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Former Boiler Worker Struggles To Keep Lung Cancer At Bay

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Just three years ago, John Barnes was making the short commute from his home in Iowa Park to Sheppard Air Force Base in Wichita Falls, where he worked maintenance. A former 20-year Navy boilerman, this good-natured Texan has always been a hard worker and a steady provider for his wife and two adopted, disabled sons.

On days off and vacation, the Barnes family liked water-skiing, fishing and just plain relaxing at nearby Lake Arrowhead, and a little farther away, at Lake Texoma. They planned to do a whole lot more of the same during a long, hearty retirement.

Today, 61 year-old John Barnes remains good-natured, but he has little to smile about. He does not possess the physical strength to get his boat out on the water for even a little light fishing. Cancer has metastasized from his asbestos-scarred lungs throughout his body and cast a dark shadow over his life and the lives of all who love him. Before the cancer, he had to wear a mask to assist his sleeping - due to a sleeping disorder. Since the cancer, he also needs oxygen to help him sleep.

EARLY TROUBLES LEAD TO A SIMPLE SURGICAL SOLUTION

John traces his troubles back to December 3, 1999, when he underwent a routine chest film at the Base hospital. The film revealed "bilateral pleural thickening" (that is, of the thin, Saran Wrap-like tissue encasing the lungs) which his doctors felt may have been related to his prior asbestos exposure. The film also showed a nodular density projecting over the left middle lung. A CT scan was suggested to rule out the possibility that the nodule represented a tumor.

A December 22, 1999, CT scan at Sheppard revealed nodular densities measuring nine and 11 centimeters on the right upper lobe. The nodular densities appeared to be associated with pleural thickening and scarring within the region of his lungs, and one of the nodular densities looked to have calcifications associated with it. His doctor also noted the possibility of "a sequella of prior granulomatous disease", that is, an inflammatory response to something foreign which had caused pathological changes in the tissues of the lung and/or pleura.

John underwent a CT-guided biopsy at Sheppard on February 1, 2000. Four more needle biopsies were taken from the upper lobe of the right lung. Pathological tests showed the existence of "chronic inflammation" and scarring of the lungs, as well as focal clusters of atypical cells. Although "no frank tumor" could be seen within this biopsied tissue, cytological tests upon fluid removed during the procedure were suspicious for non-small cell carcinoma. John’s doctors believed that he had lung cancer.

John and Jane went into shock. John had quit smoking more than a decade before. But the doctors reassured them that surgery would cure John.

On February 14, 2000, John underwent a right upper lobectomy at the United Regional Health Care System hospital in Wichita Falls. Intraoperative frozen-section analysis and subsequent permanent-section analysis of the biopsied tissue confirmed the diagnosis of adenocarcinoma. Biopsies of the lymph nodes tested negative for malignancy, a reassuring sign that the cancer had not spread to other parts of the body.

After surgery, John’s surgeon told him that he had removed all of the cancer and that John need not worry. John’s doctors did not prescribe any radiation or chemotherapy treatment. John recovered and got back to work at the Base. John and his family had dodged the bullet -- or so it seemed.

AN UNEXPECTED AND TERRIBLE RECURRENCE

About a year later, in the spring of 2001, John sought medical attention for what he calls "a clogged artery" in his neck. His cardiologist noted that John had a history of adenocarcinoma and advised him to seek a follow-up cancer screening. John contacted his primary care physician, who in turn recommended a CT scan. The CT scan of July 24, 2001 revealed two-centimeter masses on both adrenal glands. These masses were not present on the December 22, 1999, CT scan and were "suspicious for metastatic disease", given John’s prior history of lung cancer.

John was referred to a Wichita Falls oncologist who scheduled a PET scan extending from the top of the head to the pelvis. The PET scan conducted on August 15, 2001 at Medical City Dallas found increased metabolic activity at the "enlarged adrenal gland regions," as well as at the left lower lobe and in the right lung near the lower trachea. The areas of increased metabolic activity were consistent with metastases from lung cancer.

In order to be doubly sure before exploring treatment options, John’s oncologist ordered a repeat PET scan for October 4, 2001, at Baylor Medical Center in Dallas, Texas. Unfortunately, the second PET scan confirmed the first.

John consulted with his doctors, who recommended that he immediately begin a chemotherapy regimen utilizing Taxol. The chemo was administered intravenously in cycles of three consecutive Mondays, followed by one Monday off. John’s hair began to fall out, and he was tired all the time. He was given Procrit shots to help increase his energy. A recent CT scan showed that the cancer was responding to the treatments.

GOING BACK TO REGROUP

John’s doctors told him that he probably had only one more year of life. Typically, John and Jane looked on the bright side. As Jane wrote, "We are very lucky as most patients with this type of cancer from onset to end is 10 months and we are in the tenth month." The couple decided to take a three-week vacation in the Northeast, and set off after John’s final chemotherapy treatment.

John and Jane wanted to return to where they began.

Thirty-seven years ago, in 1965, they met at an outdoor movie while he was stationed with the Navy in Newport, Rhode Island. They were married five months later. Jane still has family in the Massachusetts town where she grew up, just over the state line from Newport. Their trip was a time for family, friends and -- as John hastens to add -- fried clams.

DON’T SIT BACK -- ATTACK!

They returned to Texas on July 5. Ten days later, John consulted with his oncologist who advised him to continue treatment with Taxol, despite the prior disappointing CT scan. John agreed to continue; he would rather attack than sit back.

You can see John’s influence on his two disabled sons, Timmy and Ronny. He did not coddle them, but challenged them. Their progress at water-skiing serves as a great example -- they crashed a lot at first, but they kept trying, and soon they were standing on their own. His sons had the strength to fight through their disabilities and playground taunts to graduate from high school. In his senior year, Ronny made the golf team. He got his brother hooked on the game, and now the two head out to the links together.

John wants to get back out on the water, but he just can’t do it yet. The 19-footer needs an oil change, and the impeller in the water pump has to be replaced, but his cancer and the chemo are still holding him back. So for now, Jane stays home with him and sews while John passes time on the computer. He tries to keep his mind off what will happen to Jane and his sons if he can’t get better, but it’s hard. John was the sole breadwinner in the family.

So when these dark thoughts come, John will simply prod himself: "I’m not gonna go!", he says. "I’m sticking around. If that bicycle rider can do it, so can I." John goes on to mention that Lance Armstrong is leading the Tour de France but laughs, "You won’t find me on a bicycle!"

The burly boilerman may not have the right stuff to win the Tour de France, but he has all the tools to beat lung cancer. We will keep you posted on the progress of this lesser known but equally determined Texan.

*** POSTED JULY 22, 2002 ***

*** Mr. John Barnes passed away on December 11, 2003 ***