Last June, Bruce Lowder, 59, struggled finding words. He’d say something like, ‘Watch the what do you call it, you know what I mean,” when he wanted to watch TV, for example. Over the weekend, it worsened so much that wife, Meredith Lowder, scheduled him a doctor’s appointment.
“It occurred very swiftly,” Meredith Lowder, 55, who lives in Putnam Valley, New York, told TODAY. “He was just having a lot of trouble remembering words.”
The doctor recommended that Bruce undergo an MRI and they soon learned why he was struggling to talk: He had a glioblastoma, an aggressive cancerous brain tumor.
“His primary (doctor) … said, ‘It’s a tumor and probably not a nice one,'” Meredith said. “That’s when the icy cold feeling just trickled down my back.”
Speech problems leads to disheartening diagnosis
About six months earlier in December 2020, Bruce had COVID-19 so when he first started having speech problems, Meredith wondered if it was lingering symptom of COVID-19.
“He and my daughter had a rough time,” Meredith said.
The couple has been married for 20 years but have known one another since Meredith was 13 and Bruce, 16, when they attended the same schools. Meredith is a nurse practitioner and didn’t think Bruce had a stroke — he didn’t have any one sided weakness or facial drooping. She worried it could have been an aneurysm so when the doctor told her it was a stage 4 glioblastoma, she felt shocked.
“Honestly this would have been the last thing on my list,” she said. “Glioblastomas are nasty.”John McCain, Ted Kennedy and Beau Biden all had glioblastoma that subsequently led to their death, Dr. John Boockvar said.
“It’s a malignant brain cancer. That means it comes from a cell in the brain and it never really leaves the brain,” the vice chair of neurosurgery and director of the brain tumor center at Lenox Hill Hospital told TODAY. “It stays in the brain, but it spreads throughout the brain and that’s what makes it universally lethal. So it’s an incurable brain cancer.”
Bruce’s tumor was on the left side of his brain and in his speech center, which was why he struggled to find words. He understands everything people say. He's just not always able to locate the accurate words to respond. Doctors performed surgery and removed as much of it as they could. After some rehabilitation, he went home and started radiation with chemotherapy.
“That was very hard. The chemo not so much but the radiation was pretty nasty,” Meredith said. “There were times when I think he just wanted to go to sleep and not wake up.”
After he finished treatment in September, though, it seemed like his health was improving.
“He was almost back to normal,” Meredith said. “He would forget a few things from time to time.”
But then his symptoms began to appear again and doctors recommended a second surgery.
“They found a few of those tumor cells,” Meredith said. “But not as much as you might expect given the aggressive nature or those types of tumors.”
Bruce also started experiencing seizures as well and was no longer able to drive. The Lowders have two children, a son, Ben, 17, and daughter, Abby, 19, and they wanted Bruce to have as much time as he can to spend with them. When a doctor suggested clinical trials might help Bruce, the Lowders felt lucky to have access to them.
“If, when the time comes when we have to say goodbye to Bruce, we will have tried everything that we can possibly try,” Meredith said.
Bruce hopes to go fishing with Ben one last time, something the two haven’t been able to do for the past two years because of the pandemic.
“This would be a wonderful opportunity for the boys,” Meredith said.
Clinical trials for possible treatments
Boockvar has been leading clinical trials to try devise better treatments for glioblastoma. Sometimes chemotherapy seems ineffective against brain cancer because it can’t get past the blood brain barrier, which humans have to protect their brains. So he’s examining a way to bypass it by using pericranium tissue, which lays under the scalp but above the skull. It doesn’t have a blood brain barrier, but it does have a blood supply. With this procedure, doctors remove the tumor and use the peri-cranial tissue in the cavity, hoping that it will integrate itself in the brain tissue. If successful, chemotherapy could get directly into the former tumor site in the brain.
“(Therapeutic) materials that were given either by mouth or by vein, chemotherapy, that would have a better chance of getting into this area of the brain,” Boockvar said.
Bruce is one of the first patients in the stage 1 clinical trial that is looking at whether the procedure can be safely done.
“It is safe,” Boockvar said. “(It) is really important because one of the things that people were afraid of is I’m putting in the brain this tissue that is highly vascular and tumors like highly vascular things. So would the tumor grow faster by putting in this tissue flap? And we can unequivocally say no, the tumor does not.”
The second clinical trial that Bruce participated in uses microcatheters — often used in coronary angiograms — to direct a “huge dose of a drug that’s effective against glioblastoma.”
“It’s like spraying insecticide on a lawn. You don’t want the insecticide to get on your house or your driveway,” Boockvar said. “This is an attempt to minimize the body’s exposure to this drug and maximize the exposure on a tumor.”
This trial finished phase 2 studies and is recruiting for phase 3.
“We were able to show that 1/3 of our patients live three years or longer in a disease that has an average survival of 12 months,” Boockvar said.
'That may save somebody's life'
While the Lowders hope that the clinical trials give Bruce more time with his family and a better quality of life, they know that his participation in the clinical trials could have more of an impact on other patients.
“That may save somebody’s life. That may save a child’s life,” Meredith said. “Maybe our story will give someone else (hope) knowing that we’re not alone, knowing that there’s other people out there going through the same thing.”
Despite the grueling treatments and various surgeries, Bruce, who will likely not ever regain his ability to recall words, never complains. It’s almost been a year since his diagnosis and the family knows his time is limited. They hope he’ll make it through Father’s Day and be able to join Ben fishing and maybe a family trip to the Catskills.
“It’s been a challenge. I’m not going to lie. It’s definitely affected everyone. I have a very supportive family,” Meredith said. “The hardest thing is nobody can go through the grief except you.”