Bob’s Story: Recurrent Glioblastoma

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Bob Kehm gets a kiss from his wife, Janice, while recovering in the acuity-adjustable unit after brain surgery at the UC Medical Center.

Bob Kehm gets a kiss from his wife, Janice, while recovering in the acuity-adjustable unit after brain surgery at the UC Medical Center.

Glioblastomas come back. Sometimes sooner, sometimes later, but they always come back. “That’s the nature of GBM,” says Bob Kehm, a four-year survivor from West Chester, Ohio.

For Kehm, 65, the brain cancer returned this summer, four years after his initial surgery at the Brain Tumor Center at the University of Cincinnati Gardner Neuroscience Institute. Kehm, who first shared his story publicly in 2012 as he took part in a clinical trial, underwent brain surgery for the recurrence this past July and is now once again back on his feet and living life to the fullest.

His experience tells us much about GBM, clinical research and the factors that may play a role in cancer survival.

Kehm, who follows a vegan diet, is walking an hour a day, performing strengthening and stretching exercises, and teaming with his therapy dog, Jake, a 170-pound Newfoundland, on visits to hospitals, nursing homes and classrooms with children who have special needs. On October 23, for the fifth straight year, he will join family and friends on the “Brain Stormers” team in Walk Ahead for a Brain Tumor Cure.

Patients can live and go beyond

“Bob Kehm is proof that GBM patients can live beyond initial expectations and can have a great quality of life,” says Ronald Warnick, MD, director of the UC Brain Tumor Center and the John M. Tew, Jr., MD, Chair in Neurosurgical Oncology.

Kehm has been something of a celebrity at UC Health, and not just because he is a patient helping other patients as part of a therapy dog team. Kehm also sparked interest because of his enrollment in a novel brain cancer study. He was praised at UC Health Research week in 2013 for joining the ranks of patients who participate in research and make advances in healthcare possible.

Kehm qualified for the study because he had the type of glioblastoma that contained a protein called EGFRvIII. As a study participant, Kehm was helping scientists investigate the potential benefits of a vaccine designed to help the immune system inhibit the growth of cancer cells that contained this protein. Because the vaccine study was “blinded,” however, Kehm did not know whether he was receiving the vaccine or a placebo.

“In addition to surgery and radiation, they poke me in the leg six times once a month for the experimental vaccine,” he said at the time. “I’m not sure what’s helping me, but something’s doing it and I give credit to the docs and everyone else. This vaccine may have made an impact on how well I’m doing right now.”

Kehm recently learned that he did receive the vaccine, which he took for about six months. He also learned, however, that the trial had shown virtually no difference in survival between those who were given the vaccine and those who were given a placebo. The trial, sponsored by the drug’s manufacturer, Celldex Therapeutics, was halted last spring.

“Some clinical trials work, and some do not,” Warnick says, reflecting. “The excitement of this particular trial did not materialize. But whether trials are successful or not, they are valuable. They move medicine forward because they answer important questions that help us direct future avenues of research. When a treatment fails to work, it reinforces our commitment to continue looking for a home run.”

Kehm’s experience also highlights two additional aspects of clinical trials: “Patients who participate in clinical trials have better outcomes than those who do not,” Warnick says. “And patients can do well even when a clinical trial has a negative result.”

Intangibles of survival: fitness, nutrition, social engagement

Kehm is a trim, athletic man who zipped through the 2012 Walk Ahead for a Brain Tumor Cure 5k in 23 minutes and 13 seconds. At the time, he was “not happy” with his 7:29 pace, although it was good enough to beat his neuro-oncologist, Rich Curry, MD, by 13 seconds. Kehm was still running as of last year’s Thanksgiving Day race, finishing 4th out of 153 in his age group. But a subsequent bone fracture in his pelvis has relegated him – for now — to the walking category.

On the nutritional side, Kehm has lived on the vegetariaBobn side of life for years. He converted to a vegan diet – consuming no meat or dairy products — after attending a lecture by UC Health Neuro-Oncologist Rekha Chaudhary, MD, at last year’s Midwest Regional Brain Tumor Conference.

Kehm’s athleticism and nutritional regimen beg the question: has lifestyle played a role in his longevity?

“That’s a great question,” he says. “Dr. Chaudhary recommended a book, The China Study, which talked about all the cancer survival benefits of being a vegan. I read the book twice I was so impressed, and I’ve been a vegan ever since then. It wasn’t that difficult to make the switch.”

“People often think that living a healthy lifestyle and getting therapy for their cancer are two separate things, when in fact they are intrinsically related,” Chaudhary says. “Living with a brain tumor and being treated for a brain tumor involve two very intertwined decisions and processes. When we approach treatment with these dual objectives, we are practicing integrative medicine.”

Kehm praises all who have cared for him. His first surgery was performed by Norberto Andaluz, MD, his second by Vince DiNapoli, MD, PhD, both of the UC Brain Tumor Center. Luke Pater, MD, a UC Health radiation oncologist, has overseen Kehm’s radiotherapy at Precision Radiotherapy Center in West Chester, and Curry and Chaudhary have coordinated his chemotherapy. Kehm is also deeply grateful for the love, support and caregiving provided by his wife, Janice, their two sons, and the friends who have joined their Brain Stormers team.

Looking ahead, Kehm plans to continue his therapy dog work, although a personnel change could be in store. “Jake is like me, a senior citizen, and in the next year he’ll probably retire,” Kehm says. “I’ve been begging my wife to let me get another Newfoundland before Jake retires. She finally agreed, and after the first of the year we’ll be getting another Newfoundland pup. The pup and I will work together for a year and then, if all goes well, we’ll be making the rounds at Cincinnati Children’s.”

— Cindy Starr

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