Tuesday, January 31, 2012

In the Chemo Room, again

Well, I was back in a Chemo Room all day on Friday, although I was only there to take two pills and have my blood tested nine times over 11 hours, and to collect every drop of urine I could pee.

I'm entering a new clinical trial for a drug that has been widely tested on others and that is now given orally and requires me to keep a diary of the times I take it twice a day at home. The pee collection continued at home, too, for the remainder of 24 hours. You have to refrigerate the pee until your next appointment when you bring it in and they finish checking out how quickly your body takes up and disposes of the chemical.

So after that first day, you go in once a week so they can retest your blood and urine. After a while, I'm sure they'll scan me to see if the drug -- this one is called Estybon (rigsertib) and designated ON 01910.Na for the study -- is working any magic on my tumors.

It's still a Phase 1 study, but the clinical trial has gone on so long that the docs have pretty much determined what the best dose is, especially regarding peoples' tolerance to its side effects.

The goal of the study now is to determine how effective it can be at stabilizing the growth and spread of tumors in advanced-cancer patients. It's manufactured by Onconova Therapeutics, a small drug maker out of Newton, Pa., and Pennington, N.J.

I was told I was one of the few colorectal cancer patients being tested at least locally, but the company says this about its drug:
ESTYBON (rigosertib) is a novel multikinase inhibitor, with selective cytotoxic effects on tumor cells without impact on normal cells.... A significant effect of ESTYBON in cancer cells is the induction of multiple centrosomes during cell division, resulting in a multi-polar spindle and total disorganization of the mitotic apparatus, a phenomenon called chromosomal catastrophe….

Given the unique mechanism of action on tumor cell survival pathways, ESTYBON has the potential to be active against a wide variety of cancers.... Early clinical results from ESTYBON combination studies with either oxaliplatin or gemcitabine indicate rapid response in pancreatic, breast, colon, ovarian, and lymphoma patients, suggesting multiple indications for solid tumors.

That's typically dense language for cancer-drug descriptions, but it is what we patients find hopeful even if we don't understand all of it.

I'm still feeling out the side effects this drug will produce in me. The consent forms I signed list practically every side effect known to cancer patients as having been experienced by 2 percent of the people who have been enrolled in the trial. That means only that two out of 100 enrolled patents have experienced just one of the side effects in the long list.

If you give enough cancer patients any drug over a long period of time, you can bet that one will feel at least one side effect he or she has experienced on some other chemo drug and claim it is a repeat of that symptom under the new drug. That's the nature of clinical trials.

I reported more familiar symptoms under the first "study drug" I took than I think the docs wanted to count, but they were required to count them even though I'm sure they thought I was re-imagining old hurts and past responses.

The big side effects to look for under this drug are fatigue, nausea, diarrhea, decreased appetite, and painful urination. I'm happy to report none of them so far, although it seems I am dancing with diarrhea again. The condition encourages anticipation anxiety, so  you don't really know what you've got until it hits. One thing is sure: I have no decreased appetite to report.

And I was able to play croquet on Monday, and drink a beer while once again losing the game. Who can ask more of life than a pleasant game of croquet?

Wednesday, January 18, 2012

Vectra Bank's forecast counters local good vibe

I walked into Vectra Bank Colorado's economic forecast breakfast Wednesday and quickly ran into the always optimistic Tim Jackson. President/CEO of the Colorado Automobile Dealers Association, Jackson bubbled about a 13.7 percent sales increase for his industry in November, and said he hoped that Colorado dealers would finish the year posting a full 14 percent gain for 2011.

Jackson then introduced me to Andy Rogers, general manager of the Ritz-Carlton Denver, who said December was the best month of the year for the downtown luxury hotel, and he agreed with Jackson's ebullience over how Colorado's economy seemed to be picking up.

Then I sat down to listen to Vectra's speakers for the day:
  • Patty Silverstein, who delivered the Denver Metro Chamber of Commerce's and Metro Denver Economic Development Corp.'s 2012 economic forecast;
  • Mark Snead, vice president and economist at the Denver Branch of the Federal Reserve Bank of Kansas City; and,
  • George Feiger, CEO of an investment firm in San Francisco, a past member of the Vectra Bank board of directors, and a frequent commentator on Bloomberg News, Fox Business News and in the Wall Street Journal.

Man, what a downer!

Silverstein told the crowd in the Seawall Ballroom at the Denver Center for Performing Arts that 2012 was a time for Colorado and metro Denver to "rebuild," but that the rebuilding will be "slow" because consumers are still being frugal; jobs will grow only about 1.1 percent both nationally and locally, leaving 123,000 people in metro Denver still looking desperately for work; "wages have been growing relatively slowly" in the region; and home prices may get boosted 3 percent at most during the year.

Snead, of the Denver office of the Fed, told the 400 business people: "It could be worse, it could be a lot worse. You could be in Greece."

And then he pointed out that Greece and the United States "have just about the same amount of debt."

The U.S., of course, is better equipped to handle that debt, Snead said. It is much bigger, and most of its population isn't drinking ouzo out on the beach. But still the comparison can be made; and, in general, Snead kept repeating, the U.S. and world economies during 2012 will mostly be "bottoming, not accelerating."

