Hope For a Family
Mr. Russell Denton is a 73 year old retired warehouse man, Navy boiler operator and shipyard worker who was diagnosed in May of 1998 with malignant mesothelioma. He and his wife Leona reside near Oakland, California. In January of 1998, Mr. Denton first began to experience night time sweats. He went to his local hospital where doctors gave him a prescription and sent him home.
The sweats persisted through February. In March, Mr. Denton returned to the hospital complaining of a persistent cough with productive whitish mucous. He was treated with an antibiotic and sent home.
In April, Mr. Denton could no longer stand the constant pain in his left lateral chest. A subsequent chest film showed a large left pleural effusion. On April 20th, a thoracentesis was performed. After removing nearly 1200 cc's of fluid, Mr. Denton complained of severe pain across the back of shoulders. The procedure was immediately halted. Mr. Denton began sweating profusely. He was put on oxygen and transported to the emergency room to rule out pneumothorax. The fluid was sent for testing and returned negative.
On April 23rd, Mr. Denton underwent a video-assisted bronchoscopy. Selective washings, brushings and a few small bronchial biopsies were taken from the basilar segment of the lower left lobe. The specimens were submitted for cytopathological examination, AFB and fungal cultures. The bronchial brushings returned negative for malignancy. At this point, the doctors suspected but could not confirm a malignancy.
On April 29, Mr. Denton underwent a decortication and pleurectomy of the left chest wall. Dense adhesions were found in the pleural cavity. In order to achieve a proper decortification and pleurectomy it was necessary to convert to open thoracotomy. The entire parietal pleural membrane adjacent to the left chest wall was removed. The left lung was then inflated with multiple small air leaks. Two (2) chest tubes were then inserted. The pleural peel biopsies were sent to pathology for analysis. Mr. Denton then received a talc pleurodesis to resolve the air leaks and retard the recurrence of pleural effusions.
On May 12, 1998, Mr. Denton was diagnosed with mesothelioma. Mr. Denton was discharged and sent home. He was physically and emotionally crushed.
On May 15th, Mr. Denton returned to the hospital. In addition to mesothelioma, he was now afflicted with possible pneumonia, anorexia and severe reflex esophagitis. Mr. Denton continued to have intermittent low grade fevers throughout his hospital stay. Mr. Denton was losing weight because he had lost the ability to taste food.
The Denton family began searching for medical experts to treat Russell. On June 16, they visited with Dr. David Jablons at the University of California at San Francisco/Mt. Zion Hospital. Dr. Jablons is a surgical oncologist who specializes in multi-modal therapies for mesothelioma patients. See Dr. Jablons.
Dr. Jablons determined that Mr. Denton's mesothelioma was in stage III with no signs of metastases. He advised Mr. Denton to take appetite inducers (such as Megace) to help him build up his weight and strength. He presented the Dentons with three treatment plans:
- Irradiation of the incision site (virtually mandatory). Of note, it was apparent that the doctors at Kaiser started but did not finish the job, so to speak.
- In addition to option 1, a custom irradiation of other obvious sites of tumor growth, as revealed from CT scans.
- In addition to option 1 or option 2, add systemic chemotherapy. Dr. Jablons' view on chemotherapy was guarded. In his view, chemotherapy would have only a 20% probability of reducing the tumor growth and it would certainly reduce Mr. Denton's quality of life.
Generally, Dr. Jablons was optimistic that a solid follow up treatment plan would help extend Mr. Denton's life. This was very good news to the Dentons, as their doctors at Kaiser offered little hope. Dr. Jablons also noted that UCSF/Mt. Zion was on the verge of opening several new protocols for mesothelioma, including CPT-11 and Onconase. Because of the earlier surgery, a follow up procedure, such as the pleurectomy, was not advisable. Following the radiation treatments, the doctors will assess the pros and cons of adjuvant extensive 3-D conformal radiotherapy of target areas.
