The Difference Between An Ordeal And An Adventure Is Attitude

Jim Foster decided to look further than the standard wisdom on treating-or not treating-mesothelioma. Today, three years after diagnosis, he and his wife Shannon are in the fifth month of an extended sailboat cruise down the western coasts of Europe and across the Atlantic to the Caribbean.

Jim, a corporate pilot and former U.S.M.C. fighter pilot, was 56-years-old when he was diagnosed with mesothelioma. Doctors delivered to Jim the dictum that many still consider the appropriate response when faced with mesothelioma's historically abysmal reputation: that any attempt to treat this disease was worse than the disease itself, that no one at the diagnosing hospital would treat Jim, and to go home, get his affairs in order and get ready to die. Jim decided to look further than the standard wisdom on treating-or not treating-mesothelioma. Three years later (after undergoing surgery, chemotherapy and a phase I clinical study of a new generation cancer drug so experimental it does not even have a name), Jim and his wife Shannon are currently in the fifth month of an extended sailboat cruise down the western coasts of Europe and across the Atlantic to the Caribbean.

Jim's symptoms began while he and Shannon were on vacation in Lake Tahoe in the spring of 1999. Jim experienced difficulty breathing at the high altitude and also suffered severe soreness in the lower right rib area. On his return to Texas, he underwent a thoracentesis and four quarts of fluid were removed. Three weeks later, an additional five quarts were removed.

Jim was diagnosed with mesothelioma at Methodist Hospital, Houston, on July 22, 1999. An oncologist at Houston's M.D. Anderson Cancer Clinic told him that treatment was futile. Originally from Minnesota, Jim and Shannon knew of the Mayo Clinic in Rochester, Minnesota, where family and friends went for expert medical advice and treatment. They visited Mayo in early August for a consultation. The physicians there considered Jim an excellent candidate for an E.P.P. (extrapleural pneumonectomy) because he was young (56), was in otherwise excellent health, was a non-smoker, and was only in stage 1 of the disease. Dr. Daniel Miller, a member of the Science Advisory Board of the Mesothelioma Applied Research Foundation ( MARF), performed the surgery on August 25.

The surgery lasted nine hours and included scraping the chest wall and resecting the diaphragm. Because the pleura had previously been "talc"ed, the lung was a solid mass, making the surgery more difficult. Nonetheless, Dr. Miller was able to remove much of the disease and felt positive about the outcome of the surgery.

After six weeks of recuperation at their home in the golfing community of The Woodlands, Texas, the Fosters returned to Mayo for approval to continue treatment with chemotherapy. They were given the "recipe" or protocol for chemotherapy (Gemcitabine/Cisplatin) to prevent progression of the disease and returned to The Woodlands for treatment.

Jim was very sick the entire four months of treatment. His 205 pound, 6-foot frame dwindled to 150 pounds. His blood counts fluctuated and he developed neuropathy (numbness) in his legs, feet, toes and hands, but he never missed a session. Jim would drive himself to the clinic no matter how weak he was. Late on Christmas Eve, 1999, the Fosters sat in a hospital waiting for a blood transfusion because of low blood counts. Jim looked at Shannon and said, "Well, I guess I know what I'm getting for Christmas!"

Jim and Shannon have been married 37 years. They met at a small Lutheran college in St. Peter, Minnesota. After graduating in 1964, Jim joined the Unites States Marine Corps and entered the training command to learn to fly at Quantico, Virgina. He was commissioned 2nd Lieutenant at Pensacola Naval Base, Florida, where Shannon pinned on his "Wings of Gold." In preparation for a 13-month tour in Viet Nam, Jim spent time in Meridian, Mississippi, and Beeville, Texas, training in the A-4 Skyhawk.

The Fosters enjoyed a life of traveling and dreamed of owning their own sailboat to cruise the world together upon retirement. But, plans to realize those dreams came to a halt with Jim's diagnosis. Their daughter Leesa, who lives in Seattle, Washington has worked as an environmental consultant for 5 years, and often supervised the removal and disposal of asbestos. The use of protective suits and chemical showers to shield workers from deadly asbestos fibers was all too familiar to her. She was obviously reluctant to share with her parents what she knew of the grim details and discouraging outcomes of a mesothelioma diagnosis.

