Battling for Life

As Abigail Burroughs sits at a table at Starbucks, sipping a cup of coffee and nibbling at a chocolate croissant, she seems calm and content. On the student-packed second floor of the coffee shop, one may not guess that their fellow student, a petite girl with large hazel eyes and short brown hair, is waging a huge battle in a fight for her life - a battle she was told she might lose within months.

For the past 16 months, Burroughs, a third-year College student, has battled squamous cell head and neck cancer that has spread to her lymph nodes and most recently, to her lungs. Surgery, radiation and chemotherapy have been unsuccessful in halting the tumor growth.

After a full year of attempts, two experimental drugs - C-225, produced by the pharmaceutical drug company Imclone, and Iressa, produced by AstraZeneca - provide a glimmer of hope for her particular type of cancer. But Burroughs does not qualify for the experiments being done on the two medications.

She is trying to bypass this obstacle by obtaining these two drugs under the clause "compassionate use" with permission from the Food and Drug Administration.

"Pharmaceuticalcompanies can release experimental medication for compassionate use on an individual basis if they have reason to believe the medication will be effective, and if the compassionate use request is approved by the FDA," said a spokesperson for AstraZeneca.

Aside from compassionate use, pharmaceutical companies also may use an Expanded Access Program with FDA approval. EAP is a program in which a large number of patients with a specific predetermined profile can receive an experimental medication.

A spokesperson for AstraZeneca explained that the EAP for Iressa is designed to offer the medicine to patients afflicted with non-small cell lung cancer who do not qualify for the randomized clinical trials now being conducted by the company.

However, because Burroughs does not have non-small cell lung cancer, she is ineligible for the Iressa EAP. This is why she is pursuing the route of compassionate use.

The company said it cannot administer Iressa for compassionate use or as part of its EAP in this case because it currently does not have data proving that Iressa is effective in the treatment of head and neck cancer.

Likewise, Imclone is conducting similar experiments with C-225, yet Burroughs has also run into roadblocks at that pharmaceutical company.

Even though the pharmaceutical companies allege that the use of C-225 or Iressa in Burroughs's case would be futile, the Pharmaceutical Research Management Agency, which represents the country's leading pharmaceutical and biotechnological companies, has stated otherwise. PhRMA has released statistics showing a 54 percent success rate for Iressa in cases of head and neck cancer.

Burroughs' doctors at Johns Hopkins University Hospital and the National Institutes of Health, along with oncology experts at the Sloan-Kettering Institute, are encouraged by these numbers. Johns Hopkins has been in contact with the companies on Burroughs' behalf.

Up in arms on the home front

Still, that Burroughs' case does not fall under a compassionate-use case has put many members of the University up in arms in her defense. Her friends have circulated numerous petitions in classes to send to the two drug companies.

"I just want to know what the degrees of compassion are" for compassionate use of medications, said third-year College student Sarah Rude, Burroughs' friend and first-year suite mate.

The Office of the Dean of Students, along with organizations like Third Year Council, FORCE - Fighting, Overcoming and Responding to Cancer Everywhere - as well as the Inter-Fraternity Council have united behind Burroughs with more petitions and even a letter-writing campaign.

Student Council Rep. Prince Agarwal, a third-year College student who went to high school with Burroughs, said Council would write letters to the two companies on her behalf. In addition to his position as a Student Council representative, Agarwal led Third Year Council's petition effort and has circulated information about Burroughs' situation to numerous other student organizations

"It doesn't take anything to sign a petition," said Asst. Dean of Students Stephanie Goodell, who has been leading the University's letter-writing campaign for Burroughs.

"She is my goddess," said Burroughs of Goodell. "She is so wonderful."

Abby's story

Before cancer invaded her life, Burroughs, an Echols scholar studying within the University's Political and Social Thought program, was an Honor Committee counselor and active member of the Jefferson Literary and Debating Society.

"She's one of the smartest people ever, and really loyal" said third-year College student Stephanie Osborn, Burroughs' friend and another suitemate from first year. "If you ever need anything, even something stupid like help picking out sheets, she would be there."

But in fall 1999, an unusual mouth sore that refused to heal changed everything.

"It was annoying," Burroughs said, explaining how over two months she pestered her doctors who finally removed the sore in December 1999. "I just wanted it to go away."

As part of procedure, the sore was sent to a lab and tested for abnormalities. Within the first few days of the new millennium, Burroughs received some shocking news. The sore was cancerous.

