Margaret Shepard (@margieshepard) published a blog post · December 21st, 2012
For Better, For Worse
When Janey Walch said "for better or for worse, in sickness and in health" as part of her marriage vows to her husband Andy more than six years ago, she definitely knew the implications of those words. In fact, their wedding was prompted by the discovery of a brain tumor in Andy, whose surgery was scheduled immediately following their chapel ceremony.
Originally, from Spooner, Wis., Andy was on a conference call six years ago, when he suddenly lost his ability to speak. As an attorney, he closely followed the details of a poignant Supreme Court case. "When it was my turn to present, I couldn't verbalize the information I had prepared," recalls Andy, who had been practicing law for 30 years and was planning to retire. "When I could talk again, I went upstairs and told Janey that something was wrong."
The two headed to a nearby hospital in Hayward. Via a CT scan, radiologists identified a peach-sized tumor in the area of his brain behind his left ear. Doctors in Hayward referred him to Duluth, Minn., for further evaluation. Following a MRI, specialists recommended that Andy and Janey head to Mayo Clinic in Rochester for further evaluation.
"I was seen at Mayo in just a few days," remembers Andy. "I couldn't imagine being able to get an appointment at a world-renowned facility any quicker. Easy accessibility was my first impression of the clinic and my experiences just got better and better after I arrived."
Ceremony and surgery
"After a couple of days at Mayo Clinic, I was told my tumor was a grade 4 glioblastoma — a life-threatening tumor," says Andy. "And doctors wanted to do surgery immediately."
The diagnosis led Andy to think seriously about his relationship with long-time sweetheart, Janey. "We'd been living together for nearly 10 years and I had avoided making any further commitment," recalls Andy.
Andy did his research and learned about the poor prognosis for glioblastoma. The five-year survival rate of the disease is less than 3 percent. Even in Andy's case, with complete surgical resection (removal) of the tumor, the survival rate for glioblastoma is very low.
"In addition, there was a risk of paralysis and a chance he would not be able to speak, read and write after the surgery," explains Fred Meyer, M.D., the Mayo Clinic Neurosurgeon who performed Andy's surgery.
"The whole experience and possibilities of how my life could change … or end … altered my outlook," says Andy. "Right then and there, I made an important decision about whatever time I had left — I wanted Janey to be my wife."
So, on December 20, over dinner at a local Rochester restaurant, Andy proposed and Janey accepted. The next day, just prior to his four-hour surgery was scheduled to begin, they were wed in the chapel in the Eisenberg Building of Methodist Hospital, part of Mayo Clinic.
The occasion was witnessed and celebrated by a throng of children from their previous marriages, nieces, nephews and siblings who made a special trip to Rochester for the hurry-up wedding.
A roller-coaster year
For Andy, his diagnosis came at the end of what already had been a roller coaster year in 2001.
"I was in the process of retiring from my 30-year law career," recalls Andy, who most recently worked for the U.S. Department of Justice. "I was looking forward to traveling and spending more time with Janey, family and friends," says Andy.
Then, on September 11, Andy watched in horror as the towers of the World Trade Center collapsed. He wondered if his son Bruce, who worked on the 73rd floor of Tower One, escaped. Fortunately, he did.
Fate had provided good luck once, but it seemed Andy's luck was running out in December when he was diagnosed with the brain tumor.
"After the doctors gave me the news, I prepared for the worst-case scenario," said Andy. "But, good fortune was my side again under the care of Mayo Clinic doctors." In addition, the situation prompted his marriage to Janey, which has been a true blessing.
The roller coaster ended with Andy's successful surgery and tumor removal. Early the following year, Andy would return to Mayo Clinic for radiation and participation in a clinical trial. Since then, life has been on an even keel.
Defying the odds
No one would have guessed that Andy would be around six years following surgery with no signs of the tumor returning.
"We're not certain why he's doing so well," says Joon Uhm, M.D., a neuro-oncologist at Mayo Clinic in Rochester. "We've known for decades there is a small subset of patients who beat the odds with this terrible disease." Dr. Uhm is the first doctor Andy saw at Mayo Clinic, and Andy continues to have regular appointments with him as part of his follow-up care.
"We are in a new era of classifying tumors," says Dr. Uhm. "We are able to identify molecular features, receptors and genetic markers. These patterns may offer clues as to how the tumor will respond to different treatments. Genetics has revolutionized many areas of medicine, including neuro-oncology."
"But no matter how much we know about brain tumors, what is so important is how passionate we are in what we do for our patients" says Dr. Uhm. Andy knew his doctors were passionate about helping him and advancing the science of care, so he took a chance on a clinical trial following successful surgery and radiation treatments.
"Andy has been taking gefitinib, which was first approved for treatment of lung cancer," says Jan Buckner, M.D., medical oncologist at Mayo Clinic in Rochester. The drug, sold under the brand name Iressa™, had minor side effects for Andy. His tumor has not returned in more than six years. "After six years, we took Andy off the drug, just because we are unsure of the long-term side effects of usage and we feel there's no benefit for him to continue taking it."
"I see both Drs. Buckner and Uhm when I come back for my follow-up appointments," says Andy. "They approach my disease and treatment from different angles to provide the most comprehensive care possible."
"Andy is one of the longest survivors of glioblastoma that we've seen," says Dr. Buckner. "Statistics apply to groups of people, and not to individuals. Regardless of the grim statistics with glioblastoma, there are a few patients who do well. When first diagnosed, both patients and doctors need to remember that."
Andy remembers that and is grateful. "I'm happy to have defied the odds and hold one of the records for a long-standing defeat against glioblastoma," he says. "And in the process, my two doctors have become my friends. They care about me and I think their passion for their work and my health is what made the real difference."