- Diagnosed with glioblastoma in 2009 at age 49
- Treated with surgery and chemotherapy at UW Medical Center and Seattle Cancer Care Alliance
- Received radiation therapy closer to home in Spokane
- Participated in a vaccine trial
- Received Gamma Knife radiosurgery for recurrence in 2013 at Harborview Medical Center
Michael Funk is the first person to tell anyone who asks that he has been quite fortunate in his fight with an aggressive, persistent cancer. “After two operations and one Gamma Knife [radiosurgery], it has most definitely slowed me down a bit,” he said. “One thing I have not slowed down on is my enjoyment of life.”
Mike likes to try new things; he’s an entrepreneur. He started companies and sold them—he even owned radio stations once. He developed new technologies and then moved on to something else. For over 30 years that’s what he did, devoting obscenely long hours to the tasks at hand, until June 20, 2009, when a seizure stopped him in his tracks.
“I had come home from a business trip,” said Mike, who was 49 at the time. “I was exercising at home—my son was there, home from college—when I had a seizure.”
Mike’s son, Boyd, didn’t know what was happening and immediately began CPR, even though Mike’s heart was actually just fine. “I thought I had some broken ribs after that,” Mike said.
Diagnosis and Surgery
Mike had a magnetic resonance imaging (MRI) scan at a local hospital near his home in Spokane, Washington. A pea-sized tumor was found, and his doctor thought it was a meningioma, cancer that arises from the meninges, the coverings of the brain and spinal cord. These are usually slow-growing cancers. The typical treatment is surgery. Mike’s doctor recommended that the tumor be watched and they not do anything right away.
Mike took phenytoin (Dilantin) to avoid any more seizures, “but those hit me like six beers in the morning,” Mike said. “And I decided I didn’t want to wait and see, so I went to UW Medical Center to see Dan Silbergeld, MD, who was recommended by a good friend who is also a physician at UW Medical Center.
“We’re all Cougars,” Mike said speaking of his family, “but if you have a medical problem, the University of Washington is where you go.”
The small tumor found on the initial MRI had grown in the few weeks that had passed. “Dr. Silbergeld removed it, and I was off to the races,” Mike said. Because Mike takes good care of himself, he was only in the hospital for a day and a half after surgery. “Then we went to visit our friends at Curlew Lake,” he said, not one to be kept down for too long.
A week after surgery, when the pathology results came back, Mike learned he didn’t have a meningioma but a glioblastoma, the most common glioma, accounting for over 50 percent of all brain cancers. It grows quickly and can invade nearby tissues.
Chemotherapy and Radiation
After surgery, Mike began six weeks of daily chemotherapy with the oral drug temozolomide (Methazolastone, Temodar) under the care of Seattle Cancer Care Alliance (SCCA) medical oncologist Marc C. Chamberlain, MD, and radiation therapy, which he was able to receive in Spokane. “Three days after treatment was complete, I went deer hunting in Montana,” Mike said.
Mike tried to go back to his normal course of business after surgery and the initial six weeks of therapy, but he found he couldn’t handle the time and travel he’d once put into his business. He had another seizure and decided it was time to slow down.
“Now I try to figure out what to do in retirement, and it’s kind of boring,” he said, “but it’s becoming easier. We do a lot of fishing. I have one goal: not to put my family through any more crap and fight this cancer. Everything in life is a long shot, so you can’t win without trying. I have been told that I’m ornery and stubborn, so I know I have a chance.”
Vaccine Clinical Research Study
In December 2009, Dr. Chamberlain encouraged Mike to participate in a clinical research study of a new vaccine to fight glioblastoma.
“The vaccine was administered once a month. It was an intradermal injection, usually given in the groin area as lymph nodes are in the proximity and this helps build an immune response,” said SCCA medical oncologist Maciej M. Mrugala, MD, PhD, MPH, the primary investigator for the study.
The peptide in the vaccine was engineered to attack brain cells expressing a molecule called EGFR (epidermal growth factor receptor) and specifically its mutant called vIII. Glioblastomas that express this molecule are more aggressive and associated with poorer prognosis. The vaccine plus traditional cytotoxic chemotherapy is thought to be the optimal combination to fight these tumors. Patients can continue receiving the vaccine once a month for as long as their tumor is not growing and they don’t have any severe side effects from the treatment.
“My cancer cells had the right protein to be in the study, and I got MRIs every 60 days to watch for tumor growth,” Mike said. In addition to getting the vaccine, Mike took temozolomide five days per month.
After six months, chemotherapy becomes a choice for patients. There is not enough data to show that temozolomide is beneficial after six months, so doctors often let patients decide if they want to continue taking it.
“There was not much in the way of side effects,” Mike said. “I mean, I could find some, but the disease is worse than the side effects, so I kept doing what kept the disease in check. I’m a practical guy.”
Dealing with Recurrence
The regimen kept Mike’s glioblastoma at bay for nearly four years until June 2013, when one of his regular MRIs showed tumor growth. “That ended the vaccine trial for me,” Mike said. But he believes the vaccine had a definite positive effect on his disease and helped him become part of a very small percentage of patients who live five years after a glioblastoma diagnosis.
SCCA radiation oncologist Jason K. Rockhill, MD, PhD, prescribed Gamma Knife radiosurgery, offered at Harborview Medical Center, to treat Mike’s recurrence. Then Mike took bevacizumab (Avastin) for a year. Unfortunately, that wasn’t the end of his cancer.
“We were getting ready to go to Hawaii for my daughter’s college graduation in April 2014 when they found another recurrence at my 60-day MRI. This time, Dr. Silbergeld thought it best to go in and take it out [with conventional surgery]. I’ve got this down to nearly an outpatient thing. I had surgery, was in ICU, and went home in one day.”
Because Mike’s tumor kept recurring in the place where it originated, Dr. Silbergeld was able to use the same incision area to remove the new growth. A chemotherapy patch was added to the site after the tumor was removed, and then Mike began taking lomustine (CeeNU), an oral chemotherapy, once every six weeks. “This chemo is a little tougher, and it’s kicking my butt, but if that’s what I have to do, I’ll do it.”
Mike said that he feels fortunate and that cancer is part of his family’s life, “so we go on daily with whatever the day brings. I send friends to SCCA. They’ve got the best doctors in the world.”
By Amy Poffenbarger, SCCA Staff Writer