A message from Bobby:
December 29, 2022
I am a very lucky guy.
In June, I was diagnosed with an inoperable, aggressive, stage 4 oral/sinus cancer. The first course of treatment was a combination of chemo and immunotherapy, which failed miserably. I was then essentially sent home to die. Although I had been previously told I was ineligible for radiation, I then received a call from one of my doctors who recommended I consult with one of the radiation oncologists. That call saved my life. We elected a course of stereotactic radiation combined with immunotherapy. (Stereotactic radiation is an advanced form of radiation treatment that is much more powerful and much more precise than standard radiation.) An MRI taken last week showed that we exceeded all reasonable expectations. The cancer has been dramatically reduced. Going forward, I will continue with immunotherapy indefinitely, one infusion every three weeks, along with an alternative therapy, high dose vitamin C infusion.
I am also a lucky guy because of my family and friends who made sure that I made it to all my appointments and treatments. I am also amazed and grateful that my family has been able to keep the farm operating seamlessly while dealing with my situation.
A number of people have asked “what’s taking so long” to get an update. The answer is complications and setbacks. The biggest, and a still ongoing complication, is the infection.
In early June, about the same time my cancer was diagnosed, I developed an infection on the right side of my face, either in or very near the cancer. The infection caused a high fever, which sent me to the ER. I was treated with a course of oral antibiotics and told to monitor my temperature, which I did. There was no other follow up. I’m convinced that I’ve had this infection since June, and that it is responsible for a lot of the swelling and pain that I’ve experienced.
In October, the infection “blew up”, causing significant facial swelling and swelling my right eye shut. At UVA, I received two antibiotic IVs with instructions to go to the Culpeper ER for another IV if my condition didn’t improve. At the Culpeper ER, we waited over 2 ½ hours without getting called for treatment. When I asked for an idea when we could expect treatment, they said they had no idea.
I had been getting an alternative cancer treatment, high dose vitamin C IV, at the nearby Libertas Integrative Health Clinic. So, we left the hospital and went to Libertas, hoping they had antibiotic IVs. Sarah Russell, who runs Libertas, immediately recognized the seriousness of the infection. In less than 45 minutes, I received the desired antibiotic IV. Sarah tried various combinations of oral and IV antibiotics through November, and then ordered a CT scan. That scan showed concern that the infection had entered bone. Sarah and my good friend Dr. Brooke Miller, conferred and recommended daily antibiotic IVs.
In order to accommodate that schedule, Sarah personally came in on weekends to open the clinic and administer the IVs. I finished an 18 day, every day, antibiotic IV schedule and am now twice a week for the next month. Corporate medicine doesn’t give the individual care I received from Sarah Russell and her Libertas clinic, and I am greatly in her debt.
While the infection has been the most significant of my setbacks, it certainly has not been the only problem. The first treatment I received was a combination of chemo and immunotherapy. In addition to the normal chemo side effects (nausea, fatigue, etc.) one of the chemo drugs caused me to have severe heart arrhythmia. In fact, I passed out in the oncology waiting room with a pulse rate of over 190. I was rushed to the ER to be shocked, but fortunately my pulse rate started to moderate on its own. I continued to suffer from bouts of arrhythmia until the chemo drugs cleared my system many weeks later.
I had never heard of a tumor bleed until after I woke up one morning with my mouth full of fluid. I spit out a mouthful of blood, which seemed to open the floodgates. Blood poured from my mouth, with no way to stop it. Fortunately, the bleeding eventually stopped. I later learned that a friend of a friend died from an oral cancer bleed. I had 9 or 10 of these bleeds over a week or so, half very scary. I lost a lot of blood that week, and it took a lot out of me.
The other major problems have been tongue sores from radiation, and trismus (lockjaw). The tongue sores are truly the work of the devil. They make talking, eating, and drinking extremely painful, and I’ve been dealing with these sores since late September. There are times that even drinking water over the sores feels like pouring alcohol over an open wound. Every meal is dreaded.
The trismus began in June, with the pain from the infection and has continued to get worse as time and pain have continued. My right jaw has clamped down to the point that I have no ability of open my mouth. My meals have been oatmeal for breakfast, scrambled eggs for lunch, and soup for supper for months. Those are the only type foods I can consume. So once all the other issues get resolved, I can look forward to many weeks of physical therapy to regain some jaw function.
In summary, I’ve got a lot of work to do to get back to “normal”. I’m in terrible shape, I’ve lost a lot of weight, I’m weak, and I’m tired. I’m also very lucky and never been happier to be alive. Thank you to everyone for all your thoughts and prayers.
