Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, November 21, 1994 TAG: 9411210091
SECTION: VIRGINIA PAGE: A1 EDITION: METRO
SOURCE: SCOTT BLANCHARD AND SANDRA BROWN KELLY STAFF WRITERS
DATELINE: LENGTH: Long
Nineteen-year-old Chris Dunn, who for nearly three years has fought off a brain tumor of a kind that never has allowed its hosts to survive, was asked a few weeks ago where he saw himself in a year, in five years.
"Still kickin,'" Dunn said in a voice made languid by the disease and treatments, some of them experimental. "No matter what happens."
Dunn's calm assertion now is under its most vicious attack.
New tumor growth was discovered in May and, a week ago, Dunn found out that an experimental drug, carboplatin, that his doctor hoped would shut it off, wasn't working. Not only is the tumor growing again, but it has changed from benign to cancerous.
Today, he completes the first of at least two three-day treatments at Duke University Medical Center in Durham, N.C., with another experimental drug, topotecan. The drug may be the former high school baseball player's last chance to win.
If this doesn't work, there are other drugs, "each one equally untried," said his doctor, Henry Friedman.
Dunn has had chemotherapy, full-brain radiation, more chemotherapy and a bone marrow transplant. The tumor can't be removed surgically because it spreads through the brain like "a knife through butter," Friedman said.
If the topotecan therapy works, results could show in six weeks.
Friedman said Dunn's tumor is "incredibly rare," with as few as 50 diagnosed each year. Dunn's response to treatment also has been rare.
"We got a couple of years when we thought we had beaten the disease," Friedman said. "He's lived longer than anyone else with this tumor."
Dunn, a thick-armed kid with a left-handed grip that's a pain to shake, has lost some use of his right side in recent weeks. His short-term memory is vanishing, and talking or walking can prompt seizures. Two years ago, the symptoms announced his tumor. Now, he can feel seizures coming and considers them only annoying, like a mild headache to be waited out.
He's not passive about his tumor or his life, though. While most of his high school friends are off in college and run in different circles, he has been taking classes at Virginia Western Community College.
To combat fatigue, a weakened immune system and pain, he's had acupuncture and he takes vitamins - because he wants to, not because a doctor has ordered them.
"I do for myself just as well as they do for me," Dunn said. "It's a mental boost. Everything helps, including being positive, including religious beliefs. The power of the mind. We don't know 90 percent of what the mind can do."
He'll call Friedman on the doctor's beeper to ask questions, complain about medication or just talk. Friedman amazes Dunn.
"I'm not a doctor, but I know the difference between a quack and a good doctor," said Dunn, who refers to Friedman as a "genius."
Friedman co-directs Duke's pediatric brain tumor program. He and Dunn are each other's fan club.
"He's a pleasure, extraordinarily bright. I could see him as a Duke undergraduate rather than a patient," Friedman said. "What's happening to him is rotten."
"Friedman is always very positive. He'll never tell anybody it's over," Dunn said recently.
The doctor worries about Dunn and his family even beyond the medical treatment. He was outraged Thursday when the family's insurance carrier, Blue Cross Blue Shield of Maryland, initially refused to approve three days in the hospital for the topotecan therapy.
"It's incredibly important that the family not incur more debt," Friedman said. He added that he'd "go to war" with the insurance company to prevent that happening.
Blue Cross approved the hospital stay later that day.
The topotecan drug is provided free from the National Cancer Institute, but it needs to be given for 72 hours at a time in a hospital setting. Dunn's bills for each three-day treatment can run between $5,000 and $10,000, Friedman said.
Add to that the $100 to $200 it cost family members to make the trip with Chris. This time, Bill Dunn is sleeping in a chair in Chris' room, but more to be with his son than to save money. Chris' mom, Betty Jane, has gone back and forth from Roanoke to Durham; Chris' sister Angie and brother Stephen have remained home, attending school.
Bill Dunn has had to buy his own insurance at $487 a month since he lost his job as a salesman for Progressive Beauty System. The company dismissed him after five years' employment, he said, because he was spending too much time with Chris and not making his sales quota.
Progressive's general manager, Steve Clarke, had no comment about Dunn's dismissal.
Bill Dunn said that Progressive is fighting his unemployment claim and has withheld about $4,000 of pension money from him, claiming he quit. Dunn now has a job with a mid-Atlantic cable television company, but said he may go to court to get the $4,000 from Progressive.
Dunn said that his son's medical bills since 1992 have exceeded $800,000 and that there is a $1 million cap on his private insurance. The family got a break, however, when the $175,000 cost of a bone marrow transplant was considered an ``experimental investigatory'' procedure by Blue Cross, meaning it doesn't count toward the cap. Dunn said he owes about $25,000 in insurance co-payments for treatment.
Chris Dunn will go through at least two three-day sessions of receiving topotecan in this round of treatment before a decision will be made about its effectiveness. If it works, the tumor will slow or stop its murderous march into his brain within six weeks. Friedman has seen that happen.
Friedman sees about 160 new brain tumor patients a year. He tailors chemotherapy treatments for each patient based on findings from his research. He tries out chemicals in the laboratory using tumor tissue obtained from every brain tumor biopsy performed at Duke as well as at other children's hospitals. If something works in the lab on a particular tumor tissue, he uses it to treat other victims of that tumor.
"He takes the worst [patients]. I'm the best of his worst. I'm healthy," Chris said recently.
"Going through a life-or-death experience, you grow up in a hurry," Dunn said. "Life or death. It's reality. A lot of people my age don't even think about it. They're out there smoking and drinking, drinking especially. I'm not a goof-off like I was at 15. I say to myself, `Do the best you can do. Nobody can ask for more.'"
Weeks ago, Dunn distinguished himself from most of Friedman's other patients because, among other things, he could walk. Now he's on his back, but it's unlikely his mental strength has waned.
Bill Dunn said Chris and the family were "devastated" when they heard the latest news, however.
``[Chris] went through a very strong depression,'' Bill Dunn said. ``It was like a sucker punch. Then he said, `Dad, I don't care what happens. I'm gonna go down fighting.'''
A Chris Dunn fund has been established at the Bank of Fincastle, 460 E. Branch, Roanoke 24090, Account no. 367701-10. Donations are tax-deductible.
Keywords:
PROFILE
by CNB