Russ was suddenly diagnosed with stage IV gastroesophageal junction cancer in July 2021. He was hospitalized for four weeks after his diagnosis in Ann Arbor, MI. He and his wife immediately moved from their home in Los Angeles to Ann Arbor to be close to family and receive treatment at the University of Michigan Rogel Cancer Center. After leaving the hospital, Russ tolerated his cancer treatment exceptionally well, often saying he "felt great!" Unfortunately, after he experienced a seizure in November 2021, doctors discovered Russ had developed an extremely rare metastasis to the central nervous system called leptomeningeal disease, which does not have any good treatment options and has a prognosis of 2-4 weeks. As with the cancer treatment overall, he amazingly had few symptoms and continued to live his life with joy until the last week of life. The doctors could not explain why, but Russ lived for two months with leptomeningeal disease, eight weeks without symptoms, something unheard of with this devastating disease. He died at home surrounded by love. 

We do not know why Russ developed gastroesophageal junction cancer or leptomeningeal disease. He didn't have any risk factors for this disease and had few symptoms until he became seriously ill. There is a rapid increase in esophageal cancers among young people; we were told experts believe the cause is environmental but yet unidentified. Even less is known about leptomeningeal disease and the treatment options are almost non-existent.

Russ and Amelia were extremely thankful for the care he received at the University of Michigan and for advancements in cancer treatments, especially immunotherapies that make a huge difference in the lives of people impacted by cancer. The treatment regimine Russ was treated with included a combination chemo- and immunotherapy that was only FDA approved in spring 2021. The cancer in Russ's body outside of his brain was responding very well to this treatment. The immunotherapy, Nivolumab (Opdivo), was originally developed for melanoma but is now used to treat many other cancers. Both Russ and Amelia encourage people to support cancer research.

A note on public health from Amelia (MPH, MSW): As a public health researcher, I also want to strongly emphasize cancer prevention in our behaviors and our environments. The initial thoughts are that Russ's cancer was likely caused by something environmental, an exposure of some kind that increased his risk for esophageal cancer. Something similar is suggested to be driving dramatic increases in colorectal cancer among young people (leading to a decrease in the age at first screening to 45 years). Please take care of yourselves and each other, and, where you can advocate for safer, toxin-free environments.