'Every day is a blessing' for survivor.

Byline: Tim Christie The Register-Guard

EDITOR'S NOTE: The Register-Guard reported on Kyla Nagel's experience with experimental brain surgery in June 2002. Today, a follow-up.

Under the cruel calculus of medical science, the aggressive form of cancer that grew in and on Kyla Nagel's brain should have killed her long ago.

But 14 months after undergoing experimental brain surgery, the 25-year-old Eugene woman is very much alive, with no traces of tumor left in her brain.

"I have my life back," she said in a recent interview at the Santa Clara home she shares with her husband, Jered, and 3-year-old daughter, Emma. "I feel wonderful."

Doctors are still evaluating the effectiveness of the experimental treatment, so there's no way to predict Nagel's long-term outlook, but she's grateful for every morning she wakes up.

"Every day is a blessing," she said.

Doctors discovered Nagel's cancer after she suffered a seizure in December 2001. A large tumor on her brain turned out to be glioblastoma multiforme, an aggressive type of cancer that kills half the people who get it within a year.

A Eugene brain surgeon operated in January 2002, taking out as much of the tumor as he could reach, followed by six weeks of radiation and chemotherapy.

But six weeks after surgery, the tumor grew back. The average life span for a glioblastoma patient with a regrowth of tumor is four months.

Doctors offered Nagel three options: She could undergo conventional brain surgery again, with no guarantee doctors could remove all the tumor. She could try a second, stronger dose of chemotherapy, which doesn't have a good track record. Or she could let doctors try an experimental treatment on her.

For Nagel, the choice was easy.

"I was willing to do anything," she said. "What do I have to lose?"

She enrolled in a phase one clinical trial at University of California at San Francisco Medical Center. In May 2002, she got a dose of a drug called IL13-PE38QQR Cytotoxin, or IL13-toxin for short.

The drug works by binding to receptors on the tumor with a molecule that contains a toxin that kills the tumor. It doesn't affect the healthy part of the brain because it doesn't attach to normal brain receptors.

Not only is the drug experimental, but so is the way it is delivered: Doctors injected it directly into her brain, rather than giving her a pill or a shot and hoping some of the drug would get to the tumor in adequate concentrations.

Since then, she and her husband have traveled back to San Francisco for check-ups every two months. She slides into an MRI machine, which scans images of her brain for 45 minutes, then takes a written test that determines her cognitive ability. She's always a little nervous while waiting for doctors to analyze the scans.

After the doctor tells Nagel the scan is clean, "It's like a tremendous weight off my chest," she said.

"Every scan has been getting better and better," Nagel said. "Each time, I get less and less anxious."

The scans show a black spot in her left frontal lobe, indicating an empty space where the tumor used to be.

"I have nothing in my head - there's no tumor that's visible," she said.

The experience has changed her outlook on life.

"I don't get as riled up or as tense about things," she said. Nagel takes anti-seizure medicine, but otherwise has suffered no lingering after-effects from the cancer or the surgery.

For a while, when her brain was swollen after the surgery, she had trouble finding words when she wanted to speak, but that's no longer a problem. She said her spelling skills have fallen off, but notes she can always use spell check.

Nagel's mother, Vonda Evans, said she's happy with how her daughter is doing, "but there's no telling what the future will bring."

"She looks good," she said. "We just keep praying."

Like her daughter, Evans has learned the importance of appreciating every moment.

"That's been the big lesson here - to make the most of every minute that you have," she said.

Nagel finished her bachelor's degree in history at the University of Oregon in June and is exploring her job options. She's enjoying her summer and savoring the time she spends with her daughter and husband. "I'm definitely a very blessed person," she said.

CAPTION(S):

Kyla Nagel, at home with her 3-year-old daughter, Emma, appreciates "every moment" since undergoing treatment for a life-threatening brain tumor.