The Dan Mears
Pancreatic Cancer Clinical Trials Program

Dan Mears

Inspiration Dan lived by

“Hope is one of our most vital emotions.
Cancer survivors call it life's parachute.
The moment you embrace hope, your cancer success story begins---for hope is the opposite of despair. Hope believes even when the odds look gloomy. Hope affirms we're here for each other, and it comes from all quarters. From the doctor who fights for us, the nurses who care for us, the volunteers who rally for us, the neighbors who pray for us, and the friends and family who love and believe in us.
No Matter What, No Matter What,
No Matter What.”
---Dan Zadra


Wednesday, Apr. 4, 2012
First Progress Report


Dear Family and Friends,

As you many of you know, I was diagnosed with metastatic pancreatic cancer in late February, which to say the least, was a shock of a lifetime. I had been putting-up with a nagging sore and upset stomach since early February and thinking that I might have a hiatal hernia or a stomach virus?! When Sues noticed some yellow tint in the white of my eyes and she and a friend later noticed further yellowing of my face and arms, I got serious about seeking medical help which landed me in the Scripps Hospital Urgent Care Center. After numerous blood tests and a CAT scan, I was informed that a “mass” was growing out of the head of my pancreas and blocking the flow in my bile duct, causing the jaundice condition. A temporary stint was inserted into my bile duct which along with antibodies cleared the jaundice and got my blood chemistry out of the danger zone. Next, a PET scan revealed that my cancer had spread into nearby lymph nodes which, unfortunately, precludes the operation route of treatment – at least for now.

Instead, we feel fortunate to have been selected as one of 10 “run-in” patients (assured to receive the experimental drug) for a recent clinical trial program using the state-of-the-art chemo treatment for pancreatic cancer plus an experimental application of another drug. Based on stage 1 testing, the results have been encouraging for extending the quality and duration of life for pancreatic cancer victims. A report of the clinical trial program is attached for those who may care to know more details.

My first treatment was on March 14. The weekly treatment protocol is a 2 to 3 hour chemo injection through a port implanted into his right chest followed by a drip injection via a fanny-pack pump of the experimental drug application over the next 2 days. The treatment cycle is 3 weeks of such treatment followed by a week-off and then repeat such 4 week cycle for nominally 6 months. I have now completed his first cycle with minimal side effects so far, except for some hair loss on an already thin haired head and the overdue loss of about 20 pounds! They will be monitoring my progress with CAT and PET scans, etc. after every 2 cycles, and making adjustments to optimize results.

We are learning much more about pancreatic cancer than we ever cared to know! For example, it is the 4th largest cause of cancer deaths with about 37,500 deaths projected in the U.S. during 2012 . To date, there is no screening test for early detection and my doctors estimate that my cancer is at about a year old. Without the hopeful benefits of the clinical trial program, the prognosis for my stage of cancer is about 50% survivability for one year, about 25% for two years, etc. In spite of such a bleak outlook, we are and will remain positive that cancer treatment advancements are happening every day with such clinical trial programs. I intend to be their poster child!

Since my diagnosis, there has been a heartwarming outpouring of encouragement, prayers and love from family and friends – both present and from the past. We are eternally thankful for such kindnesses. Along with the medical advancements, a positive attitude, Faith in the Almighty and the greatest support Team ever, such kindnesses are the substance for miracles in which to believe. There's no place like Hope.

As an efficient way of keeping family and friends informed on the battle, we will send an occasional email on my status. We welcome your sharing such emails with mutual family and friends as you see fit plus additions to the distribution of future status reports are welcome.

Onward and Upward with Love to All,
Dan

PS – Sorry if you received an earlier draft of this email!!


Friday, Jul 6, 2012
Second Progress Report


Dear Family and Friends,

My battle with pancreatic cancer continues to be positive. Excerpting from my July 3rd CT scan report - “the mass has decreased in size so much that the margins are indistinct and comparison is imprecise”. The report estimates the longest and shortest dimensions of the mass are 1 x .7 cm versus 2.3 x 1.2 cm from my scan on May 7th . The original size on in late February was 3.5 x 2.5 cm. The report also states that the lymphatic tumors are stable or decreased. Another and now more accurate indicator of the success of my treatment is my blood count of the pancreatic cancer marker – called CA 19-9. CA 19-9 is a substance produced by secreting cancerous tumors in the pancreas and colon as well as by other diseases. In particular, it is a sensitive indicator used to evaluate how my type of pancreatic cancer is responding to treatment. The normal level (baseline) for a non-cancerous individual is 0-37 units/ml. My first test indicator level was 4156, which was in late February as part of the overall diagnosis. Since then, monthly test results have been 6275 (initially increased), 4018, 1433, 348 and now 198. Needless to say, we are ecstatic with the progress to date. To boot, I have been feeling well most of the time with side effects being limited to some occasional flu-like fatigue and achiness symptoms.

