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The Truth About Cancer
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The Truth About Cancer + Take One Step: A Conversation About Cancer with Linda Ellerbee  

Watching: The Truth About Cancer

Chapter 10: The Cost of Surviving [10:01]

Jamie joins a phase 1 clinical trial. Linda and Larry continue to film his cancer story, even as his heath gets worse.

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Transcript: Chapter 10 - The Cost of Surviving

NARRATOR: Larry had enjoyed only a month or two of freedom upon completing his surgery, radiation, and chemo when the old disquieting signs of pain and fatigue returned. Imaging revealed the cancer was now in his remaining lung, his liver, and even his hips. Without knowing that clinical trials are usually a long shot, with a nine-out-of-ten failure rate, we signed him up for an experimental drug. In retrospect, it seems as if we had stopped asking certain questions.

*

JAMIE KLAYMAN: As much as I'm sort of nervous about a first run clinical trial, it just doesn't, doesn't seem to be the right thing to just sit and wait and do nothing. You can hear about cancer survivors, you know, with the "LIVESTRONG" bracelets, and you hear of all these people saying, you know, that "Oh, you can fight this," or, "You can overcome this," or, "You can do this." They don't understand that you can be the strongest person but you can only bring yourself so far, and there is that pressure of -- you don't want to let anyone down. I'm not ready just to give up at this point.

JAMIE KLAYMAN: It's coming...lift it up again? Nice.

DAVID RYAN: We're doing two drugs.

JAMIE KLAYMAN: Yeah.

DAVID RYAN: The first drug is a conventional chemo; it's the Irinotecan. Um, the second drug is the E7070, and that's the experimental drug. And it's one of these targeted drugs, but we're not quite sure on what it's targeting. You're actually the last patient on this Phase I study. It's been going on now a couple of years, and, um...

ABBYE WARREN: You saved the best for last...

JAMIE KLAYMAN: Yeah.

DAVID RYAN: We saved the best for last, which means you're getting the dose that...

JAMIE KLAYMAN: That the maximum dose that you can get.

DAVID RYAN: The maximum dose, right, of both drugs, and it also means that we have some experience. So we've had a few people actually do well on this.

JAMIE KLAYMAN: Right. Yeah, that's what you were saying.

DAVID RYAN: And what I mean by "do well" is they...the cancer actually shrinks and, and, uh, people get a little reprieve from the cancer, so that's...

JAMIE KLAYMAN: Right, yeah, that's good.

DAVID RYAN: That's what we're hoping for.

JAMIE KLAYMAN: Yeah.

DAVID RYAN: Yup. We always rather see people, um, if they're not doing well at all.

JAMIE KLAYMAN: Right.

DAVID RYAN: And so just come right on in, any day. I'm here, Caroline's here, Marguerite's here, all these people are here. In the middle of the night, you can call me.

JAMIE KLAYMAN: Okay.

DAVID RYAN: So, we'll give it our best shot. I'm hopeful.

JAMIE KLAYMAN: Yeah. We'll go from there.

DAVID RYAN: Alright.

JAMIE KLAYMAN: Good to see you.

DAVID RYAN: Ah. Good luck, guys.

JAMIE KLAYMAN: Okay, thanks.

ABBYE WARREN: Thanks.

JAMIE KLAYMAN: Bye.

*

KEITH LATAL: I've had to tip people upside down. Have them stand up, sit down, dance, and do all sorts of things. But I got a good blood return, so...

JAMIE KLAYMAN: Okay, good.

KEITH LATAL: Chemo through here...

JAMIE KLAYMAN: Yup.

KEITH LATAL: We'll have methadone through there, blood coming out there.

JAMIE KLAYMAN: Great.

ABBYE WARREN: It's fine.

JAMIE KLAYMAN: You okay? What's wrong?

DAVID RYAN: There are people out there who will have these incredible responses to these Phase I trials, and so you just don't know, and it is like the lottery. In medicine, it's often the things that you didn't expect that worked, and the things that everybody got behind often didn't work. For instance, Endostatin was the hot drug a couple of years ago. And it was supposed to starve the tumor of its blood supply. And I was a participant in the Phase I study of that. And we had so much interest in that drug that we actually had to set up a lottery to get on it. So that, just because you knew Ted Kennedy, uh, it didn't mean you were going to get the drug. But it was a dud. It was a dud. And it didn't work. And it was one of the, ah, you know, nine out of ten drugs that, ah, we do in, in these clinical trials that turn out to have no effect and at, and at worst, are harmful.

*

JAMIE KLAYMAN: Hey there.

JESSICA PAGE: Dr. Ryan.

DAVID RYAN: How are you?

JAMIE KLAYMAN: I'm doing alright.

JESSICA PAGE: Okay, go ahead.

