Playing the part well
How actor Rudy Fernandez fights an off-screen nemesis called cancer
By Story by Grace Roxas
Photographs by Ma. Cristina Torres
"No drama."
Actor Rudy Fernandez had these two words to say-tongue-in-cheek-to visiting friends and family during one hospital stint in the course of his much-publicized bout with periampullary cancer, a rare one that forms near an area called the ampulla of Vater, an enlargement of the ducts from the liver and pancreas at the point where they enter the small intestine.
Now holding on to his last straws treatment-wise, he was all sangfroid and dry humor in late February as he prepares to undergo another session with the gene therapy Rexin-G at the Asian Hospital and Medical Center in Muntinlupa City, the only place in town where this novel treatment is offered.
Accompanied by actress-wife Lorna Tolentino, herself now something of an authority on the subject of Rudy and his obscure disease, the actor put forth his resolve to either beat this off-screen nemesis to the ground or to go down with guns blazing.
Winning the first round
Beating the disease to the ground didn't seem like such a tall order when the actor was first diagnosed as a stage-I case two years ago.
He recalls a comic evasiveness at first among the people around him who didn't want to say the "C" word to his face. But an appropriate decision was reached anyway on how to deal with his condition.
He underwent the Whipple operation, a highly delicate procedure that involved removing parts of the pancreas, bile duct, gallbladder, and duodenum and then suturing together the remaining bile duct-intestine connection.
According to Lorna, they were reassured by the good prognosis for other local periampullary-cancer patients who had undergone this procedure and went on to live long years after. Under the able hands of surgeon Samuel Ang whom the couple credited as "one of the best, if not the best," the almost 10-hour operation (longer than a heart bypass by six hours) was generally a success.
With his condition detected quite early, the actor has also so far avoided the more debilitating trappings of being with cancer, although the unavoidable disruption on his system from such a procedure as the Whipple led to a choice of living with forced diabetes, a lesser evil in the general scheme of things. The actor is taking daily insulin shots to manage this major side effect of the operation.
The Whipple postop was an ordeal of a week-long intensive-care confinement, subsisting for half a month on a liquid diet through tubes, excreting through other tubes and having a persistent idiopathic fever.
Back with a vengeance
For a year, they thought they had the disease licked until a January 2007 magnetic resonance imaging (MRI) showed that like a wounded wild animal, the tumors were only in tactical retreat to muster force for a deadlier return engagement.
The MRI disclosed metastases in the liver and the SMA (superior mesenteric artery) node. Rudy was put on an initial chemotherapy regimen (gemcitabine and oxali-platin) which had to be changed after only two cycles with the continued increase in size and activity of the existing cancer nodes and the growth of new liver lesions.
The second chemotherapy protocol (gemcitabine and capecitabine) performed better but still failed to stop the disease on its track. By the fifth cycle of this treatment, it was decided to try a third protocol after one of the tumors not only resisted the poison but outflanked it.
Really hurting for the first time since he had been diagnosed, Rudy put his foot down against a third chemotherapy protocol. "Lahat ng grabeng side effects [of chemotherapy]
napagdaanan ko," he recalled, "and wala namang guarantee yung third protocol."
And though he may have faced off with goons and weapons in his movies and would choose fight over flight even in an off-screen brawl, this Filipino macho sheepishly admitted that he'd sooner run from a nurse with a big needle.
After a lifetime of caring for the personal good looks that are stock-in-trade in his profession, his biggest objection to continuing with a third chemo option had to do with the barrage of acne that is an expected side effect of the new drug treatment. As it was, he was not exempted from the de rigueur temporary baldness among chemo patients.
"Mamatay na nga ako tapos sira sira pa ang mukha ko. Gusto kong mamatay ako ng masaya kesa mamatay ako ng malungkot," he wryly quipped.
Added Lorna: "The key to Rudy's personality is, he's a fighter. His will to survive is so high that if that deteriorates, what's the point?"
Keeping up a high morale also made medical sense for them, noting that there appears to be a connection between a period when Rudy was in low spirits and the cropping up of new tumors in his body.
Late last year after Rudy refused the third chemotherapy combination, radiotherapy and radiofrequency ablation were resorted to for the two persistent nodes but to no avail. The tumors seemed to disappear, only to multiply again.
Last option
Refusing to be defaced on top of having his insides twisted by both disease and treatment, the couple finally heeded the advice of Rudy's medical oncologist Dr. Malou Tiambeng about trying out the Rexin-G treatment.
They've known about it since a year ago but were less willing to take chances with something that was only a little beyond the experimental stage. Although Rexin-G has been approved for prescription by the local Bureau of Food and Drugs, United States regulatory authorities have yet to grant the same imprimatur on the drug.
By the time the couple were already open to trying other experimental therapies, only Rexin-G was immediately available. Rudy felt that he didn't have the luxury of time anymore to wait for approval as a subject for clinical trials for the other new cancer therapies.
The actor started on the thrice-a-week regimen with Rexin-G in early February. Although there's no verdict yet on how well the therapy is working as of this writing, Lorna is buoyed by the positive change in her husband's complexion from the ashen days of chemotherapy.
"It [the gene therapy] gave us so much hope," she said. She also said she looks forward to continuing her husband's treatment in the US, where Rudy was recently approved to take part in the clinical trial.
Rudy also feels the treatment is progressing well but is not exactly waiting with bated breath for the outcome. Although he is raring to fight the disease to the finish, he professes resignation as well-a mindset that his wife traced back to the time of his hospital ordeal after the Whipple operation.
"I think he had a one-on-one talk with God during his time in the ICU wherein he said
na kung gusto na siyang kunin, kunin na siya. Wag na lang pahirapan," said Lorna. She noted with relief that in terms of pain, Rudy is so far getting off lighter than most cancer patients, despite a self-confessed low threshold for it.
Rudy added: "Kung oras mo na, oras mo na talaga. God's been very good to me.
Naging maganda naman ang buhay ko with my career, family, and friends."
In the meantime, there is one more thing about his forthcoming US trip that he is excited about. "I'm watching [Manny] Pacquiao's next fight in the States," he beamed.
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