Dairy Farmer Chooses EPP With Dr. Vallieres

As a youngster, Ron Barnes just knew he wanted to be a farmer. He also knew he would need a farm. So he set out early in life to realize his dream. At the age of 18 years, he left high school and jumped into his first job at the Simpson Insulating Board Plant in Shelton, Washington. Work went on around the clock -- as did Ron. Ron worked the rotating shifts and then some, logging countless hours of overtime. He saved every penny he could, hoping one day to have enough to buy a few of God’s Green Acres.

Funny thing was Ron didn’t know a thing about farming. Despite that, in 1970, at the age of 32, Ron quit his job at Simpson, and he and his wife, Mary Ann, sold their house in Shelton and bought a dairy farm in Randle, Washington.

Ron had learned how to hay in Shelton, and he had spent a few weekends prior to moving with the previous owner of the dairy farm as the more experienced man taught the novice a few things about how to keep the farm up and running. With their new neighbors only too glad to instruct them from time to time, and their five children helping out, for 30 years Ron and Mary Ann made their farm flourish. They dreamed of retirement and travel sometime in the future.

NOT THE KIND OF TRAVEL THEY HOPED FOR

So, after 30 years of working 12 to 16 hours per day, seven days a week, milking 65 cows twice a day, building barns, mending fences, maintaining his vast dairy enterprise and somehow nurturing a family, Ron Barnes is finally traveling. Once a week, he makes a 200-mile round trip from his home and dairy farm in Randle to his doctor’s office in Olympia, Washington, for his periodic dose of chemotherapy. Not exactly a relaxing trip abroad.

Just over six months ago, Ron was still working the farm as he always had -- milking the cows, baling the hay, collecting silage and conducting everything else necessary to run a dairy farm, as well as getting ready to turn the reins over to his son, Todd. In June, however, in the midst of baling over 12,000 bales of hay, Ron began developing a nagging cough. At first, he ignored the cough, attributing it to the dusty activity; however, as the cough persisted until September, Mary Ann insisted he visit a doctor.

Ron went to see Dr. Hansen at the Morton Medical Center in Morton, Washington. Upon examining Ron, Dr. Hansen immediately ordered a chest film. From the film, he could clearly see fluid build-up on the right side of Ron’s chest cavity. Ron underwent a thoracentesis, and approximately one liter of fluid was drained from his chest. The fluid was sent to the pathology lab for testing. Cytological tests on the fluid were positive for an undetermined malignancy. Dr. Hansen referred Ron to Dr. James Lechner, an oncologist in Olympia. Dr. Lechner could not be certain about the diagnosis and subsequently conducted further tests in addition to draining another liter of fluid from Ron’s chest. The the tests resulted in a diagnosis of malignant pleural mesothelioma.

DR. VALLIERES' EPP PROTOCOL

Dr. Lechner referred Ron to Dr. Eric Vallieres at the University of Washington Medical Center in Seattle. A member of the Science Advisory Board of the Mesothelioma Applied Research Foundation (MARF), a 501(c)(3) non-profit charity whose mission is to eradicate mesothelioma as a life-ending disease, Dr. Vallieres is a prominent thoracic surgeon and treater of mesothelioma. After examining Ron on September 24, Dr. Vallieres believed that Ron was in stage one and concluded that in view of his overall health, Ron was a candidate for the rigorous multi-modality therapy that he offered at the University of Washington. Dr. Vallieres’ protocol consists of pre-surgical induction chemotherapy, and if the tumor responds to chemotherapy, as evidenced by CT scan, extra-pleural pneumonectomy, followed by radiation.

An extra-pleural pneumonectomy is considered to be a radical surgery with a significant patient mortality, depending on where the patient undergoes the procedure. It is controversial, as other doctors would instead recommend a pleurectomy / decortication, which calls for sparing the lung and removing the visible tumor only. See http://www.mesothel.com/pages/brauch.htm.

The selection process itself is difficult, as from the number of patients screened since 1997, only 37% have been accepted to the initial phase of chemotherapy for the protocol at the University of Washington . Of those, only 70% went through with the surgery with just under six percent dying due to complications from the surgery. The survival rate following surgery is better, with the entire group lasting almost a year, although at twelve months, only about half the group remains. The encouraging news about the surgery is that more than ten percent do live for three years following surgery, and a select few even longer. For a complete profile of the above statistics, please see Dr. Vallieres’ notes presented to MARF on their website at www.marf.org.

When performing the EPP, Dr. Vallieres removes the patient’s affected lung and the pericardial sac (along with the diaphragm) and replaces the same with a new lining made of Kevlar®. Several weeks after surgery, after the patient has partially healed, radiation therapy is applied to the affected area in an effort to eliminate all traces of the tumor. Eligibility for surgery, however, relies entirely on the patient’s response to chemotherapy. If, after two rounds of chemotherapy, the tumor has not shrunk, the patient may not continue with the treatment protocol and surgery.