"I locked myself in the bathroom and cried and screamed at my mother," Burroughs said. After the margins of the sore were removed to ensure the cancer cells were gone, Burroughs was told there was a 90 percent chance the cancer would not return.

And so, after getting past her scare with cancer, life for Burroughs returned to normal as she finished her second year at the University.

But the nightmare returned last July when she found a suspicious lump on her neck.

"It was throbbing and painful," she explained. "It kept getting bigger."

Her doctor insisted the lump was stress-induced and gave her antibiotics and anti-inflammatory medications before later performing a fine needle biopsy and CT scan on the lump.

The cancer was back - and this time it had invaded her lymph nodes.

"I was freaked out," Burroughs said. "I was thinking, 'Oh, I'm going to have a big scar,' when that was the least of it."

But Burroughs is no stranger to the terror of cancer. Her aunt is currently fighting breast cancer, and her mother's breast cancer now has been in remission for seven years.

"Weirdly enough, ever since I was little, I've always felt something bad was going to happen health-wise when I got older," Burroughs said. "It was an odd premonition."

Unfortunately, it has come true.

The lump in Burroughs' neck was removed last September and she underwent radiation and chemotherapy at Martha Jefferson Hospital until mid-November, an ordeal she described as "incredibly challenging."

"I had radiation in one of the worst parts of my body," she said, referring to the severe burns on the inside of her mouth that prevented her from eating most foods or drinking caffeinated or acidic liquids until this past January.

Throughout the ordeal, Burroughs' mother stayed by her side, moving from Northern Virginia to Charlottesville with her last semester.

"My mom is amazing," Burroughs said. "She knows me so well and has gone through the same thing" through her experiences with cancer.

But when she found yet another lump in the lower part of her neck in January, Burroughs said, "I knew at that point that standard procedures had been exhausted."

At a crossroads

After another series of scans, Burroughs' doctors at Martha Jefferson found new tumors in her lungs and stomach and told her there was nothing more they could do. She was referred to Johns Hopkins University Hospital in Baltimore where she underwent yet another round of unsuccessful chemotherapy. It was the doctors at Johns Hopkins who told Burroughs and her family about the two new experimental drugs, Iressa and C-225, yet to be approved by the FDA and still in clinical trials.

Burroughs explained that her tumors showed high EGFR expression, a cancer protein that is the target for Iressa and C-225, making their likelihood for success much greater.

But for Burroughs and her family, communication with the companies has been a source of constant frustration.

"We've been getting a lot of the run-around," Burroughs said of the lack of answers or explanations she and her family have received from the two drug companies.

"It's been difficult to get the right person and get the right answers," said her father Frank Burroughs, who lives in Arlington. Frank Burroughs, who is divorced from her mother, has been heading an extensive lobbying effort on his daughter's behalf, getting letters from presidents of several large companies as well as Virginia Senators John Warner and George Allen.

Looking toward the future

Burroughs and those around her remain optimistic. She currently lives in Charlottesville, with her two cats Kenny and Rags, to be close to her friends. She withdrew from the University for the second time this year to allow travel time for potential treatments.

"I'm always optimistic," she said. "If we can get enough publicity, they have to cave."

"She will get the treatment and get better," said Burroughs' boyfriend, fourth-year College student George Cauble. "It's painful to see somebody go through this ... it doesn't seem just."

Cauble has stood by Burroughs' side throughout her treatment and has circulated petitions around his fraternity, Theta Delta Chi, and the IFC.

"He's my chef," Burroughs said, smiling at Cauble. "He makes a mean omelet."

Osborn also is confident that Burroughs will recover.

"She's going to be fine," she said. "She's Abby ... not a constant sign of mortality."

For now, Burroughs is looking toward the future.

"My fondest wish is to take one class next semester and live with the girls I have a lease with" for next year, she said.

But her goals don't stop there.

"If I make it, I want to devote the rest of my life to helping people with cancer," she said.

This effort would start at the University, where Burroughs wants to start a support network for students with cancer as well as raising awareness.

"This is typically a disease of old men who have been smoking and drinking all their lives," she said of her type of cancer. It has recently been appearing more frequently in young women.

"A lot of dentists aren't looking for it in people our age," Burroughs said, recalling her original mouth sore.

But even though she must rely on a huge network of advocates and physicians, in many ways, she is her own best diagnostician.

"You are your own best doctor at this point in your life - you have to trust your instincts," she said.

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