During the next 30 months, Jim regained most of the weight and strength he had lost prior to diagnosis and the initial chemotherapy regimen. Jim and Shannon started to play golf again and Jim returned to a full work schedule. He was able to stay with the same company as aviation manager but knew he would never fly again due to the numerous pain medicines he required daily. A new team of experienced doctors and researchers that specialize in the treatment of mesothelioma had been hired at the MDA Cancer Clinic since the Fosters' first visit. Jim returned to MDA for monitoring.

For two years CT scans remained clear of any signs of the disease. Jim and Shannon researched treatments by monitoring mesothelioma websites. Pet scans were often mentioned as a new tool to detect mesothelioma. In February 2002, MARF Science Advisory Board member Dr. Roy Smythe of MDA ordered a PET scan for Jim. The Fosters waited days to hear those welcomed words: "good news." Instead, they were told that the mesothelioma had returned in the form of many tumors scattered throughout the diseased lung cavity. The left lung remained cancer-free. A thoracic surgeon, a radiologist and an oncologist at MDA evaluated the tumors and agreed that nothing more could be done. Jim's body could not tolerate additional conventional chemotherapy. The tumors were too widespread; surgery and radiation were out of the question.

Then oncologist Dr. Roy Herbst offered Jim the opportunity to participate in a phase I clinical study that was just starting at MDA. Jim fit the study's patient profile and became the new cancer drug's first recipient. The experimental drug, referred to only by its function and a number - tyrosine kinase inhibitor VEGFR-2 #013736 - and made by Agouron Pharmaceutical, is administered in tablet form. Trial physicians addressed the drug's side affects: high blood pressure, achy joints and acid reflux. After eight weeks, scans and blood samples were taken. The scans indicated that the tumors were not only arrested, but they had shrunk! The doctors and nurses were ecstatic. The Fosters hoped for continued success after 24 weeks and began to get ready to fulfil their dream of taking an extended sailboat cruise together.

Jim retired, the Fosters sold their Texas home and they found the sailboat of their dreams in Turku, Finland. They christened the 42-foot Nauticat "Gustie" because they had attended Gustavus Adolphus College whose students and alumni were known as the "Gusties." The Fosters set out from Finland and sailed down the Swedish coast, through Denmark to Kiel, Germany. Their journey would take them through the Kiel Canal, into the North Sea, and on to England. From there, they cruised the coasts of France, Portugal, and Spain, and down to the Canary Islands. They have joined the ARC (Atlantic Rally for Cruisers) and plan to cross the Atlantic Ocean to spend the winter of 2002-3 in the Caribbean.

Every 4 weeks Jim flies back to Houston for physician visits, medical exams and scans. During his visit in September, the Fosters received both good and bad news. The tumor had shrunk again, this time by a total of 40%. However, Agouron Pharmaceutical was shutting down the clinical trial, as two of the four patients enrolled at MD Anderson had recently died. The Fosters never knew whether this was due to the drug or not. They also did not know if and when the drug company would allow Jim to return to the drug.

Undaunted, Jim and Shannon sailed on, slicing through the Bay of Biscay at 8.5 knots, or as Shannon put it, "Like a hot knife through butter." Even the Costa de Muerte (Coast of Death) could not deter them, though Gustie rolled rail to rail and pitched in enormous swells crashing on her foredeck. Sleeping was out of the question as they watched every unsecured item in the cabin fly from side to side, and trusted their lives to the skill of Gustie's master boatbuilder, Kai. Finally, Jim and Shannon put in to the harbor of La Coruna, Spain, and celebrated Shannon's October birthday. Jim has to monitor his high blood pressure three to four times a day, but other than that, the Fosters are warm, dry and cozy in their cabin, and looking forward to the authentic paella they will find in Bayona, Spain. They also continue to look forward, as Shannon puts it, to "seeing the world while we're still on it."

