Bruce Fuerbringer

Bruce Fuerbringer has fought fires for more than 30 years. With Mayo Clinic's help, he's fighting a different battle.

Bruce Fuerbringer celebrated his 50th birthday by ending his yearlong regime of daily interferon injections. "It was definitely an 'over the hill' party," he says with a laugh. He took the drug following a diagnosis of malignant melanoma. The cancer had spread to a sentinel lymph node by the time a suspicious mole was removed from his chest. Following the procedure, Bruce remembers his physician telling him, "The horse had gotten out of the barn." What followed was a year's prescription of interferon to destroy any rogue cancer cells that might be lingering.

"At the conclusion of my therapy, I thought I was in the clear," says Bruce, whose interferon treatments left him feeling like he had a case of the flu for the entire year. "I thought I had paid for the sins of my youth, which included ample time at the local swimming pool as a youth, and later as a lifeguard — seldom wearing a shirt. We didn't have sunscreen at the time, and having a tan was everything," he remembers. One time, Bruce had a second-degree sunburn that required a doctor's visit and took several weeks to heal.

A couple of years later, Bruce noticed a lingering rib pain whenever he coughed or sneezed. "At first I didn't think much of it," says Bruce. "I thought maybe I had pulled a muscle sneezing hard or during work." Bruce was a longtime firefighter, emergency medical technician and fire chief for the city of Eau Claire, Wis. In those roles, Bruce had taken care of people and put out fires nearly all of his adult life. Soon, however, Bruce would be the one in need of help.

Cancer returns
Bruce mentioned the rib pain to his local physician, who ordered chest images because of Bruce's history of cancer. "What they found was a malignant tumor on the rib that ran up along the chest wall," he says. "And there was a suspicious spot on my liver."

Unfortunately, the rib cage tumor was located in a risky location for surgery — and because it appeared the liver was also involved, doctors offered no treatment options, gave Bruce six to eight months to live and referred him to Mayo Clinic. "I remember going home and soberly sitting in my living room," recalls Bruce. "I thought — at least I know how my life is going to end." Bruce also thought about all the things he put off doing and wouldn't get to experience — especially a motorcycle trip to the West he always dreamed of taking.

Somewhere during that thought process, Bruce mustered all the courage and strength he had and called his wife to his side. "I told her that if she believed in me, I was going to fight with every ounce of energy I had and explore every possible option before giving in to cancer," he says. "At the very least, I wanted to buy a little more time."

Bruce's fight led him to Mayo Clinic in Rochester, Minn., and into the care of medical oncologist Gary Croghan, M.D., Ph.D., and Matthew Callstrom, M.D., Ph.D., a radiologist experienced in tumor ablation. Bruce entered a clinical trial testing the efficacy of a new chemotherapy drug. During the trial, and the testing ordered by Dr. Croghan, hope emerged for Bruce and his wife, Shelly.

Ablating the odds
"Ablation can be used when there is limited metastatic disease," explains Dr. Callstrom. "While radiation therapy is a good option, melanoma can be resistant, and since it was strongly suspected the liver was involved, we needed to look at other options." Ablation can also be used to reduce pain caused by tumors and potentially extend the lives of people who have terminal, metastatic disease.

Through clinical trials and practice, Mayo Clinic has treated more patients using cryoablation and radiofrequency ablation as a palliative measure for pain than any other medical institution in the world. "We've treated over 1,000 patients with ablation," says Dr. Callstrom. "Ablation is used to treat limited bone, kidney, lung and liver cancers when surgery isn't an option, and when other forms of treatment have not been effective or are not desired by the patient."

Fortunately, after further investigation, physicians determined Bruce had a benign growth in his liver. "This type of benign cavernous hemangioma is quite common in the liver as people age and does not require medical treatment," says Dr. Callstrom.

After the trial, Bruce and Dr. Callstrom discussed cryoablation, which involves freezing tumors to kill them. The procedure has been performed at Mayo Clinic since 2003. Mayo Clinic also uses this therapy to treat "hotspots" that cause arrhythmias in cardiology patients. Mayo Clinic is currently leading a multisite clinical trial, funded by the National Institutes of Health and National Cancer Institute, studying cryoablation for patients with metastatic cancer to control pain and improve quality of life. A small subset of patients has actually achieved complete remission using ablation.

"The entire procedure takes two to three hours to perform," explains Dr. Callstrom. "We place small needles that are sealed and insulated through a skin nick using CT and ultrasound to guide the precise placement of the probes. The tips of the probes get to minus 170 degrees centigrade." As the tissue freezes, ice forms and radiologists follow the formation of ice with CT. "This allows us to be very specific — completely covering the metastatic lesion and destroying the tumor while avoiding nearby normal critical structures," he says.

"As soon as the procedure was over, Dr. Callstrom visited my wife in the waiting room," says Bruce. "He told her that I should start planning that motorcycle trip, and she knew that was very good news."

Bruce has made a full recovery. He has a PET scan every six months, which shows no signs of cancer. "I took that two-week motorcycle trip to California — riding a new firefighter edition Harley-Davidson that I purchased shortly after I retired from the fire department after 31 years of service," says Bruce, who no longer puts anything off.

Bruce and his siblings took a first-ever trip together to the Grand Canyon via Amtrak, and he and Shelly recently took another extended motorcycle trip to Montana. "My goal when I was having treatment was to beat the cancer and participate in a triathlon with my son," says Bruce. "We accomplished that dream last fall." The triathlon was his first, and he did very well. "I didn't come in first, but I finished … and that's pretty good considering everything I had been through in the year prior," he says.

"Mayo Clinic gave me another shot at life, so I'm living every moment," says Bruce. "And, yes, I'm wearing sunscreen."