“ONE FAMILY’S STORY”

John Emond, NASA HeadquartersHuman Interest Panel

FLC Mid-Atlantic Region Annual ConferenceSeptember 16, 2009

GRIM STATISTICS

MEN WOMEN

TOTAL CASES: 766,130 TOTAL CASES: 713,220

TOTAL DEATHS: 292,540 TOTAL DEATHS: 269,800

CASE BY TYPE:• Prostate 25%• Lung and Bronchus 15%• Colon and Rectum 10%• Urinary Bladder 7%• Skin Melanoma 5%• Non-Hodgkin's Lymphoma 5%

CASE BY TYPE: • Breast 27%• Lung and Bronchus 14%• Colon and Rectum 10%• Uterine 6%• Non-Hodgkin's Lymphoma 4%• Skin Melanoma 4%

DEATH BY TYPE:• Lung and Bronchus 30%• Prostate 9%• Colon and Rectum 9%• Pancreas 6%• Leukemia 4%

DEATH BY TYPE:• Lung and Bronchus 26%• Breast 15%• Colon and Rectum 9%• Pancreas 6%• Ovary 5%

2009 ESTIMATED U.S. CANCER CASES AND DEATHSSource: American Cancer Society

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LIFETIME PROBABILITYDEVELOPING CANCER, 2003-2005 DATA

Source: NIH/NCI

MEN WOMENALL TYPES OF CANCER: 1 IN 2 ALL TYPES OF CANCER: 1 IN 3PROSTATE: 1 IN 6 BREAST: 1 IN 8

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John and Mary Brough EmondBrough/Emond Family Does Not Need Statistics

John and Dolores Brough, Parents 9 sons and daughters

Joseph and Ellen Emond, Parents 3 sons

John Brough died brain cancer age 53 Son Joseph:• Treated for prostate cancer

Daughter Dolores: • Treated for breast cancerHusband William: • Treated for Non-Hodgkin's Lymphoma

Son James:• Treated for prostate cancer

Son John:• Treated for Non-Hodgkin's Lymphoma

Son John:• Diagnosed with prostate cancer, May 2009

Son Vincent:• Treated for bladder cancer

Daughter Maureen:• Treated for basal skin cancer 4

Early Detection• Annual checkup March 2009 yielded substantial spike in

Prostate-Specific Antigen (PSA) level in blood2006 2007 2008 2009 1.1 1.3 1.7 6.7

• Subsequent blood tests confirmed elevated PSA level, additional testing required

• Joined an NIH clinical study April, 2009 for prostate analysis

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NIH/PHILIPS MEDICAL SYSTEMSCOLLABORATION

• NIH study merges MR imaging and biopsy to more accurately detect possible presence of prostate cancer. I was 95th participant in study

• Collaboration between NIH and Philips Medical Systems (CRADA 01864) with NIH Drs. Peter Pinto, Peter Choyke and colleagues

• Philips provides NIH access to software code, latest imaging technology, and 2 onsite physicists to develop quantitative MRI

• NIH provides Philips with real-time feedback: what does, does not work

• Jointly develop innovative technologies including fusion MRI and ultrasound fusion biopsy

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Diagnosis• NIH MRI scan April 16, endorectal and phased array

surface coil– Two suspicious sites identified in the prostate

• “Small subtle age lesion in the midgland…making this a moderate risk lesion”

– Family history of brothers with prostate cancer increases this as risk

• NIH Biopsy May 19– Biopsy of 18 sites included usual random sampling of

prostate but also targeted within the 18 the two suspicious sites found by the MRI

– Biopsy revealed 5 sites positive for prostate cancer including the 2 sites identified in the MRI

– Prostate cancer “Gleason Score” 6 (3+3), easier to treat compared to higher Gleason scores 7

Treatment• Prostate surgery July 27, Johns Hopkins, Baltimore

– Released from hospital July 29 (food was pretty good)

• Successful Operation:– Post-surgery pathology report cited “negative margins”,

indicating cancer fully contained in prostate

– First post-surgery PSA reading was < 0.1 nanograms per milliliter of blood; threshold of 0.2ng or less is success

• Indicators point to cancer cure

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CONCLUSIONS• Cancer touches many lives

– Some families have more than their share– Cancer creates sadness and trauma far beyond what is seen in dry

statistics/actuarial tables; there are real people behind these numbers!!

• Cancer remains a deadly threat but technology advances across a broad front towards early detection, treatment, and hopefully cure.

• NIH CRADA with Philips Medical Systems– Fuses data from MRI/Magnetic Resonance Imaging and prostate biopsy– Provides a targeted approach to biopsy site selection rather than purely

random sample approach• Purely random biopsy site selection can lead to false negative findings, false

sense of security when in fact cancer can be present

• My early cancer detection including the NIH MRI study, and subsequent treatment, is giving me the best chance for cancer cure.

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IF ANYONE WOULD LIKE TO DISCUSS DEALING WITH

PROSTATE CANCER I WOULD BE HAPPY TO TALK TO YOU:

JOHN EMOND, INNOVATIVE PARTNERSHIPSPROGRAM,

NASA HEADQUARTERSPHONE: 202-358-1686

E-MAIL: JOHN.L.EMOND@NASA.GOV10