Iowa City man, family mark special day by overcoming tumor-induced kidney failure

What were the odds that the worst medical crisis of Bernard Collins’ life would intersect with his 50th wedding anniversary? Probably pretty slim, considering his lifelong medical history and lifestyle.

Collins’ health problems began in 2002, with a sharp pain in his stomach. “I’m usually the type of person who when I get something, it goes away tomorrow, and if not, the next day,” said the 73-year-old Iowa City resident. “But this went on for three months. It got to where if I was swinging a golf club or twisting a certain way while sitting, it really hurt.”

After an examination by Oscar Beasley, M.D., with Towncrest Internal Medicine, L.L.P. in Iowa City, Collins was referred to Holden Comprehensive Cancer Center at The University of Iowa, where he was seen by Raymond Hohl, M.D., Ph.D., professor of internal medicine and pharmacology. Hohl diagnosed Collins with multiple myeloma, a type of cancer where plasma cells (white blood cells that produce antibodies) in bone marrow and other bone tissue grow rapidly and uncontrollably to form tumors at multiple locations.

Hohl outlined a treatment plan that included a drug called pamidronate, which inhibits bone absorption and is very effective for patients with myeloma and other cancers. “We participated in the study that led to FDA approval of this drug some years ago,” Hohl said.

Collins began to feel better immediately following his first pamidronate injection. “Up to this day, I’ve had almost no pain since that first dose,” he said.

Still, Collins did have a very serious myeloma-related crisis in November 2003, when he went into renal (kidney) failure. The kidneys remove excess fluid/waste material from the blood; when they lose this filtering ability, dangerous levels of waste accumulate in the body. “He had been switched to a second bone strengthening drug--zoledronic acid--that might have contributed to the problem,” Hohl said. “A larger contributor was likely his worsening myeloma, which in itself can cause renal failure.”

Luckily, Collins faced the crisis boosted by a large support network and his religious faith. Most of his family--including his four children, 12 grandchildren, one great-grandchild, and even his 94-year-old mother--had gathered in Iowa City to help Collins and his wife, Patricia, celebrate their anniversary. They were all on hand to hear Hohl and his team’s prognosis: Collins would likely die quickly without treatment.

The family had to decide among a strict palliative care approach (keeping the patient comfortable but letting nature take its course), dialysis (an artificial means of removing waste products/extra fluid from the bloodstream) and the difficulties and risks that go with it, or chemotherapy, which was high risk considering his condition but might reverse the kidney failure. “The myeloma protein that is in the blood is toxic to certain cells in the kidney,” Hohl said. “As we give chemotherapy to eradicate the cells that produce this protein, the protein levels decrease and the renal function may return.”

One detail both Collins and Hohl remember vividly about that day is the family’s thunderous response to their options: “We’re going to fight it!”

“We decided to go with chemotherapy, and it worked,” Collins said. “Away we went, and we won out. The treatment I’m receiving is wonderful; there aren’t enough adjectives to describe it. It’s beautiful, the teamwork, and I say that as someone who was in the military for 20 years.”

Multiple myeloma is not often cured, but today’s medicine often allows patients to maintain a high quality of life. “There are many new drugs being rapidly approved and we are studying many of them here,” Hohl said. “Mr. Collins does have active disease, and my job is to help him live as long as possible as long as he wants treatments. With all the new advances, that could be a long time.”

Happy Anniversary Bernard Collins and his wife, Patricia, have extra reason to appreciate their 50 plus years of married life together.

Optimistic Outlook Cancer specialist Raymond Hohl, M.D., discusses cancer care with Bernard Collins, who has maintained an active life since undergoing treatment for multiple myeloma and tumor-induced kidney failure.