung showing fluid build up. My father was seen by the cardiologist
to rule out any heart problems that could have caused the fluid. We left
there with the recommendation that we make plans for a thoracentesis to
drain the fluid when we return home. Four days later we were back in Texas
and made arrangements for a CAT scan and thoracentesis. My father's
shortness of breath had been worsening. The CAT scan revealed a pulmonary
embolism in the right lung and increased fluid in the left lung. He had
1200cc's of fluid removed from the left lung and was admitted to the
hospital for treatment of the pulmonary embolism. He started high doses
of blood thinners. Days later, we heard the terrible news that the cytology
report on the fluid from the left lung was positive for cancer. Although
it was devastating to hear this news, my father bravely moved forward,
simply asking the doctors to give him any treatment they think may help him.
In February 2005, he began Alimta alone. The doctors felt he was very weak
and this may be tolerated better than anything else at this time. But
after 2 treatments, the fluid returned and he underwent another thoracenteses
draining 1200cc's of fluid again. The oncologist decided to add Carboplatin
to the mix and after 2 more treatments the CAT scan showed improvement
and shrinkage. He continued with this regimen until July 2005. In May,
he again underwent thoracentesis of the left lung, but the doctor felt
he still needed to complete this cycle of treatment before considering
another treatment. His overall strength and stamina had declined although
he would somehow will himself to continue to drive the tractor and harvest
the soy beans. His work and family give him so much desire. He is truly amazing.
In the last 2 months he had been complaining of worsening shortness of
breath and fatigue. The CAT scans had showed stable disease, but the doctors
thought that maybe he had developed pneumonia because he had some fevers
and a cough. His pain had also increased for which they prescribed a Fentanyl
patch that was very helpful. Finally, on August 8 2005, the oncologist
started him on oxygen therapy and again had him consult with his pulmonologist
for possibly removing what seemed like fluid from his left lung again.
Upon consultation 2 days later, the doctor decided to do a bronchoscopy
that revealed no pneumonia or excess fluid. Instead he said it was his
airways being squeezed by something, most likely the tumor on the pleural
lining. We went home that day feeling very depressed and just decided
we had to accept what was happening. Just 2 days later his condition had
worsened to the point that we had to take him to the emergency room due
to severe shortness of breath. The ER doctors determined he was very anemic
and decided to give him 2 units of blood. After receiving one unit he
did not improve, he actually worsened. The doctors started looking closer
and discovered that he had a massive pericardial effusion. He had to have
an emergency procedure to drain it. The doctor removed 1150cc's of
blood from the pericardial sac. My father felt instant relief, but still
faced a long road ahead. Because it was 3:00am on a Saturday night, my
father did not get to see the thoracic surgeon until the next day and
it was decided that on Monday he would have a heart surgery to perform
a pericardial window to drain the fluid in the future if necessary. My
father again bravely faced the procedure and made it through. We are not
sure at this time why he had the bleeding around his heart, the cytology
exam of the fluid is negative for cancer and we are still waiting for
the biopsy report. They think the bleeding could have been caused from
the high levels of Coumadin he had been taking for 6 months following
the pulmonary embolism. He was discharged on the following Saturday August
20. Home health care began and like always, the nurses and therapists
comment on my father's positive attitude and sincere kindness and humility.
He saw his oncologist 2 days ago, and was told that his chest x-ray looked
great with no fluid accumulation in his heart or lungs. His blood counts
had improved and his breathing was getting easier everyday. He plans on
weaning himself off of the oxygen as he figures it will be hard to bring
in the combine for the upcoming corn harvest. The oncologist plans on
beginning chemo this week Friday. He will be taking Navelbine once per
week indefinitely. Daddy says, "if they think it might help me, I'll
take it." My mother is continually at his side giving him the best
care possible. She even climbed in the tractor with him yesterday as they
brush cut 30 acres together His six children, 11 grandchildren, 4 sisters,
3 brothers, and his entire extended family and community are all continually
amazed at his desire for life and strength to endure all that he has.
He has 2 more grandchildren on the way, one of them being mine due in
October of this year, the other being my brother's due in February
of next year. We feel so cheated by this horrible disease. We are thankful
for the wonderful times we have so greatly appreciated and treasured for
the past 2 years. Besides the tremendous medical worries and stresses,
the financial burdens of attaining treatment, traveling, medicines, etc...
have been astronomical. We thank the Roger Worthington Law Firm for all
of their support.
Please let me know if you have questions concerning any of this information.
His medical history is quite complicated. Thanks again and God bless!
Julie Martin
Mr. Alloys Fuhrman passed away on June 22, 2006