DAVID RYAN: Just feel lousy, huh?

JAMIE KLAYMAN: Yeah.

DAVID RYAN: Oh, go ahead.

JESSICA PAGE: No, I have an hour, within an hour, so please.

MARGUERITE PARKMAN: No, no, go ahead, yeah. We'll take care of this and then we'll get it.

DAVID RYAN: So tell me what's been going on.

JAMIE KLAYMAN: Nothing, it was a tough night. I got home, I was very nauseous, you know, nauseous, heartburn. I didn't really get sick until early in, you know, the early hours of the morning. Um...

DAVID RYAN: And just miserable.

JAMIE KLAYMAN: ...and just overall, yeah.

DAVID RYAN: And did the, the pain that's in your back. Did that precede the chemo yesterday?

JAMIE KLAYMAN: That star--yeah, that had started up, and it wasn't as bad, but it sort of built up a little bit.

JESSICA PAGE:...pressure, too...

DAVID RYAN: Okay.

JAMIE KLAYMAN: Yeah, and it built up. It's been building up over the, you know, the last twenty-four hours.

DAVID RYAN: Okay.

JESSICA PAGE: If you had to rate it through...

DAVID RYAN: The cultural message that Jamie's getting right now is, 'Fight Fight Fight. Chemo Chemo Chemo.'

DAVID RYAN: And, and the PCA hasn't been helping?

JAMIE KLAYMAN: Hasn't been helping it, no.

DAVID RYAN: And so it's very easy for me to say, "I've got a new drug for you." Um, in fact, that's the easiest thing. To walk in a patient's room, who is in her situation, and go, "I've got a new drug for you." But is that the fairest thing for her, and is that...am I fulfilling my responsibility as her physician? 'Cause, ah, you know, first and foremost, I - I'm her doc. You know, I gotta look out for her.

DAVID RYAN: And um, did the nausea and the vomiting, did that predate the chemo, in retrospect?

JAMIE KLAYMAN: No, it was, it was after.

DAVID RYAN: So this was completely...

JAMIE KLAYMAN: Completely, yeah. The nausea and the vomiting was after.

DAVID RYAN: Okay. The pain? The pain...

JAMIE KLAYMAN: The pain was before...

DAVID RYAN: People want to live. And some people will do almost anything to, um, to live. And sometimes your job is to hold them back and say, "That's going to hurt you. You can't do that."

DAVID RYAN: I'm thinking maybe we ought to bring you into the hospital and try and help you out and get the pain under control. And this way we can manage the pain overnight. You'll have a nurse who can give you some extra IV, um, boluses of the pain medicine. Alright, so I'll call you in for a bed.

JAMIE KLAYMAN: Okay.

DAVID RYAN: We'll try and get you a private room if we can.

JAMIE KLAYMAN: Okay.

DAVID RYAN: And then go from there.

JAMIE KLAYMAN: Alright.

DAVID RYAN: Okay?

JAMIE KLAYMAN: Okay.

[Dr. Ryan gets a page.]

*

NARRATOR: On any given day in Boston, Massachusetts, thousands of cancer patients meet with their doctors. On May 30th, 2001, one of them was my husband. On that day, Larry's oncologist advised him to stop all further treatments. That's when I heard a startling gasp, as if the air had suddenly been removed from the room. And when Larry and his doctor turned toward me, I realized that the gasp had come from my own body; and for the first time since my husband had been diagnosed, I completely and utterly broke down.

NARRATOR: That night, sitting in a chair next to our bed as Larry slept, I experienced a powerful delusion. Surrounding myself with a stack of outdated biology books, I read about cells, and genes and mutations--and I actually thought that I could hit upon a cure for cancer. When Larry woke the next morning, he brought me back to sanity with one merciful and elegant sentence: "You can't save me," he said, "and that's okay."

LINDA GARMON: This is Monday, June 4th, I think... So now, this mic doesn't work, and your mic works.

LARRY D'ONOFRIO: Okay.

LINDA GARMON: So, just totally start over. I'm not a real good camera person.

LARRY D'ONOFRIO: Well, this is...let's explain what this is. This is a, something we pledged to do, uh, two years, ago, uh, less than two years ago, when we had what I considered the most dire day of our existence. When we learned that I not only had cancer, but that I had a type of cancer that was terminal. Even though we were both devastated by that, that fact, I felt there was a kind of, "What are they talking about?" attitude in the room, and a kind of a feeling that, you know, somehow we'll beat it. And we, we vowed that we would put this on videotape. We're doing this together, which is the most important thing of all, that I'm doing with my Linda. And we finally now, in the last few weeks, have reached the conclusion that we're heading for, you know, an ending. And the end is, ah, sort of more or less in sight.

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