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An account of my brother's battle with Hodgkin's lymphoma

These pictures are a photo essay of my brother, Marc Gregerson, and his battle with lymphoma. Marc was 10 months older than me, and was adopted by my parents (Linda and Dave) before I was born. They lived in Minneapolis, Minnesota. Marc and I grew up together in Minneapolis, attending the Minneapolis public schools (including South High School). We lived in Prospect Park most of that time.

He and I both moved to California with our Mom around 1988, but while I returned to Minneapolis, he started a family in the Palm Springs area. He was living with his wife, daughter, and two step-sons in Morongo Valley, California, when he developed his first signs of lymphoma: painless lumps in his neck. He mentioned them to his doctor at the time, and was told not to worry, his white blood cell count was normal so he did not have an infection (which is true -- he had cancer).
Marc and Chris on the patio

Some time later, a lymph node in my brother's chest grew so large it impaired his breathing. When it became bad enough, his wife took him to the emergency room. He was diagnosed with Hodgkin's Disease in August of 2000. It was stage 3 (out of 4), but his chances of recovery were still favorable (perhaps somewhat better than 50/50).
Marc at Christmas, 2001 He received chemotherapy for six months, during which time he was (surprisingly) still able to work as a long-haul trucker (working for Swift out of Oxnard, CA.).

When his first round of chemo was completed, his follow-up PET scan looked good (at first). There were no obvious tumors. Around that time he lost his job (and his health insurance), and so he postponed getting the consolidation radiation treatment he needed. cement mixer Marc drove for AAA He found new work, driving a cement mixer for AAA. After waiting for his health insurance there to kick in, he saw a radiologist. This was three months later, and she said he was not a candidate for consolidation radiation treatment -- upon closer inspection of Marc's PET scan, his cancer was not gone.

Marc tried another course of chemotherapy, called "mini-beam". He developed intense pain, and went into a coma. He was admitted to Desert Hospital in Palm Springs, and there was no medical explanation (for this or several chemotherapy-related neuropathies yet to come). Marc in the hospital with neuropathy Note that this is not a normal side-effect of chemo, my brother's case was unusual.

The coma required the chemo to be stopped. Due to the severity of my brother's illness, and the diminishing chances of recovery, he was considered for high-dose chemotheraphy with a peripheral blood stem cell transplant (PBSCT) at UCLA. Marc was accepted, and scheduled to go there in early January of 2002.

Marc had a central-line catheter installed in his chest, and was started on Neupogen. Marc in the Emergency room at UCLA He received cytoxan as preperatory chemotherapy in advance of going to UCLA for pheresis, the harvesting of his own stem cells for later transplant back to him (an autologous transplant, where the donor and recipient are the same). The cytoxan put Marc in a second coma, and later he was rushed to the ER after having seizures. Marc with a central line catheter This is highly unusual. It was suspected that the chemo had passed the blood-brain barrier or some other anomaly was now occuring with each round of chemo Marc got.

The high-dose chemotheraphy treatment Marc got was, frankly, grueling. It involved high-dose radiation (painless), but the chemo causes very painful mucositis, which makes taking anything by mouth physically impossible for a period of time. In my brother's case, he also developed neuropathy, including dementia and paranoia (this is unique to him, highly unusual).
Marc suffering from neuropathy

My brother survived this treatment, and was discharged to the Tiverton House (across the street from UCLA) for observation while he continued to recover. He eventually went home, and soon travelled back to Minneapolis to see some old friends and relatives. He was able to meet his biological Mother for the first time, stay with his Grandmother, and enjoy himself.

In less than a year, he developed back pain, which turned out to be coming from a tumor in his pancreas.
The lymphoma had returned. It was deemed to be an agressive case, especially for Hodgkin's Disease, which is often survivable. I knew from my own reading that each time the cancer returned, his odds of recovery were getting worse. Hospice was now an legitimate option. There was one final treatment with at least some chance of "significantly prolonging" Marc's life, a bone marrow transplant.

Marc's own stem cells had been used for his stem-cell transplant. His bone marrow could not be used (I believe it was too weakened by the chemo he already received, or the cancer was believed to be in the marrow). A search for a matching donor was done, and a match was found ("thank you" to the anonymous stranger who made the donation).

Marc's system could not handle another high-dose chemo treatment, but he could get a weaker regimen. The expected "graft-versus-host disease" (GVHD) that should follow the transplant might attack the cancer, and result in remission. In other words, the lymphoma would be attacked by a kind of "organ rejection" phenomenon.

Marc again survived the chemotheraphy at UCLA, and was discharged to a nearby hotel for observation. As expected, he developed mild GVHD -- he began to vomit, get dizzy, and get rashes. He was re-admitted to the oncology unit at UCLA, and the GVHD was treated. Unfortunately, it went from mild to severe GVHD: his liver began to fail. This made him disoriented, and when his breathing began to fail, he was intubated (put on a ventilator) and transferred to the ICU.

I knew, from my own research, that this was about as gravely, seriously, ill as a human being could get. I had been visiting my brother in the hospital often (hence the photos you see here), and I stayed with him in his room for weeks at a time.
Marc in the ICU with GVHD His condition as almost without any hope. I went back to Los Angeles to be with him (although he was not conscious at this point). Marc did not expire, but his stay in the ICU drew on. At one point, Marc regained consciousness, was moderately alert, came off the ventilator (was breathing on his own). He was even discharged from the ICU. He seemed to have a real chance of surviving, at least for period of time. Unfortunately, within two days he needed to be intubated again (was back on a ventilator) and was returned to the ICU.

The GVHD was ravaging his internal organs; he required dialysis, and his liver was damaged beyond repair. We learned his bone marrow transplant had failed, and so his lymphoma would return eventually anyway. Marc's funeral, 2003

Marc Allan Gregerson passed away on the morning of March 20th, 2003, a few hours after seeing his wife and children one last time. His weakened heart had failed. He was 34 years old. Rest in Peace, Marc.
Marc and Chris together as kids

I would like to thank the staff of UCLA, such as the oncology nurses and doctor Emmanouilides, for the care they gave my brother. Marc consented to the photographs shown here. There is a more extensive collection images of Marc's experience here: Hodgkins Disease.

This page last modified on 2007-12-03

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