Doctor's Note 03-31-09

It is with sadness that I am reporting the passing of our patient and friend Kevin Brock. Kevin passed away February 18, 2009 at his home in Richmond Kansas with his parents and family members at his bedside.

Kevin was initially diagnosed with metastatic melanoma in 2002, when he presented with a melanotic lesion in his left calf. After resection of this lesion he had a sentinel lymph node dissection in the left groin. Unfortunately he had lymph node involvement. Kevin spent a year receiving adjuvant therapy Alpha Interferon. He was disease free until June 2007 when he developed subcutaneous skin lesions in the neck and under the left axilla. These biopsies were positive for metastatic melanoma. In the ensuing months he received two different trials of chemotherapy, none of which worked. He developed rapidly progressive skin lesions throughout his body. As a last resort, the FDA allowed us to give Kevin our vaccine on a compassionate basis.

Kevin is the first person to receive this vaccine. He started the vaccine therapies in March 2008. At that time, Kevin had five index lesions that were measured; these were all subcutaneous lesions (under the skin). Within two months of treatment four of the five lesions disappeared completely. The fifth lesion was excised and we found a hematoma (blood clot) and very little residual cancer. Kevin successfully completed two cycles of the vaccine treatment. He had very few side effects from the treatment. He did have some intermittent joint pain which responded to Aleve and Tylenol.

Kevin developed new subcutaneous lesions within four months of completing his vaccine therapies. The recurrence was much more aggressive, and Kevin developed more than six nodules in one week. By October 2008, these lesions were rapidly progressive. After extensive discussion with Kevin and his family we decided to give the vaccine another try. Once again the vaccine was effective in controlling the older lesions. This time around despite vaccine therapy, new lesions were developing under the skin in various places of his body. It seemed like the vaccine was able to control the older lesions but not prevent the development of new lesions under the skin.

I discussed alternative treatments, such as experimental clinical trials at other institutions. Kevin was tired and declined further treatments. Following the Christmas and New Year Holidays Kevin was admitted to the hospital. He received radiation treatment to some of the more painful subcutaneous lesions. An epidural catheter was placed in his back with a pump that would deliver pain medication continuously. He was then dismissed home to the care of his parents with Hospice support.

With the experience of treating our first patient with the vaccine we have learned some valuable lessons. It appears the vaccine is well tolerated with very few side effects. Joint pain which is easily relieved with Aleve and Tylenol seems to be the only major side effect. In terms of efficacy and benefit of the vaccine, this would be too difficult to assess with one patient. However, Kevin did respond to the therapy, however briefly, and our future assessments may need to include a period of maintenance therapy with the vaccine. Kevin was a kind and courageous young man whose fight to find a cure for melanoma has already aided us in improving our treatment protocol and ultimately curing melanoma. Kevin will be missed. Listed below is Kevin’s biography (reproduced with permission).

Kevin was born on May 13, 1976 in Garnett, Kansas, the son of Jerry and Marie (Peine) Brock. He graduated from Central Heights High School with the Class of 1994. Immediately following his graduation Kevin was a dedicated employee of Jarit Industries until 2003. After leaving Jarit Industries, Kevin was happily employed by Performance Electric until his death.

Probably the best way to describe Kevin to those who were not lucky enough to have had the pleasure of knowing him would be to simply say that he was truly “special.” Kevin was dedicated to his family, to his work, and to his friends. He was one of those very rare people that just make everything better with their presence. Kevin’s coworkers have said that they enjoyed going to work simply because Kevin was there.

Kevin measured himself not by how much money he made or how popular he was, but by the things that he did for others. On his list of priorities Kevin always placed himself behind his family and friends. If ever you were in need Kevin was there to lend a helping hand. From building a deck to finishing a basement, or even just an open ear Kevin could not say no. When Kevin’s help was enlisted it could be assured that anything he did was done right. Kevin took pride in the work that he did and would not stop until the job was completed to his satisfaction.

Lazy was not a word that could be associated with Kevin. For him there was always another project that he volunteered to help complete. During his life Kevin was a metal worker, electrician and a plumber. No matter what the task before him Kevin would not stop until he had achieved his goal. Whether it was his epic battle with cancer or finding the solution to a problem which lay before him, Kevin was a fighter who always refused to quit. During his life Kevin had probably endured more pain than any three people combined but he never felt that his situation was unfair or felt pity for himself, he simply continued on no matter how bad it hurt.

The foregoing paragraphs focus on Kevin’s work ethic, caringness and dedication. Although those sections may reveal the source of some of our admiration for Kevin, they do not tell a complete story of his life. Kevin’s greatest joys in his life were his family, friends and dog, Keisha. He especially enjoyed the time he spent with his nephews; for them a kinder, more caring and loving uncle could not have existed. One of Kevin’s joys in life was to provide homemade gifts for his family and friends. Kevin’s creativeness in developing these gifts and the method in which he gave them is beyond comprehension to those who have not been witness to the event. We will always have our cedar chests, toy boxes, lamps, etc. to remind us of him.

Now that he is gone we are left only with those cherished memories we have made with Kevin while hunting, fishing, or just spending time with him. To those of you who knew Kevin, may your memories of him be long lasting and pleasant; to those of you who did not, just know that Kevin was truly “special.” This world is a lesser place without Kevin in it. Though his time has passed he has left his mark in the memories of those of us who were lucky enough to have known and loved him. Kevin, until we see you again please accept this small tribute to you and know that it does not do your memory justice.