"Now cracks a Noble Heart. Goodnight sweet Prince and flights of Angels sing thee to thy Rest."
Mark and I grew up together in the small town of Crossville, Alabama. We married in 1984, built a home, and raised our children among friends that had known us literally all of our life. Mark was a mechanical designer. He was proud of his work and the people he worked with at TOCCO and Guntersville Sheet Metal Works. Mark loved the challenge of designing, and his early design work at Jacobs on the hydrogen tank for the NASA Ares I launch vehicle and the people he worked with there was a dream come true. Mark was comfortable at a computer or driving a tractor on our family's farm.
When Mark and I married, he had a raised mole on his upper back that looked harmless but was irritated often by the top of a chair when he would slide into a seat. In 1991 Mark had the mole removed, and the test came back negative for abnormal cells. Three years later the same surgeon removed scar tissue or a possible cyst at the surgical site. This pathology came back inconclusive. The surgeon went back and made a wide margin incision just to be sure. Melanoma nor any other cancer was ever mentioned.
Mark was very healthy, full of energy and physically fit. In December 2004 Mark had surgery on his left leg dislocation, ACL, PCL and lateral ligament repair. Mark was helping a lady on the side of the road when he was hit by another car. Mark worked daily on his physical therapy, and in nine months was not just walking but running on a leg he almost lost. Mark continued to work out during his lunch hour almost daily. In October of 2006, he started experiencing some pain he thought was a possible muscle strain in his right shoulder. In early November he saw our family doctor for the golf ball size lymph node under his arm. Mark had a biopsy and lymph nodes were removed under his right arm on Dec 8th, 2006. He was diagnosed Dec 12th with metastatic malignant melanoma. The recommendation of our doctor in Alabama was to seek treatment at MD Anderson Cancer Clinic in Houston, Texas.
Mark had surgery January 5th, 2007, at MD Anderson. Thirty-two lymph nodes were removed, 6 of them had tumors, and some had grown outside the lymph node capsule, but all scans of organs looked clean. He had radiation therapy, high dose Interferon Alfa treatments, and then interferon shots at home for the next 8 months. September scans revealed a small spot next to the spleen. Scans in October confirmed the tumor next to the spleen as well as one on his back just below the 1991 surgery site. The tumor on the back was removed, and the tumor on the spleen was monitored for its response to the Interleukin-2. Mark tolerated ten doses of IL-2 in his first round and gained seventeen pounds of fluid in 48 hours. He had a second round of IL-2 in January 2008. Scans indicated the tumor by his spleen did not respond to the IL-2 and had grown a little larger. Scans also found another tumor in his abdomen. Dr. Patrick Hwu laid out our next options. The IL-2 treatments were discontinued, and Mark had surgery to remove the new tumor in the abdomen. The plan was to try and grow T-cells from the abdominal tumor. This was a new effective therapy, but the necessary T-cells were difficult to isolate and grow. Mark had plans to start a clinical research study of a drug in March when we were told the T-cell growth was successful. We felt this was Mark's better option, his own T-cells targeting his specific melanoma tumors. March scans showed a significant spread of the cancer, spots on the liver, a spot in the pancreas, and a lymph node under the left arm. The tumor near the spleen had not changed. The medical insurance company then became part of our battle. They can take up to 30 days to review and approve a treatment, and we needed to start in two weeks.
Mark's PET scan before starting the T-cell therapy showed all earlier tumors had increased in size. There was an increase spread of the melanoma with new activity in the lungs and bone. Mark was admitted to the hospital for the first week to decrease his immune system so that when he received the T-cells, they would not have competition from other white blood cells. On April 21, 2008, in ICU they transfused about 69 billion T-cells and gave doses of IL-2. Two weeks later a second round of IL-2 was given to help to stimulate the T-cells. Dr. Hwu and the melanoma clinic celebrated with us the hopeful and surprising results of the June scans. All of the tumors were getting smaller. Some were 50% smaller, but the tumor in the pancreas was unchanged. Dr. Hwu showed us the before and after scans. It was very impressive, even to our untrained eyes. July scans showed all tumors appeared to still be responding to the T-cell treatment by decreasing in size. The ones in the liver were barely visible, and no new disease was present.
In August, Mark was having increasing abdominal and back pain. August scans showed continued improvement and a decrease in size of the spots in his liver (almost completely gone) and other tumors. There was a problem with the pancreas. He had a biopsy of the pancreas tumor. It was strange that all of the other tumors were responding to the T-cells, but not the ones in the pancreas. Melanoma is so unpredictable. Mark started a cocktail of four different chemotherapies for five days to try and boost the T-cells. In September, the tumors in the pancreas continued to grow and caused fluid to collect in the legs and abdomen. The T-cells were still shrinking the cancer everywhere else. Mark was given Taxol and Carboplatin to try and shrink the pancreas tumors.
We returned home, but the tumors in the pancreas continued to grow. The DNA of the pancreatic tumors showed a mutation that the T-cells did not recognize. There was no treatment for this mutation. There might have been some experimental studies, but Mark's condition was too weak. During his 22-month battle, Mark was quick to volunteer extra blood, or tissue samples to any clinical study that asked. Now Mark had decided not to do any other treatments. We talked a long time about his decision, he asked me not to be mad at him, but he was tired. I told him I wanted what he wanted. He talked to his family and told our children (Lucas,15 and Kelsey,13) not to be mad at God; he wasn't and this was what was meant to be. He told them he had a great life and a wonderful family. He stressed to them the importance of their faith in God. I know his words of comfort will remain with them.
Those who knew Mark knew he hated the spotlight. I constantly would sing his praises, and the times he was with me I would get the "that's enough, be quiet" look, but I couldn't. Mark's frequent words of "thank you" seemed automatic, but they were heartfelt. Mark was quick to forgive and ask for forgiveness.
My dearest Mark, as in the words of our Lionel Richie wedding song "...our two hearts beat as one..." At your worst, you were better than my best! I've always felt that way. You made an impression on everyone you met, not in a loud showy way, but your soft-spoken gentleness and help that you would rather go unnoticed. I have always said that you were so perfect, it was depressing to try and keep up with you. You were the perfect father: helpful, kind, patient and loving to Lucas and Kelsey. I remember the tears in your eyes when you first held each of them. When Lucas was born and we were leaving the hospital, you said that you didn't want to have any more children because you didn't want me to have to go through that much pain again. You said the same words just days before you left us, wishing you could relieve our pain. I felt the same way. I too would have taken away your pain or would have traded places with you without hesitation if I could. I cherish every moment of our past. God answered my prayer when you came into my life. I share the feelings of your last spoken words to me and the messages in your eyes when you could not. Although only my heart beats now, it beats for you.
My Endless Love, Belinda