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Answered Prayers: CA Pastor Embraces Innovative Treatment

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Pastor Charles Van Kirk enjoyed lifelong health. In the spring of 2007, however, he noticed shortness of breath when going on lunchtime mountain bike rides with a friend. His normal route, which he could easily do with minimal exertion, left him with a painful stitch in his side.

He decided to follow up with his family doctor for a check-up. A chest x-ray revealed scarring or thickening in the lung. , Dr. Elwood Cohen of Lake Arrowhead, California, then ordered a CT scan with contrast. Charles suffered an allergic reaction to the iodine and was hospitalized for over a week. The CT, however, confirmed the presence of an abnormality in the lung.

Charles was next referred to a pulmonologist, Dr. Jason Linn, in San Bernardino.

Dr. Linn diagnosed a pleural effusion and drained the fluid surrounding Charles's lung with a thoracentesis. The fluid returned, which required a second thoracentesis to remove it. Unbeknownst to Charles, this was the classic pattern for mesothelioma. Fortunately, his pulmonologist was concerned about the recurring fluid and referred him to a surgeon, Dr. Christopher Gibson.

Dr. Gibson decided to surgically remove the mass from Charles's lung, but when Dr. Gibson entered the chest cavity, he realized that the tumor was very big and actually encasing the lung. The planned procedure couldn't get the tumor, so he took the opportunity to cut off a slice of the tumor for lab analysis. Pathology analysis of the tissue resulted in a diagnosis of malignant pleural mesothelioma. That was the bad news. The worse news was that the cellular subtype of the tumor was biphasic, or a mixture of epithelial (40%) and sarcomatoid (60%) cells. This type of tumor is especially resistant to chemotherapy and to surgical treatment.

Surfing for a solution

Charles and Diane with their daughter Christa and her husband in Santa Monica, California. May 2006
Fortunately, Pastor Van Kirk had a secret weapon: his two daughters and their use of the Internet. As they meticulously searched through the countless web sites purporting to provide medical options for mesothelioma patients, they finally located information about the best treater for pleural mesothelioma in California, Dr. Robert Cameron at UCLA's David Geffen School of Medicine and director of the UCLA mesothelioma program.

Dr. Cameron ordered a PET scan and requested that the UCLA pathologists be provided with the tissue slides in order to confirm the diagnosis. If the pathology report indicated that Charles's tumor was epithelial rather than biphasic, he would be able to perform the lung-sparing PD surgery.

Unfortunately, the UCLA lab confirmed the initial reading from San Bernardino. Charles had biphasic meso, and unless the tumor could be reduced with chemotherapy Dr. Cameron would be unable to perform the lung-sparing surgery. Given the refractory and aggressiveness of biphasicmesothelioma , the promise of chemo seemed dim.

Ace in the hole

Dr. Cameron recommended that Charles consult with the leading researcher and practitioner on the West Coast specializing in chemotherapy for sarcoma, Dr. Sant Chawla of the Sarcoma Oncology Center in Los Angeles. Dr. Chawla has treated several of Dr. Cameron's sarcomatoid mesothelioma patients with many of the same drugs that are used to treat sarcoma. Dr. Chawla is one of only two doctors nationwide who offers a clinical trial for mesothelioma using conventional Alimta and Cistplatin, plus an innovative anti-angiogenesis drug that has not been approved by the FDA.

Dr. Sant Chawla
Charles consulted with Dr. Chawla and enrolled in the Phase I/II trial. In order to enroll, Charles had to meet several criteria: he had confirmed biphasic pleural meso, with measurable disease greater than 20mm, staging greater than equal to stage II using the IMIG system, ECOT performance status less than or equal to 2, and an estimated survival time of at least three months.

The regimen produced an unexpected tumor response of sorts, although medically a "response" is defined by a uniform reduction of tumor by one centimeter or more. Though the tumor did not shrink, follow up scans performed by Dr. Chawla showed the tumor had not expanded, which itself is rare for such an aggressive tumor.

At the earlier examination in April, Charles's tumor measured 55 x 36mm in diameter. Rather than the expected growth and spread of such an aggressive tumor, the CT scan taken in late May showed that the tumor size in spots was 49 x 33mm, which the reading physician evaluated as "essentially no change in size since prior examination." As importantly, the physician noted that there were no new masses.

Although Charles's left hemithorax demonstrated a decrease in overall volume and a circumferential pleural thickening that was particularly prominent at the base of the left lung, a medical comeback of sorts was in progress: The lack of spread was enough to justify a second consultation with Dr. Cameron, who was pleased. "First, I was surprised by the lack of growth," said Dr. Cameron. "Second, I was pleased to learn that Dr. Chawla had a new protocol that incorporated an anti-angiogenic compound into the mix along with Cisplatin and Alimta. I had referred many sarcomatoid patients to Dr. Chawla before, but Pastor Van Kirk was the first to participate in this new protocol."