My oncologist indicates that such dramatic progress is also occurring with the others in this clinical trial program. However, he cautions that we are realistically striving for remission of the cancer and an extension in the quality of life versus the elimination of the cancer. My path after the clinical trial program, scheduled to be completed in mid-August, will be determined based on the results by then. Potential options include an extension of the trial program treatment, going onto a reduced dose maintenance program and, in either case, taking a break from treatment altogether.

As before, we are forever mindful and grateful that my progress is not only the result of the medicine in my clinical trial treatment program but to the army of family and friends (and many of their friends) that have been supportive in their prayers, encouragement and caregiving. Further, I have reconnected with many such family and friends from the past. Altogether, this has enriched my life and bolstered my determination in this battle, which the doctors and all agree, is so crucial for a positive outcome. An example to share is from a friend, Dan Zadra, -“Fight like hell, stay immersed in the power of hope, and know that you are surrounded by love, prayers and so many friends, family and admirers who are in your corner and fighting with you. Cancer is a bully, and bullies hate it when people look them in the eye and stand up to them. And remember, every victory you make in your treatment---large or small---is a victory for others who have yet to fight their battle”. Other examples to share include special visits with us in San Diego from faraway family and friends - Debbie, Monica, Ferman and Tak, the “we missed you” giant card and contacts from high school classmates at our 50th reunion, the contacts and ‘60s music CDs from SAE fraternity brothers, and the steadfast, everyday support from Sues and my “first responders” of closest family and friends. Finally, I would like to share a photo with my two grandsons who had just finished a football camp weekend with Phil Rivers (San Diego Charger quarterback and fellow NCSU alumni).

Indeed, I am blessed with such family and friends and to report more progress in my battle with pancreatic cancer.

Onward with Love to All,
Dan


Friday, Aug 31, 2012
Third Progress Report


Dear Family and Friends,

I have now completed the initial 6 month clinical trial program for my stage 4 pancreatic cancer treatment. Overall, the results have been most positive and satisfying to me, my oncologist and the team of cancer treatment specialists following this program. To date, 60% of the patients taking the experimental drug in this program have experienced 25% or greater reduction in the size of their tumor. Being the second patient to enlist and therefore one of the first to complete the initial 6 month program, I have achieved about a 70% reduction in the size of my tumor. However, per the recent CT scan compared to the previous one, the shrunken tumor has now stabilized into a “residual” state. As before, the lymphatic tumors remain stable and there is no detectable evidence of further metastasis anywhere else. For now, we are declaring victory for the initial trial program with such significant reduction and enjoying a relatively high quality of life that accepts some occasional fatigue and achiness. More recently, I am also experiencing neuropathy in my toes and fingers which is attributed to one of the chemo drugs that, accordingly, has been withheld for the past 4 treatments.

Going forward, I will be continuing the treatment program over the next 2 months, with a hold on the neuropathy causing chemo drug until the numbness eases. After each 2 month interval, there will be another CT scan and set of blood tests to support the decision whether to continue, adjust or suspend the treatment. BTW, for my nuke friends, my cumulative dose from the 5 CT cans and 1 PET scan is about 7.5 rems – about 1.5 times the maximum allowed annual dose for a nuclear power plant worker in a radiation-related job. For me, the benefits from such scans far outweigh the potential radiation-related risks.

In the meantime, Sues and I are off to Colorado Springs after Labor Day for a break in scenery and routine, plus thinking about plans for the year-end Holidays as well as next year. Overall, Life is Good – my appetite is fine, my weight has stabilized, my color is improving and my hair is returning - albeit whiter and finer! A recent photo is attached taken with my cutting-edge oncologist, Darren Sigal, and my soul mate, Sues.