And then, with coffee in the room growing cold, Feiger took the lectern and told everybody the euro zone would definitely fail before it got better; China is actually in worse shape than its Communist leaders will ever let on; at least the U.S. is "the least bad place to be" in the world today; and nothing about what he was telling all the business leaders, who are generally paid to be optimistic about the outlooks for their firms, was funny.

"It's very far from funny," Feiger added.

No one was laughing as everybody headed for the doors.

Wednesday, January 11, 2012

4 bankers ready to lend

Dana Bondy, senior vice president for business banking at Colorado State Bank and Trust, likes to make lists, and so he made one during a panel discussion Wednesday on small business access to capital. Not a "top" 10, and in no particular order, here is his list:

1. Communicate with your lenders, sharing both good and bad news about your business.
2. Get behind your results, to take credit for your successes, and accountability for your losses.
3. Ask a lot of questions of your banker or lender.
4. Listen to your lender's answers to those questions. He or she provides an honest perspective on the risk and potential presented by your business proposition.
5. Expect great partners in your lenders. Expect them to return your calls, and be quick to return theirs.
6. Get specific when asking for money.
7. Work with the decision-maker on your loan.
8. Connect to business-finance resources like SCORE, a group of retired execs who do business counseling, or SBA or your local Small Business Development Center, all of which give free advice.
9. Connect with your peers. Many small business owners have already experienced the problems you may be facing in operating your business. Learn from their experience.
10. Shop your loan request around until you find the lender who wants to loan you money; any banker's advice about your business proposal, even if he or she turns down the loan, is valuable to you as a business operator.

Bondy was one of four bankers who spoke at a forum on access to capital hosted Wednesday by U.S. Rep. Diana DeGette. Bondy was joined on the panel by Mark Abell, of Vectra Bank Colorado; Mary Rogers; of JPMorgan Chase, who said she was the national spokeswoman for Chase on small business; Alan Ramirez, senior commerical loan officer at the Colorado Enterprise Fund; and Greg Lopez, Colorado district director of the Small Business Administration.

The bankers' collectively suggested a willingness to lend to business owners who did their homework and presented viable proposals, but they also admitted their institutions might be among the nine of ten who rejects a loan proposal before one institution accepts it from a specific business owner.

That was the point of Bondy's 10th item on his list. Just because a banker doesn't review your loan proposal favorably doesn't mean he or she can't teach you something about the proposal while reviewing it. Take all the advice you can get and move on to the next banker.

Access to capital is a traditional complaint of small business owners, and Rogers from Morgan Chase admitted credit got very tight during the financial crisis of 2008-2009.

But she said her bank's loan window didn't close altogether; it lent $8 billion in business loans during 2009 and has been increasing that number by multiples of billions ever since, looking forward to another increase in 2012.

Abell of Vectra Bank said Vectra didn't change their lending policies throughout the crisis years, and he gave examples of borrowers who backed up their proposals with good information and obtained loans even during the hard times. Ramirez explained the Colorado Enterprise Fund's goal is to lend to companies that cannot obtain capital elsewhere. He said the fund loaned $3.1 million in 2011, averaging $30,000 a loan.

SBA district director Greg Lopez said it was a moral obligation for the people on the panels to help small businesses succeed. He said SBA in Colorado guaranteed 1,425 loans with a value of $619 million last year.

He also said SBA is about to roll out a program that will partially guarantee loans based on contracts the borrower holds with customers. Contracts, or the promise of future revenue, traditionally have not been considered collateral, preventing many firms from obtaining the capital they need.

Monday, January 9, 2012

Denver chamber to the leg: 'We're coming in as strong as ever'

Kelly Brough, president and CEO of the Denver Metro Chamber of Commerce, told lawmakers and business friends Monday the chamber expects to exert its influence on big issues at the state Capitol this year, but always with small business in mind.

"We're coming in as strong as ever," Brough told legislative leaders and others gathered in the Old Supreme Court Chambers to hear the chamber's legislative agenda for 2012.

She then spelled out the biggest business issues facing lawmakers: refunding the unemployment insurance trust fund, and deciding on the future of the state's successful workers' compensation system.

And in the realms of what the chamber considers the three "pillars" of an economically viable state government -- health care, transportation and education -- Brough made it clear the state's largest business organization will continue to support a state health-insurance exchange, the funding of FasTracks, the metrowide light-rail public transportation system, and new methods of financing public schools and higher education.

"Our economy depends on their (students') ability to graduate from high school," she said.

Those are big issues that require public funding -- tax money -- which is always a sensitive issue for small business owners.

But Brough kept pointing out that Colorado is a state with a business community that is 90 percent small business, companies with 100 or fewer employees, including many, many one-man or one-woman shops. She suggested any solutions to the state's economic problems must be crafted with that small business community top of mind.

Yet strangely, the only issue that was raised during the presentation that generated a mild debate was over a bill State Sen. Betty Boyd said would be introduced to give Colorado businesses and employers preference when it came to state purchasing contracts.

A questioner in the audience asked if Boyd had considered the downside of such legislation, and House Speaker Frank McNulty piped in, "The concern is a real concern."

McNulty said if the Senate, where Democrats hold a majority, passed such a bill it would get close scrutiny in the House, where Republicans hold a one-vote advantage. McNulty said such bills often create "hurdles" for business people who operate best with the least government interference.

The new legislative session starts Wednesday.