The best defense

Dr. Robert Cameron in surgery
Dr. Cameron decided to operate, another "first "of sorts. He scheduled Charles for the lung-sparing pleurectomy / decortication (P/D) surgery. The surgery was grueling, lasting over twelve hours. Once inside the chest cavity, Dr. Cameron found something even more promising than the "no growth" of the preliminary CT scan. He found extensive scar tissue surrounding the tumor, something he'd never before seen from a biphasic patient on a chemotherapy protocol. He couldn't be sure until after the pathologist reviewed the specimens later, but at the time Dr. Cameron's impression, in so many words, was "Wow, the chemotherapy regimen must have helped."

A week later, the pathologist issued his report, which further stimulated Dr. Cameron's interest. About 75% of the tissue was scar tissue and 25% was tumor. What did this mean? Did it mean that Dr. Chawla's cocktail had killed 75% of the cancerous mesothelioma cells?

Not necessarily. "We don't know if the treatment was solely responsible for the pathologic finding that only 25% of the tissue removed was tumor. The scar tissue could be a natural biologic result of the tumor itself. We need to follow up on this very intriguing clinical result," observed Dr. Cameron.

So much to live for

Shortly after the difficult surgery, the robust and hard charging pastor was back on his feet. The best defense had truly been an aggressive and innovative offense. A miracle? That depends on who you ask. For Pastor Van Kirk and his family, the remarkable response, and the successful surgery, was more than random luck. "There are all kinds of miracles," says Charles. "Mine happened to be the kind that comes from great science, lucky timing, and the best mesothelioma doctors on the West Coast."

Charles officiating at his daughter's Lindsey's wedding in June of 2006
Charles and his wife have three beautiful daughters who have given them three lovely grandchildren. Their happiness and rejoicing at seeing their family grow is a special kind of love and joy known only to grandparents. As Charles says, "Few moments compare to a father walking his daughter down the isle to give her to a deserving young man, and fewer moments still compare with the joy of being blessed with grandchildren."

For the last eighteen years, Charles has served as the pastor of the Rim of the World Community Church located in Running Springs, California. Running Springs is a mountain community located near Lake Arrowhead and Big Bear Lake. "As a mountain preacher, you wear a lot of hats," Charles says with a big grin. Charles has a congregation of approximately 130 and is involved in the church's men's group which performs home repairs, shovels snow, and chops wood for widows and others in need of assistance. Charles and his church provided extensive shelter and assistance to families who were displaced as a result of the wildfires which ravaged the area in 2006.

"I love my work and have kept up with my responsibilities as pastor despite the symptoms and the treatment. Of course, I've had lots of help from my family and congregation."

Charles has always lived the healthy and active lifestyle. As a veteran who served during the Vietnam War and as a state champion swimmer in high school, an excess of strength and energy have characterized his life. It's an excess he has always put back into the community and into the lives of people in need. Since moving to Running Springs in 1985, Charles has taken full advantage of the numerous recreational activities available in his mountain surroundings. Before the onset of his symptoms, he and his wife Diane would go for hikes virtually every morning. Charles was also fond of going out for exercise at lunch. In the winter this involved going snow shoeing and in the summer this involved going mountain biking or jogging. He and Diane also enjoyed skiing at many of the nearby ski resorts.

Charles Van Kirk family June 2006
Charles is a man who is loved by his family and by the community which he serves. He is used to being the one that others turn to for strength and support in their time of need, and is grateful for the outpouring of love and support he has received since being diagnosed with mesothelioma. His optimism about the future has been tempered by concern for the well-being of those who have grown to rely upon him. "I put my faith in God, my love in my family, and my trust in my doctors. What we've been able to get as far as extended life from the treatments so far is more than we ever hoped for at first. We're not giving up."

He can't give up now. Charles is the poster boy for what hopes to be a breakthrough treatment plan for sarcomatoid mesothelioma patients.

*** POSTED NOVEMBER 20, 2008 ***

An Update -- 7/30/2009

Since undergoing the pleurectomy/decortication surgery with Dr. Robert Cameron at UCLA Medical Center in September 2008, Dr. Cameron has continued to monitor Charles closely. Charles has been seen once every three months and undergoes CT and PET scans before every visit so Dr. Cameron can determine whether the tumor is recurring. On January 9, 2009, Dr. Cameron found that the scans did not reveal any recurrence. Scans taken prior to an April 24, 2009 visit revealed some activity in the cells which Charles’s oncologist characterized as “suspicious” for recurrence, but Dr. Cameron concluded that the activity was part of the normal healing process from the surgery and post-surgical radiation treatments. The most recent visit with Dr. Cameron occurred on July 24, 2009, during which Dr. Cameron concluded that there was once again no evidence of recurrence!

Even with chemotherapy, surgery and radiation, it is impossible to remove all of the cancer cells from Charles’s chest. It is for this reason that Dr. Cameron will continue to monitor Charles’s condition closely so that prompt action can be taken at the first sign of recurrence.