More importantly, we are heading forward being the wiser about cancer causes and treatments in general and pancreatic cancer in particular plus much richer in Faith and relationships. For my brief take, cancer is caused by toxins, whether from the external environment or generated internally by emotional forces such as stress, causing abnormalities in cell growth as well as depression of the immune system’s ability to counter such abnormalities. Such conditions are furthered by poor nutrition and/or lack of exercise. The treatment may be one or a combination of chemotherapy, radiotherapy and surgery; plus good nutrition and exercise; and a positive, determined attitude and environment. The latter factor draws upon and enriches one’s Faith and relationships with Family and Friends. I am blessed with the support and encouragement from close-by Family and Friends and the network of distant Family and Friends, all of which I have tried to include in the distribution for this series of personal progress reports. I am forever grateful to all for such support that has been crucial to my progress to date. I will send the next progress report as any newsworthy developments warrant, but always welcome any and all contacts in the meantime.

Onward and Upward with Love to All,
Dan


Sunday, December 02, 2012
Forth Progress Report


Dear Family and Friends,

Since my last progress report on August 31, I have continued with my pancreatic cancer clinical trial program with adjustments to balance control of the neuropathy and the various blood counts and markers. CT scans have consistently indicated stability in the shrunken tumor in my pancreas, no change in the lymphatic tumors and no “CT detectable” evidence of further metastasis anywhere else. Overall, my quality of life has been very good for which I am extremely grateful. Further, I am proud to have beaten the odds of the mean survival rate of about 6 months for pancreatic cancer plus contributing to improved treatment and ultimate cure of this cancer through my clinical trial program. All of you share this pride and success to date through your loving care, prayers, friendship and encouragement.

But we are not finished yet! During the past few weeks I have been experiencing increasing pain and numbness at the top of my spine, across my shoulders and down my left arm. This culminated with an MRI on November 27 and diagnosis that the cancer which has metastasized into the C7 vertebra of my spine. The tumor has been increasingly pressing against proximate nerves causing the pain. Unfortunately, such metastasis into this spinal area is not “CT detectable”. With above and beyond priority care by the oncologist and radiologist (acquainted already as member of my medical team plus neighborhood friend), I am underway with high powered pain relief medications and an initial radiation treatment program for 10 minutes a day for 10 weekdays that began on November 29. I am fortunate to be in such good care plus have access to the Scripps Hospital’s new state-of-the art radiology treatment center. The plan is to annihilate the spinal tumor with x-ray radiation with the 10 radiation treatments and then, pending results, determine how best to continue with some combination of radiation and/or chemotherapy treatment program. In any event, it will not be part of the current clinical trial program as the treatment for spinal based cancer involves other protocols. I am not sure where this is going, but I am not going down easy!! So please keep-up the prayers and positive energies coming this way as well as for all the victims of cancer known to you .

In the meantime, Sues and I are still relishing a very special Thanksgiving in Napa with my daughter Susan, her husband Mick and our grandsons (Everett and Daniel) plus a visit with dear friends Barbara and Gordon in Santa Barbara. The Christmas decorations are up, most of the shopping is finished and we are already enjoying a very special Christmas Season with family and friends close-by and afar. A photo with my daughter Susan and son John from last night’s family dinner party, hosted by Georgia (best ex-wife ever) and her husband Bill, is below.

So, as never before, Sues and I wish you a joyous and meaningful Christmas or Chanukah and a prosperous New Year+. It will be a better one and we shall overcome – don’t look back.

Onward and Upward with Love to All,
Dan


Sunday, Jan 6, 2013
Fifth Progress Report


Dear Family and Friends,

Since my last progress report on December 3, I have completed the radiation treatment for the tumor in my C7 vertebra. Since then, I have taken a radiation healing break with the help of steroids, pain medications, and an abundance of TLC from family and friends. Altogether, this made the Spirit of Christmas more meaningful than ever. To boot, our Grandsons from Napa spent treasured time with us the week before Christmas which made for brief escort visits with their Mom and Dad. A photo from one of our Christmas dinner celebrations is attached.