As of this writing, Jim has received word that the clinical trial at MD Anderson is again underway, allowing him to get back on course with his treatment as well

*** POSTED DECEMBER 23, 2002 ***

An Update -- 7/9/03

Jim and Shannon crossed the Atlantic Ocean with the A.R.C. (Atlantic Rally for Cruisers). 225 boats with multicolored sails departed Las Palmas, Canary Islands on November 24, 2002. Jim relayed that sailing Gustie on the Atlantic was like surfing a 15 ton surfboard, up one crest and down the next. Their emotions varied from exhilaration to boredom, fear to pride, contentment to confusion and amazement to joy, sometimes all in the same hour. After 18 days and 2700 nautical miles, their crossing ended in St. Lucia. Leesa, their daughter, greeted Jim and Shannon joyously, and they celebrated The Holidays together aboard Gustie.

Leaving winter behind, relatives and friends began to arrive in The Caribbean. They also wanted to experience life on Gustie and swim in the crystal clear waters. After almost a year aboard Gustie, Jim and Shannon left Gustie in Trinidad and returned to their home in Minnesota for the summer.

Throughout this journey, Jim has returned monthly to Houston and MDAnderson for blood tests and scans to monitor his mesothelioma. He's still participating in a phase 1 clinical trial with Dr. Herbst at MDAnderson. The progression of the cancerous tumors has remained static, after the initial tumor reduction no new growth is still noteworthy.

Jim believes that with the new generation of cancer fighting drugs it will be possible to continue to live rewarding lives with so far, incurable cancers.

Jim and Shannon are charting the next leg of their sailing journey. In the fall of 2003, they plan to return to Trinidad and Gustie, sail the northern coast of South America through the Panama Canal and on to the Sea of Cortez.

An Update -- 6/16/04

Dear friends,

We left Gustie in Puerto Rico at the end of January. Jim was not feeling well enough to continue our journey to Florida. A tumor was pushing on the SVC (superior vena cava) and a stint was inserted. Jim found immediate relief.

Rick Olson, my brother-in-law, a hired captain and I sailed Gustie to Charleston, SC. Jim (feeling better) joined me to sail the ICW (intercostal waterway) to Rock Hall, MD, (Chesapeake Bay). After much deliberation and consternation our thought is to sell our lovely floating winter home. The boat is equipped with all the bells and whistles to ease the sail of her, but we both think it has gotten to be too much for Jim.

In early Feb. Alimta, a new and approved drug became available. Jim has just finished the 6th round of treatments (every 3 weeks) along with radiation. Yesterday we met with doctors, viewed and received ct scan results. AND……the new drug is working. The tumors as are reducing in size and the cancer markers have halved. So, who knows? We may end up living aboard Gustie next fall anyway, if the tumors continue to go away AND the boat hasn't.

Jim was diagnosed 5 years ago in July with mesothelioma and given 6 -" 12 months to live. In celebration of our 39 anniversary and another July together we are taking a Hawaiian Island cruise.

Because of all your good thoughts, wishes and prayers (and don't quit now)

THE JOURNEY CONTINUES.

The Fosters.

Jim Foster, 62 of White Bear Lake, died after fighting mesothelioma courageously for six years, an insidious disease caused by asbestos exposure.

Preceded in death by his father, Elmer and father and mother in-law Dean and Agnes Shawbold.

Jim is survived by his best friend and wife of 40 years Shannon (Shawbold); daughter and husband Leesa and John Koch, Seattle, Washington, mother Jeanette Foster, New Hope, sister and brother-in-law Mary and Rick Olson of Annandale, MN, brother and sister-in-law Dean and Mary Shawbold, White Bear Lake, MN.

Jim, an Eagle Scout, graduate of Gustavus Adolphus College and the University of Minnesota was a Marine Corps Pilot, Vietnam Veteran and Corporate Pilot. Upon retirement Jim and Shannon turned their dream into reality with the purchase of Gustie, a 42 foot sailboat.Theysailed from Turku, Finland to St. Lucia Island, in the Caribbean.

A celebration of Jim's life for family and friends is scheduled for 4:00 PM, Sunday, August 14 at Jim and Shannon's residence.

Memorials are preferred to MARF Mesothelioma Applied Research Foundation, 1123 Chapala Street, Suite 200, P.O. Box 91840, Santa Barbara, California 93190-1840.

Shannon, Leesa and John