Happy New Year,
June 12, 2022
For those who don’t know, in the fall of 2019 I was diagnosed with squamous cell carcinoma of the right maxilla. I had two surgeries, which took quite a bit of the upper right jawbone and left a “hole” going through my right palate into the right sinus, so the surgeons could get cancer from the sinus. Those surgeries were followed by a full course of radiation and chemotherapy. For over two years since, things went well.
Then in late March, 2022, just before our bull sale, I noticed a couple of what felt like small bubbles form in the void area. The next week, I went to see my dentist. I had just received a prosthetic to fit into the void area, and had been having problems with it. She thought I likely damaged radiation affected tissue, and that radiation damaged tissue can heal in strange ways. She did not think it looked like cancer, but it should be monitored. For most of April, the little bubbles continued to stack upon one another, and the hole into the sinus actually sealed off, which I thought was great. No more water running out of my nose when I tried to drink. I could even drink with a straw.
In late April, the growth began leaving the void area, and it started adhering to my inner cheek. I became more concerned. I had a previously scheduled MRI set for May 11, so I followed that up with a visit to the oncology team at UVA on May 13, where a number of biopsies were taken. The MRI report said no cancer, and that the growth appeared to come from radiation damaged tissue. The pathology report said no cancer, but a few “atypical” cells. The folks at UVA wanted me to be examined by one of the surgeons, so I went back for another visit. The surgeon told me I had cancer, and that my best option was surgery, if I qualified for surgery. She said the surgery would be an all day event with a team of surgeons, where the cancer surgery would be followed by full facial reconstruction. An extended hospital stay would be followed by 6+ weeks at home. More biopsies followed.
Things finally came to a resolution on Wednesday, June 8 when I talked to the surgeon. She told me the tumor board decided the tumor was too advanced for surgery. I thought she handed me a death sentence. Then she referred to the new pathology report, which began with the statement “this is an exceedingly challenging case”. Multiple teams of pathologists independently examined the biopsies, and they finally agreed that I had an aggressive cancer, essentially of indeterminate type. Good news finally surfaced when she told me that cancers that are PDL1 positive have a chance at responding to immunotherapy, with higher scores having better chances of responding. My PDL1 score was very high. The doctors think we have a realistic chance of shrinking the tumor with chemo and immunotherapy to the point that surgery is possible.
As you can imagine, my life has been an emotional roller coaster the past few weeks. On top of the cancer stuff, I’ve been running around at a crazy pace, getting all the cattle vaccinated for pinkeye and poured for flies and trying to get the first cutting of hay finished. I hadn’t been feeling well for a couple of weeks and thought it was likely due to mental stress, so I just kept going. In fact, I had an infection in all the mess. I finished raking hay last Sunday, June 5 and pretty much crashed. I had a fever of over 103 and was taken to the emergency room. Antibiotics seem to have my temperature under control, and I’m just now starting to feel better (June 11). It’s been a bitch of a week. I know that I have to focus on my health and to reduce as much stress as possible. I still want to do some work on the farm, as I’m able, but know I need to find a balance between work, rest, and treatment. I plan to keep a very low profile. The swelling in my face has advanced to the point that it’s quite noticeable, and I really don’t want to answer a lot of questions.
My niece, Caitlin, will monitor the White Ridge Angus website and Facebook page. She will provide updates as necessary. If therapy works, I don’t expect a quick resolution. More likely surgery would be many months away. My first infusion is scheduled for Friday, June 17. Let the fight begin.
July 11, 2022
An update on Bobby:
He's still in a lot of pain from both the cancer itself and the chemo treatments. This makes it hard to talk and hard to eat. If you've called him in the last few weeks and he hasn't answered, don't be offended. Shoot him a message instead, and don't be upset if he doesn't reply. His energy level is very low.
Thank you all for the continued prayers. Keep them coming.
August 24, 2022
An update on Bobby:
He received a call from UVA today to say his imaging shows the cancer has continued to advance. Surgery is still not an option. He will be meeting with the head of radiation oncology at UVA as soon as it can be arranged.
The fight continues and we appreciate the continued prayers. Keep them coming.
September 7, 2022
Bobby has elected to receive radiation treatments at UVA with their stereotactic radiation unit. It is likely, but not guaranteed that treatment will shrink the tumor to gain more time for him. He's not done fighting yet..
December 2, 2022
There hasn't been much to update on lately- sorry for that. Bobby's been fighting an infection for the last few months. He's also still doing immunotherapy treatments. His energy level is low and it's very uncomfortable to talk. Please keep him and our family in your prayers.