On January 3, another round of CT scans indicate that the radiation has successfully annihilated the tumor and there is no detectable evidence of new tumors in the spine. Further, the CT scans continue to indicate stability in the shrunken tumor in my pancreas, no change in the lymphatic tumors and no detectable indication of further metastasis anywhere else, even though my last chemo treatment was nearly 2 months ago. This is a good thing! I am ever so grateful for these results and indeed blessed with the quality of my medical care plus your loving care, prayers, friendship and encouragement.

Going forward, I have resumed chemo treatment on January 4 with the same two state-of-the-art drugs as before for my type of pancreatic cancer, but without the experimental drug in the clinical trial program. The treatment regime is the same as well with three weeks on and one week off, followed by another CT scan and evaluation for how best to wage the battle after eight weeks.

Going forward elsewhere, Sues and I are planning for a full and active 2013. A near-term highlight is a visit from my sister and her family in late January, plus several travel plans are in the making. So cheers to you all for your happiness, prosperity and health in the new year and beyond. Please keep-up the prayers and positive energies coming this way as well as for all the victims of cancer known to you. There is no place like hope!

Onward and Upward with Love to All,
Dan


Wednesday, January 30, 2013

Just wanted to share that on Thursday Dan goes in for surgery to replace his C7 vertebra with a cadaver bone as a result of the metastasis of his pancreatic cancer back in November. We believe the radiation treatment eliminated the cancerous tissue but left a compressed vertebra that is pinching a nerve – see MRI photo below. We are all hopeful that this will restore the use or at least limit any further loss of his left arm and hand. As you can see below, his left hand is starting to curl and he has increasing numbness and decreasing use of his arm and hand – none with the last three fingers. He will be in the hospital for two to three days and recouping for about 8 to 12 weeks. Thanks for all of your prayers and support. Onward and Upward -- Susan PS – Dan’s next Progress Report will follow later!

Not able to hold up hand
Left hand unable to point out straight.


Not able to hold up hand.


Notice here the compounded vertebrae.

Friday, Feb 15, 2013
Sixth Progress Report


Dear Family and Friends,

Since my last progress report on January 5, I have undergone spinal surgery on my C7 vertebrae on January 31. Even though the radiation treatment is believed to have killed the cancerous tissue, the C7 vertebrae was being compressed and causing major pain across my shoulders and down my left arm plus loss of function, particularly in the last three fingers of my left hand. It is rare (<5%) for pancreatic cancers to metastasize into the bone or nervous systems.

The operation is a medical marvel that was conducted through a three inch incision in the lower, front side of my neck. The compressed vertebrae and any debris from the cancerous tissue was surgically removed and replaced with a cadaver’s vertebrae. A mesh cage was inside the vertebrae to enhance the growth of the nerves and blood vessels. A titanium brace was then fused from the C7 vertebrae to C6 vertebrae above and the T1 vertebrae below. The great hope is that my C6 and T1 vertebra are sufficiently dense to assure a strong bonding. Age and local cancer are both factors of having a degree of “soft tissue” – so it may take longer and be limited in the degree of strength. Accordingly, I am wearing a neck brace at least until March 11 when I see my neurosurgeon next. Overall, the full whatever degree of recovery will likely take about 3 months. Btw, I continue to have the best doctors there are – my prejudiced opinion! – with this one being the head of neurosurgery at Scripps Green hospital.

Overall, I am recovering fine while also managing a large pressure sore on my left buttock, coming-off of the steroids and coming-down on the pain medications. Even though there are occasional low fevers, chills, aches and pain, what the hey, I am still here and determined to get through this and keep moving forward. Indeed, I am very blessed to have the loving care from Sues (who broke her toe recently!) and close family plus the prayers, support and encouragement from all of you. Already, I have about 50% recovered strength of my left hand’s middle finger and about 20% for the other two far left fingers. This is a good thing!! A collage of recent pictures is attached to capture the moments.

Going forward, my renewed chemo treatment has been deferred at least until March 11 in order to allow further healing and regained strength. The specifics of the chemo drugs are TBD pending the results of then current scans, blood counts and overall state of health.

Going forward elsewhere, Sues and I are still planning for an active 2013. The planned visit from my sister and her family in late January has been deferred at least until late March, as my brother-in-law has had a major case of flu along with a bacteria infection in his liver. We shall both get through this!! Other plans are evolving which keep us looking forward to every new day. So please keep the prayers and positive energies coming this way as well as for all the victims of cancer known to you.

Onward and Upward with Love to All,
Dan

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