Cancer patient grateful for drug trial

By LINDY ANDREWS

Julie Howe's glowing complexion and broad smile make it hard to believe she has been ill, let alone so ravaged with cancer that secondary tumours were erupting from within her skull, ribs and spine.

Her workmates at a Katikati packhouse call Mrs Howe, who lost her marriage and her eldest son during a four-year battle for life, a very special lady.

Did she experience a miracle cure? For now, that remains a mystery. She won't know whether it was divine intervention or a new experimental cancer vaccine, Theratope, that saved her until she knows whether she was injected with the drug or a placebo.

A dark shadow was cast over her life in February 1997, when she discovered a lump as she ran a hand over her left breast during a routine self-examination.

A little over a month later, on March 26, the 47-year-old mother of four underwent her first operation for an aggressive cancer. By then, that single lump had multiplied into a triple carcinoma the size of three golf balls and 44 smaller ones.

Doctors performed a radical mastectomy and took 11 lymph nodes, six of which tested positive for cancer. A course of chemotherapy followed.

By October of that year, Mrs Howe was in remission and back at her two jobs, as accounts clerk for a building supplies firm and packing kiwifruit.

"At that point they (doctors) said chemo would cure it," Mrs Howe remembered. "That should have been it. But in June 1999, I discovered another lump on the scar line.

"I panicked because I was so sure I had been cured."

After a second operation, Mrs Howe's oncologist scheduled nine weeks of radiotherapy to begin in late August. But worse was to come. The mother of four was suddenly faced with becoming a single parent.

"When I said I was going to have to stop work and spend nine weeks in radiotherapy, my husband Mike couldn't cope any more. The minute Mum walked in the door from Australia, he walked out."

There was no time to grieve. While her mother cooked and cleaned, Mrs Howe focused on getting well "for the kid's sake".

When her mother couldn't be there, wonderful friends, neighbours and hospice staff stepped into her shoes.

By November, Mrs Howe had completed radiotherapy but in the months that followed, was plagued by nagging doubts. Something just wasn't right.

"In the middle of last year, the awful tiredness came back. You just kind of know. You do everything in a kind of daze. Everything is dark. You just can't keep going after 4pm.

"I knew something was going on, so I just kept looking."

Weeks later, her worst fears were realised. One night she examined her scar to find the area peppered with dozens of tiny cancerous lesions. By the time she had her third operation, three tumours had appeared in her right breast. They were duly removed but the cancer raged on.

"A week after I came out, I picked up a bag of groceries and couldn't get out of bed the next day," she recalled. "The pain was agonising."

Mrs Howe's former husband arrived to pick up the children for an access visit. Along with a family friend, he rushed her to hospital.

"It was secondary cancer. There were tumours in my skull, lower spine and ribs. As the cancer replaced my bone matter, it created breaks in the bones. They started chemotherapy very quickly but I was terminal."

By then, Mrs Howe was under the care of Waikato Hospital oncologist Dr Ian Kennedy, who called a family meeting. Chemotherapy might keep the seriously ill woman alive for nine months.

Then came a slim ray of hope. Throughout her illness, Mrs Howe's brother sent her newspaper clippings about a new breast-cancer vaccine, developed at Melbourne's prestigious Austin Research Institute. She begged Dr Kennedy to let her join an international trial.

Coincidentally, Auckland Hospital's oncology department was about to embark on a four-year, third-phase trial of Theratope, a Canadian experimental vaccine. Mrs Howe's name went on the list. Of 950 patients world-wide, half would be given a placebo - a sugar pill. The others would receive Theratope, which attacked cancer cells by mimicking a naturally occurring antigen.

On June 17 last year, Mrs Howe began a course of nine injections. She was understandably nervous but had nothing to lose. By that stage, chemotherapy was keeping her stable but she was only able to stand for about 20 minutes at a time.

Mrs Howe was prepared for unpleasant side-effects but experienced only a little discomfort around the injection site.

"After the very first one, there was absolutely no pain," she recalls.

"Within two weeks, I was walking all day - like normal. My energy levels came back about two months after."

In March this year, Mrs Howe's happiness was marred by the death of her 16-year-old son Mitchell, who died in a car accident after falling asleep at the wheel. But "three beautiful, amazing children and wonderful neighbours" gave her the strength to carry on.

Today, her MRI scans are clear and she is back at work. In radiant good health, she is convinced she had Theratope, not the placebo.

"I was the first in New Zealand to get it and they say number one usually gets the real thing.

Mrs Howe says she won't feel cheated if the cancer returns. Theratope is intended to be a life-extender rather than a cure, although she feels so well all her instincts say the battle is won.

"I live one day at a time and I'm grateful for each day that I have. Each day is a miracle."

Auckland Hospital's director of clinical oncology, Dr Vernon Harvey, said Theratope is the first of a number of breast cancer vaccines undergoing trials. Although in Mrs Howe's case it had been used therapeutically, in the future the vaccine could also be used to immunise at-risk women against cancer. But doctors and scientists remained unsure of the drug's full potential.

"Because we're treating secondary cancer, we can't claim a cure. There is no cure for any secondary cancer, bar a couple of exceptions...but it's not often you see all visible bits of disease gone, as in Julie.

"Her response has been remarkably good."

- BAY OF PLENTY TIMES