In early August, Country Music Association Artist Stephen Michael Apatow [1] received the the devastating news, a differential diagnosis of squamous cell carcinoma of the tonsil. According to the American Cancer Society, there are between 47,000 and 50,000 new cases of head and neck cancer each year. [2] The challenge encompassed a life transforming process of reflection and analysis, with engagement of medical experts across the globe, to help attack the problem with an objective for eradication of the disease and restoration of overall health.
As founder of the nonprofit organization Humanitarian Resource Institute and the United Nations Arts Initiative, Stephen's role in humanitarian operations and policy development are embraced under his title of Director of Research and Development of the Humanitarian University Consortium Graduate Studies Center for Medicine, Veterinary Medicine and Law. [3] In the fields of Sports Medicine & Exercise Physiology, he is best known for his work as Director of Research and Development of the Sports Medicine & Science Institute. [4]
The Neck Dissection
Following the differential diagnosis came an array of tests, biopsies and related diagnostics. The initial differential diagnosis and biopsy was made by tumor specialist, Dr. Ronald Hirokawa in Milford, Connecticut. Within one week, full body CAT and PET scans were scheduled, leading to a fast track appointment with Dr. Clarence Sasaki, Section Chief, Otolaryngology at Yale Medicine School and the Yale Cancer Center. That same morning, after a short review of the pathology results, a treatment course was outlined, accepted and facilitated the immediate engagement of his specialized medical team.
Following the morning appointment with Dr. Sasaki, the ENT Nurse Coordinator for the team walked us down to the Radiation Oncology department for a meeting/examination by Dr. Yung H. Son, Director of Therapeutic Radiology and Surgery (Otolaryngology), Chief , Section of Invasive Therapeutic Radiology. After examination of the tumor, Dr. Son outlined an action plan to utilize brachytherapy [5] or the placement of radioactive palladium seeds to facilitate eradication of the primary tumor. The procedure would be completed in conjunction with the deep neck dissection, removal of nodes and tissue samples associated with cervical spread, for pathology and staging of the cancer.
Dr. Son emphasized that the objective of the team was to incorporate the most effective treatment approaches, minimizing the use of chemotherapy and radiation treatment, to facilitate containment and eradication of the disease. He repeatedly emphasized the goal to minimize the potential damage that could result from over treatment, that reaches beyond the needs of the patient, potentially causing more destructive damage than the cancer itself.
On September 6th, surgery was scheduled, lymph nodes removed and brachytherapy initiated. Upon release from the hospital, the rehabilitation/treatment phase began, with a optimized nutrition, exercise and adjunctive therapies regimen [6, 7,8,9,10] from day one, with notes on the program recorded into the Never Give Up: Cancer Journal Log on Facebook. [11]
Chemotherapy/Radiation
Following the neck dissection and initiation of brachytherapy, came the next phase of chemotherapy and radiation therapy. The member of the oncology team that directed this treatment was Dr. Hari Deshpondi, Associate Professor of Head and Neck Cancer, Sarcoma, Genitourinary specialization. The post surgery pathology results identified three nodes associated with spread, with extracapsular growth, a finding that warranted the addition of chemotherapy to the radiation treatment schedule.
As an music artist, composer, author and publisher, concerns were presented regarding potential neurological and auditory side effects associated with the use of the first line chemotherapy drug and appropriately targeted a less aggressive chemotherapy drug named Carboplatin. [12] Following initiation of chemotherapy, Stephen was able to remain minimally symptomatic (only minor post surgical challenges) for approximately 3 weeks. This state of health facilitated the capacity to record and produce the soundtrack "The American Way." See: Top40 Charts - Nominate "The American Way" 2010 Country Music Song of the Year. [13]
Approximately 4 weeks into combined chemo/radiation, a significant inflammatory challenge occurred in the radiation treatment fields. This challenge was met with an immediate response by the Sasaki team to stabilize the condition, control inflammation and pain, allowing radiation treatments to progress through the last session that was completed on 23 November 2010. Progress during this time encompassed limited restoration of salivary gland function, taste and ability to transition from a liquid to a soft foods diet, with an overall discomfort level at 1-2 on a scale of 10.
In conjunction, with the Cancer treatment program at Yale, Stephen opened an international academic dialogue on the topic of "Tumor Infiltrating Lymphocyte Therapy" as a standard of care in conjunction with with advanced diagnostics and treatment. See: Top40 Charts - H-II: Stephen Michael Apatow Pushes New Standard Of Care For Cancer Treatment. [14]
On 18 November 2010, Stephen announced the formal release of the album "Country Goes Global," through CD Baby for International Distribution. The project, four years in the development, that focuses on "Sharing a message of hope and inspiration with a world in need." [15]
Website: http://www.unarts.org
Music: http://airplaydirect.com/music/stephenmichaelapatow/
References:
1. H-II: Stephen Michael Apatow: Founder of Humanitarian Resource Institute and the United Nations Arts Initiative. Url: apatow.org
2. Understanding Head and Neck Cancers: Guest Expert: Hari Deshpande, MD, Assistant Professor, Medical Oncology, Clarence Sasaki, MD, Professor and Section Chief, Otolaryngology. Yale Cancer Center Answers, Connecticut Public Radio, 25 October 2009. Url: unarts.org/nevergiveup/ref/Oct2509-Drs-deshpande-and-sasaki-1.pdf
3. Pathobiologics International - The Consulting Arm of Humanitarian Resource Institute and the Humanitarian University Consortium. Url: pathobiologics.org/groundzero.html
4. Sports Medicine & Science Institute: A program of the Humanitarian University Consortium Graduate Studies Center for Medicine and Veterinary Medicine. Url: esportsmedicine.org
5. Head and Neck Brachytherapy Program: Yale School of Medicine. Url: radonc.yale.edu/clinical_people/brachytherapy.aspx
6. Infrared Sauna: Far Infrared Studies. Url: unarts.org/nevergiveup/ref/far_infrared.html
7. Experimental L-Glutamine Agent Shown Effective in Oral Mucositis: The Journal of Supportive Oncology. Url: supportiveoncology.net/journal/articles/0306414.pdf Note: Utilized L Glutamine in all fluids for hydration, from the start of combined chemo/radiation therapy.
8. Guaifenesin: PubMED Health. Url: ncbi.nlm.nih.gov/pubmedhealth/PMH0000696
9. Oral mucositis prevention by low-level laser therapy in head and neck cancer patients submitted to concurrent chemoradiation: A prospective randomized study. J Clin Oncol 27:15s, 2009 (suppl; abstr 6019) Url: asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=31765
10. Low level laser therapy: Wickpedia. Url: en.wikipedia.org/wiki/Low_level_laser_therapy
11. HRI/UNArts Never Give Up: Cancer Journal & Resources. Url: unarts.org/nevergiveup
12. Carboplatin: A Platinum Based Chemotherapy Agent. Url: carboplatin.org
13. Top40 Charts - Nominate "The American Way" 2010 Country Music Song of the Year: Top40 Charts/Humanitarian Resource Institute, 13 November 2010. Url: unarts.org/news/aiie_top40charts1132010.html
14. Top40 Charts - H-II: Stephen Michael Apatow Pushes New Standard Of Care For Cancer Treatment: Top40 Charts/Humanitarian Resource Institute, 9 November 2010. Url: unarts.org/news/aiie_top40charts1192010.html
15. Top40 Charts - H-II Album Release - Country Goes Global - CD Baby International Distribution: Top40 Charts/Humanitarian Resource Institute, 20 November 2010. Url: unarts.org/news/aiie_top40charts11202010.html
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