The Hammocks
Guiding one family's final chapter
'We hate this prognosis'
The Hammock family.
Tina Hammock, who was 58 when she died, had begun to face her death long before her referral to hospice. In the spring of 2002, her primary-care physician discovered a brain tumor after ordering an MRI to find the cause for her persistent headaches. Tina wrote in her journal, "[The doctor] was very clear. This looked like a glioblastoma, and the number of people who survived this could be counted on one hand."
Still determined to fight her cancer and live a full life, Tina turned to Dana-Farber and partnering Brigham and Women's Hospital. In time she would undergo three brain surgeries, many radiation treatments, and several rounds of chemotherapy. On a leave of absence from her job as an elementary school teacher, she continued her political activism, involvement in her church, and quilting with her daughters. Above all, she remained a dedicated wife, mother, and friend.
"She knew what was up from early on," John Hammock wrote in his introduction to a chronicle of the family's experience that includes Tina's journal. "She had a frankness that was disarming when she spoke of her tumor."
When Tina arrived for her first DFCI appointment with Patrick Wen, MD, her husband and their daughters Ana, 26, and Amy, 30, came along. "They were — are — an incredibly loving family who participated fully in her care," recalls Wen.
The most common type of brain tumor, glioblastoma is nearly always fatal. What is it like for Wen and nurse practitioner Lisa Macdonald, NP, OCN, to care for patients they know will die? "We hate this prognosis," says Wen. "But it drives us to work as hard as possible to find better treatments."
Research is a significant part of the neuro-oncology program at Dana-Farber, and Wen says that Tina helped future glioblastoma patients by participating in three clinical trials. "Treatments developed here and by our Harvard affiliates can be brought quickly to the bedside," he says. "Although, sadly, these didn't work for Tina, we felt that we had tried everything," For example, in one trial Tina helped investigators test an approach developed at Children's Hospital Boston by Judah Folkman, MD, in which chemotherapy is given continuously to stop a tumor from making new blood vessels. In another study, she took tarceva, a targeted molecular therapy similar to those being developed in the Dana-Farber laboratory of Charles Stiles, PhD.
Even with such a bleak diagnosis, there is a lot you can do medically to make a patient's life better, says Macdonald. And when it's time, you can play a role, too. "We help our patients make all the transitions from diagnosis to death," she says.
After Tina's third surgery, which was intended to take away part of the tumor but caused a stroke, Wen and Macdonald advised her to end treatment and begin hospice. "She and her family were very open to the idea," remembers Macdonald, who remained in close contact with the Hammocks.
Next page: A finely-tuned transition
