November 2010: Dave Herin

Featuring: Dave Herin
Written By: Carolyn Herin

My name is Carolyn Herin and I have the most adorable husband, Dave. Cancer entered our lives on Jan 15, 2010. Dave was having lower back pain with discomfort and nausea after eating. We received the results of his scan with wide eyes and disbelief. He had a large mass of 13cm on his left kidney with mets to his liver, both lungs and lymph nodes. Dave is 34 years old, a neuroscientist conducting research and an assistant professor in the Psychiatry Department at the University of Minnesota. Not sure if it was professional courtesy or not; but, by later that afternoon, we were squeezed into an appointment with a kidney cancer specialist at the U of M cancer center. He was started on Sutent in effort to shrink the tumor before removing it. The biopsy of his liver confirmed clear cell renal cell carcinoma. A brain MRI was scheduled to check for mets as Dave had a history of headaches;  unfortunately, it revealed 4 mets as well, one too large for radiation alone, it had to be surgically removed. Dave had to stop taking Sutent in preparation for the surgery. On Feb 2, 2010, Dave had a left craniotomy to remove a 5 cm mass from his temporal lobe. The surgery was unremarkable and after 2 nights in the hospital, he was home recovering without complications.

Now a little back-story. We are new to Minneapolis-moving here from Houston, Texas so Dave could begin his career. Dave and I had just gotten engaged one month before finding out about his diagnosis. Our families and friends, our support, was back in Texas. We decided to “up” our wedding and with 8 family members surrounding us, we were married Feb 13, 2010, on the same bridge where he proposed to me in December.  Yes, outside in Minnesota in February! And, yes, 11 days after Dave’s brain surgery!!

Dave remained off Sutent for gamma knife radio surgery to the other brain mets and surgery bed. We had another interruption with Sutent again later on due to a grand mal seizure 3 weeks after the radiation, an unfortunate side effect. We happened to be in Florida on our honeymoon-it occurred our second night there. Dave was then started on Keppra for seizures and not able to drive for 6 months. Re-staging scans after the on/off cycle with Sutent revealed some shrinkage of primary tumor. We were thrilled. The decision was made to remain on Sutent for another cycle without breaks to drive this tumor down. The following scan was not good. Sutent stopped working. Dave then started Afinitor and Avastin together. That treatment was not working either. Votrient was started and Dave was finally set to have surgery on June 30, 2010. It was going to be a tough surgery as the primary tumor appeared to have attached itself to his intestines. After a couple hours, the surgeon came out to talk to me.  If he removed the kidney with the tumor, he would be doing more damage than good as Dave’s intestinal tract would be too damaged.  They closed him back up without removing the tumor or the kidney. Dave still had to recover from the large surgical incision as a result of the attempted open nephrectomy. While in the hospital, Dave became allergic to the heparin they were giving him to decrease the chance of blood clots postoperatively. He developed heparin induced thrombocytopenia ~ his  platelets dropped to a scary low number. While in the hospital on July 4th, he started coughing up blood.  A bronchoscopy was ordered and revealed RCC mets inside his airway. The cancer was out of control and he was not in any condition to reinstate treatment. It took 3 weeks in the hospital for the blood counts to normalize. He was restarted on a low dose of Votrient and slowly advanced to the full dose. Another brain MRI revealed excellent results from the initial radiation; however, 2 new spots were identified. A second round of gamma knife was completed on Aug 25, 2010.

Now a little more back-story. Dave continued to work as much as he could and wanted. He was able to work from home and also give 3 talks during this time at various conferences. He had very mild side effects from the various medications - that allowed Dave to remain so functional. We were able to travel and continue our “new normal” life during this time. I was in awe of him and his abilities. He is a fighter and has remained positive the whole time.

Labor Day weekend 2010, Dave began coughing up large quantities of blood with blood clots. We rushed to the ER and they discovered a complete obstruction of his left lung from the airway mets and bleeding in both lungs, his left lung had fluid and collapsed; he had to have emergent surgery to remove the clots and fluid. After 2 days on a ventilator, Dave was stable and could breathe on his own; however, the outlook was not good and he was very weak. We decided on palliative care with hospice. Three weeks of being home, Dave continued to feel better and get stronger. He was breathing better and even started showing breath sounds in his left lung. There was always a possibility of the clot dissolving on its own and Dave was showing signs that the clot had dissolved. We did some traveling during that time and then came to the conclusion that we wanted to get back on treatment. Our oncologist was supportive and Dave just last week on October 22, 2010, started Gemzar and Xeloda.  These are chemos that are used with other types of metastatic cancer. As we have all read, RCC does not typically respond to traditional chemos. There are a couple new studies that showed some response in the more advanced cases as a salvage treatment. We are not sure of the response but just remain hopeful for more days together. Our goal is getting to celebrate our first year of marriage on Feb 13, 2011.





Dave is no longer with us here on earth as he won his battle with kidney cancer by the way he lived his life!  He will live on in the hearts of those who knew and loved him!

Sadly, Dave Herin, 35, passed away February 19, 2011.