RON AND HIS FAMILY GET READY FOR THE NEXT STEP

Ron agreed to participate, and thus far, has completed two full rounds of chemotherapy and is gearing up for his third. He has had two doses of Cisplatin and has alternated between more frequent dosages of velbanine and methotrexate. He has endured nausea and night sweats and lost weight, and the long drives to Olympia and Dr. Lechner’s office, where he receives his chemotherapy, are taking their toll. His CT scan in December indicated that Ron is responding well to the treatment; however, his tumor is not shrinking. He has developed a cough, and he begins another round of chemotherapy this week. He will undergo a PET scan in February, and at that point, his doctors will determine if he is eligible for surgery and a better shot at life.

The Barnes family is close. They have worked hard together. The children built their houses together on the 140 acres, and they feel fortunate enough to have spent the holidays together on the farm. Until the results in February and for longer than that, the Barnes family will rally together to help Ron get through this. We will keep you posted on the progress of this tenacious and united family.

*** POSTED JANUARY 25, 2002 ***

An Update -- 1/30/02

To whom it may concern

I just wanted to comment on your profile of my Uncle. It was very accurate on the points of his wanting to farm and the closeness of his family. What it didn't say was what the rest of of us know.

Ron and Mary Barnes are wonderful people who are loved by ALL who know them. They have touched many lives with their warmth, caring and love.

Uncle Ron and Aunt Mary hosted most, if not all, family reunions. We are not a small family. At the last reunion one count had between 60-75 people roaming and playing around their wonderful home. There were probably more than that there, but nobody stayed still long enough to get an accurate count. All children love this man. He has a way of making them feel like they have his undivided attention. He plays with them, teases them and loves them like only he can. As busy as he was on that wonderful farm, he always had time for us kids.

Thank you

Kathy Reynolds

An Update -- 4/3/02

Ron and Mary Ann Barnes returned from Seattle, Washington, yesterday where Ron went through routine post-surgery tests to determine his progress. Ron underwent an extra-pleural pneumonectomy with Dr. Vallieres in Seattle on March 14, 2002. During the procedure, Dr. Vallieres removed Ron's right lung, part of his diaphragm and a portion of Ron's pericardial sac. Cytological tests on the biopsied tissue from Ron's pericardial sac revealed that, despite the chemotherapy he had endured prior to surgery, cancerous cells had still found their way to his pericardial sac.

After surgery, Ron's white blood cell count skyrocketed to more than 21,000, and it wasn't until April 2 that doctors measured his white blood cell count at around 11,000 -- still above normal, but short of the critical levels it had reached. Additionally, Ron has been prescribed a large supply of painkillers -- normal procedure following such radical surgery -- and he has been battling fluid build up. Constipation and dehydration have not been absent. He is trying to walk without aid, and little by little, he tries to eat more every day. He is doing everything he can to build up his strength for the grueling radiation treatments that will start in about four to six weeks. With a genuinely sweet but determined Mary Ann by his side, Ron hopes that he just might be the one to beat the odds.

An Update -- 8/1/02

Ron completed radiation treatment three weeks ago. He handled the radiation better than expected, however he has lost 30 lbs. since he began his surgical, chemotherapy and radiation regimen. Prior to beginning radiation, Ron had a feeding tube installed in anticipation of him developing a sore throat from the treatments; fortunately this never became an issue. He did develop a little cough and soreness in the chest area. Ron's doctors want to give him a little time to recover before they remove the feeding tube. He is scheduled to return mid-August for a follow-up X-ray. After having spent six weeks near the Olympia Radiation Clinic, Ron and Mary Ann are just happy to be back home. Ron feels like he's making progress in his recovery from the radiation, his appetite is making a comeback but he is concerned about his increased shortness of breath. There are days when he over-exerts himself, so now he has to guage what he can and cannot do. Mary Ann says they deal with each week differently, as one problem solved is quickly replaced by a new one.

An Update -- 10/27/03

From Mary Ann:

Ron is doing well. He just had a CT scan on October 20 and saw his physician on October 21. The doctor was pleased with the scan results. There are still signs of fluid build-up, but not enough to warrant having it drained. Ron keeps busy around the farm. After being advised by his doctor to stay out of dusty environments, Ron decided he'd buy himself a tractor with a cab to shield him from the dust while working the fields. Ron will continue to get CT scans every three months.

An Update -- 3/17/05

Mary Ann is very pleased to report that Ron is really doing great. Every now and again something will come up, especially when the weather gets cold and he experiences discomfort in his chest. Ron is still keeping busy on the farm. His follow ups with his physician have now been extended to every six months. Mary Ann says she believes it is Ron's positive attitude and sense of humor that keeps his recovery on the right track.

Mr. Ron Barnes passed away on June 8, 2005