The Dentons were pleased with Dr. Jablon's attention, expertise and bedside manner. According to son Dwight, who has been instrumental in helping his mother and father find the best medical treatment available: "Overall, this young man is very sharp. He is aggressive and has a `what are we waiting for' attitude! His analysis was immediate and objective, based on the data presented physically or in the form of the CT scans. He gave us his analysis interactively with four family members in the room."
The following is a very poignant account of Russell's medical history by his daughter- in- law, Linda, who also writes about the impact that mesothelioma has had on the family.
"Dad was the picture of health up until the latter part of 1997. He walked 3 miles everyday with his brother Herschel and kept busy daily helping his family and friends. He has lived his life serving God and his family. Everyone in his neighborhood knows Dad because he's always there to lend a helping hand. Whether it's picking up someone at the airport, or making repairs around the house, Dad is always there. That is, until he became so exhausted that he was unable to continue his daily routine.
On April 19, 1998, Dad was admitted to Kaiser Hospital in Hayward, California. He had gone to his doctor earlier in the day to have fluid extracted from his lung. He had been having problems with a persistent cough and the drugs his doctor prescribed were not working.
Finally, at the insistence of his wife Leona and myself, we pressured him to obtain a chest film from his doctor. Fluid was discovered and then extracted on April 19, 1998. During the procedure Dad developed unbearable pain and was admitted to the hospital. While he was in the hospital he underwent a battery of tests. Everyday we waited anxiously for each test result to come back.
On April 21, Dad celebrated his 73rd birthday in the hospital with the family but was so sick he was unable to eat his birthday cake. A few days later, Dr. Franco, a lung specialist, advised us that he suspected Dad had a lung tumor even though he has never smoked. Dr. Franco performed exploratory surgery looking for a tumor that wasn't there. Next, Dr. Saw, a thoracic surgeon at Kaiser, came in and told Dad and Mom that he suspected mesothelioma.
On April 29, 1998 Dad had a pleurectomy, which involved inserting two chest tubes. He was in alot of pain and slept most of the time. Dr. Saw then came in and told Leona that the biospy came back positive for mesothelioma and there was nothing else he could do for him. He advised us what we had to "take Russ home to die." We were devastated! How was it that an exceptionally healthy man -- who never drank or smoked in his life -- is now so sick? In four short months Dad's weight dropped from 205 pounds to 164 pounds.
Dad has always been the one to take care of his family. When his son Greg had cancer 2 years ago, he was the one to drive him the 30 miles each way for radiation treatments. When I had 13 surgeries for my debilating arthritis, he was the one who made sure that I had everything I needed. In December of 1997, his grandaughter Angella had a beautiful baby boy who was born premature with serious heart problems. Not to worry, Dad was there to see to it that his great grandson Devin and his sister Alexandria had everything that they needed. The families are the light of his life and he is commited to them.
In late 1997, Dad was exhausted but he insisted on seeing his grandaughter Ashley's soccer games. He was always there to cheer her on and to bring her a treat of her favorite french fries after the game. While Dad was in the hospital he continued to tell us how much he missed seeing his grandson Josh's baseball games. Josh would call the hospital after every game and give his "Boppa" the details. Dad hopes to gain some weight and stamina so that he might be able to see some of Josh's summer league games even if he has to go in a wheelchair.
Dad has worked hard all of his life. He was in the Navy and he also worked in a shipyard in Oakland. He worked for Western Electric for 38 years. He was a warehouseman. He worked 12+ hours on many days and weekends. After his long hours at work, he would go home and take his wife Leona out for dinner and run errands (never to complain), as she has never driven a car.
Dad is currently undergoing radiation and his family hopes and prays that it will slow down the progression of this awful disease. It's almost unbearable to see such a loving and wonderful man in such pain and sadness. This is a man who others aspire to be like. His family continues to pray for more time with him."
** POSTED AUGUST 25, 1998 **
Mr. Russell Denton passed away on October 12, 1998