For now, “Pastor Chuck” (as he is known to his parishioners at the Rim of the World Community Church) is healing from the effects of the cancer and all of the treatments needed to kill it. He remains encouraged by the continued good news and the answer to his prayers that his current status represents. He is now "back in the saddle" at Rim Church, giving the Sunday messages, attending or presiding at a full schedule of meetings, and doing counseling and administrative work.

We join with Pastor Chuck’s family, friends and parishioners in asking for the Lord's continued grace in keeping the cancer from returning.

A Holiday Message and Theological Response to “The Median Isn’t the Message” from Meso Survivor Pastor Charles Van Kirk

November 30, 2010

By John Caron:

A few days before Thanksgiving, I came back across the insightful and inspirational essay “The Median Isn’t the Message” written by Harvard and NYU evolutionary biology professor Stephen Jay Gould shortly after he was diagnosed with peritoneal mesothelioma in 1982.

In the essay, Professor Gould discusses his reaction to the median survival statistics of only eight months for patients diagnosed with his disease. Rather than resign himself to this fate, Professor Gould explained that statistics are merely abstractions which do not encompass the full range of variation and concluded that he should be in the favorable half of the upper statistical range because of his age, positive attitude, early diagnosis and the fact that he received the best available medical treatment. Professor Gould proved to be correct, surviving 20 years following his diagnosis with mesothelioma before passing away due to an unrelated condition.

I thought some of my mesothelioma clients would enjoy reading this timeless and optimistic piece and forwarded it to them along with a Thanksgiving greeting. Once such client was Thurl Charles Van Kirk, Pastor of the Rim of the World Community Church in Running Springs, California. “Pastor Chuck” has himself defied the statistics by surviving almost three years since his diagnosis with biphasic mesothelioma—and counting!

Knowing that Pastor Chuck received degrees in theology before serving 30 years as a Pastor, I was eager to receive his perspective on the evolutionary biology professor’s essay about statistics and survival. Pastor Chuck certainly did not disappoint.

Printed below with his permission is Pastor Chuck’s eloquent and thoughtful response culminating in a timely and valuable prayer for this Holiday Season.

Please enjoy and pass along to others.

Thanks again Pastor Chuck!

Dear John:

Thank you for the article, “The Median Isn’t the Message” by Stephen Jay Gould. It reminds me of a passage in Luke 16.8,

“…There was a certain rich man who had a steward, and
this steward was reported to him as squandering his
possessions.

And he called him and said to him, ‘What is this I
hear about you? Give an account of your stewardship, for
you can no longer be steward.’

And the steward said to himself, ‘What shall I do,
since my master is taking the stewardship away from me?
I am not strong enough to dig; I am ashamed to beg.

I know what I shall do, so that when I am removed from
this stewardship, they will receive me into their homes.’

And he summoned each one of his master’s debtors,
and he began saying to the first, ‘How much do you owe my master?’

And he said, ‘A hundred measures of oil.’ And he said
to him, ‘Take your bill, and sit down quickly and write fifty.’

Then he said to another, ‘And how much do you owe?’
And he said, ’A hundred measures of wheat.’ He said to him.
‘Take your bill, and write eighty.’

And his master praised the unrighteous steward because
he had acted shrewdly; for the sons of this age are more shrewd
in relation to their own kind than the sons of light.”

Professor Gould shed some light upon a gloomy topic. Statistics, ah, in college I spent a year deriving formulas by hand just in case our computers crashed. Through all the exercise of tangent and co-tangent, designing experiments and penning down conclusions, never mind their significance; we learned that Professor Gould was right. Statistics can be so stretched. And there is that mystical point where truth gives way to lies and lies fade into truth. “It’s all relative? To what? To whom?” My answers came from the study of theology.

What appeals to me in the above scripture appears in its preface, “this steward was reported to him as squandering his possessions.” Professor Gould dazzles the reader with his understanding and definitions. But the point in Luke’s account is that there shall be a day of accounting where the mean and the median will be required for each of us.

Yes, attitude is everything. At times my hardest struggle is just to get up in the morning. Deep, throbbing pain in my side demands attention. So I pop some pain meds and lay back down pondering what heaven will be like when we receive new bodies that never break down, get sick, wrestle with illness or suffer!

So thank you again. I’ll be seeking to be in the distribution of those who thrive even in the midst and realities of diseased bodies. The steward was wise in how he finally got those uncollectible accounts to pay up. It wasn’t the full measure but something is better than nothing. I suspect his employer had been trying to receive payment for years from his debtors. This shrewd servant found a way to endear himself with his master and those who owed him money.

My prayer for you and yours this holiday season is that you make time to celebrate the little things, the kindnesses and tenderness afoot from strangers, friends and family. Perhaps we as sons of light might advance those in our sphere of influence to reconsider the glory of Christmas, the cheer of Thanksgiving and fulfill the goals our master bids us do in 2011.

God Bless,

Charles Van Kirk

*** Pastor Van Kirk passed away on May 25, 2012 ***