So What Is Your Treatment Choice?

So What Is Your Treatment Choice?

Patrick had ridden a motorcycle for years. His wife hated it at first. Later, she accepted it and even rode one herself. She still was quite timid on the bike. Pat, however, could not get enough. Nothing he drove could replace the wind, the wide open feeling and mostly the acceleration. He would just twist the knob and he could get a rush that was truly addictive. When he was sitting in his car, he could not seem to have nay fun. On his bike, he felt free. Otherwise he felt trapped and when he could not seem to breathe, day or night, he would open the garage door and go for a ride. Better, much better. He came home and he was relaxed again. Until the next time.

It was Saturday morning and the sun came up after a fresh night of rain and Patrick got up, pulled up his jeans and a shirt. He did not even eat. Went on the highway and hit a turn and laid his bike down. He felt pain in his right side and could not get up. Soon an ambulance came and he went to the emergency room. A quick CAT scan of his abdomen revealed no bleeding but he had four broken ribs. That wasn’t the problem. The radiologist called the ER doctor and told him there was a 4-inch tumor in his liver that looked malignant. In pain, he told Patrick the good and the bad news. Patrick had a tumor.

P.J., his wife, rushed into the room and was in tears. Patrick was admitted and later he had a biopsy performed which revealed a hepatocellar carcinoma – a tumor which started in the liver itself. Apparently the liver doctor told them both it was probably related to the hepatitis B that Patrick had but never knew. He had gotten hepatitis B from some tainted tattoo ink. The ink reused from another customer who had the B infection. At 51 Patrick asked for treatment. Since the tumor had invaded the vessels in his liver the oncologist recommended coagulating the tumor with a needle and starting a brand new drug “Sorafenib”. It would probably give him a year or more to live. A liver transplant was considered but the transplant center said he would be low on the “list” and should go with the treatment proposed.

“Sorafenib” is a member of a whole new class of drugs for cancer called multikinase inhibitors. Expense was a sore problem. It costs $5,000 a month and P.J. prayed her insurance would approve it. It was turned down. The insurance company stated the drug was not FDA approved for this use. She appealed but it took 6 weeds. The tumor grew and Patrick developed a clot in his leg. The clot was thought to be related to the accident. Patrick swelled up in his left leg and was readmitted to the hospital. He was immensely depressed. No hope, Patrick left the hospital against medical advice (AMA) and drove to the Honda dealership. A brand new Kawasaki ZX14RR sport bike was there…. in bright yellow! He charged it figuring he wouldn’t be around to pay for it anyway. He rode off but he felt great. He suddenly lost consciousness at 170 miles per hour and wrecked. There was no surviving that “outing”. He left a note for PJ stating he thought she would want him to be happy, he said the bide was a cheaper treatment than the drug.

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