How are you guys doing?
Welcome to my home.
So, what do you want to talk about?
Kidney cancer, prostate cancer, heart attack?
With so many things that I've been through,
and people go like, "How do you survive four cancers? Two heart attacks?”
It doesn't matter what happens to me medically.
I know Penn and the Penn doctors have my back.
Saved my life too many times.
(music)
My name is Abraham Bren.
I was born and raised in Puerto Rico.
And I moved here after I joined the Air Force in my 20s.
- What is my dad like?
He is very energetic.
He loves music.
The light that shines from him when he's on stage is something else.
(singing)
- He sings very well.
When we were dating, he used to woo me.
- Yeah, he woo you. - Yeah, he woo me.
- He's also super supportive.
He's always someone that I can count on and he's always there for me.
My older daughter, Gabriela, is an Eagles cheerleader.
Also, she is an ICU nurse at Penn.
And my little one, she is in Texas.
She is a physical therapist.
Lex, your birthday is in like two days.
Monday.
- Sunday. - Sunday.
(laughter)
My daughters are my life and if I can give them everything,
I'll give them everything.
I still pay for a couple cell phones...
(laughter)
My family have become my rock in this journey.
(singing)
(singing faintly)
I've been to Penn Medicine 158 times in the last 10 years.
Sometimes it's a little bit more serious like today.
Can you tell me your full name and date of birth?
Abraham Bren, 7/20/64.
- Have you had a CT scan before? - Yes, many.
I've been treated with immunotherapy for the last 8 weeks
and we need to know what the change has been until now.
Take a deep breath in and hold it.
Based on Abe's first scan on this treatment,
I'm really hoping that his lung nodules are going to be smaller.
There is a lot riding on it because
the first six months of therapy
are kind of a watershed that we look at and
if we see shrinkage, that's a really good indicator
if a patient is going to live a long time or not.
- Well, good luck with everything. - Thank you, my dear.
And now it's nerve-wracking. We'll see how it goes with the doctor today.
Health-wise, my journey started about 10 years ago,
when I got diagnosed with prostate cancer.
When I got sick, I went to another hospital.
They did my first surgery, removing my prostate.
And it didn't last a year until it came back.
That's when I met the doctors at Penn the first time.
I went to see Dr. Haas.
We did a nuclear scan,
where they go from head to toe and find every little cancer cell.
Dr. Haas recommended that I got radiation.
And that's where I met Dr. Vapiwala.
We did 54 radiations and then
she recommended to do a week of proton treatment.
In the area, nobody has proton like Penn.
It's an amazing technology.
They did it for a week and everything disappeared.
It was the end of cancer for me.
I was like, “I beat it. This is awesome.”
Four months later, I was in the store of a dear friend.
It was like 9 o'clock in the morning. By 11 o'clock,
I went down, boom, on the floor.
I had a heart attack.
One of the things that I most dislike from life
is when the punches come in and I'm not ready.
I don't want to be hit.
Throw me the punch, but I'm ready.
I'm ready to counterpunch or I'm ready to defend myself.
They flew me in a helicopter to Presby.
And they gave me two stents.
After the stents, the heart was in good shape.
I kept going to the doctors.
That's where I met Dr. Carver.
Heart doctors at Penn are very special.
Dr. Carver gives me his cell phone number.
He says, "Kiddo, if you ever need me, call my cell phone number."
Who does that?!
Because of the relationship I had with Dr. Carver, and I was so close to him,
one day I said, "Hey Dr. Carver, something is wrong.”
“Something there is beating wrong."
He goes, "Let's go in there and see what's going on."
He said, "Abe, you need a triple bypass right now,
because you're closed about 90% in two arteries."
And I go, “Hey, after all that happened already,
I'm like, let's go for it.”
That's where I meet Dr. Hargrove.
Really great guy. He has a really cool mustache.
He explained to me what he's going to do.
Usually, at other hospitals, they stop your heart so they can fix it,
and then they start it again when they're done.
But at Penn, they fix your heart while your heart is still beating.
When I see him afterwards,
He goes, "Abe, I got you four for the price of three."
It was... and I was like, "What?"
Because the heart was beating while he was fixing it,
when he finished the third one, he saw that there was something wrong,
and he found a fourth one.
So I finished with a quadruple bypass.
Had he not done that, they probably would’ve had to open me up again.
Since then, the heart has been great.
I have the heart of a 26-year old. It's awesome.
- I'm gonna have you put your hands down,
and I'm gonna get your vitals.
- Thank you.
- You can breathe a little bit. - Yes.
98.6
- 150 over 77. - Okay.
That's a little high, but that's cool.
I've been emotional today.
I got too many things going on.
I just had a CT scan, too.
- Can't pre-stress. No pre-stressing.
- After the cancer and the heart problem,
it also messed me up as a man.
For a year and a half, two years, I wanna say,
I had no erections. I was dead.
And that frustrates you as a man a lot.
And a Spanish man, phew,
you don't have your manhood, you're nothing, right?
I tried everything.
All the brands of pills,
I even got a shot that you had to put
in your penis so you can get an erection.
It's ridiculous.
Also, part of the problem was incontinence.
I was so self-conscious about not being able to hold myself.
I had to wear diapers for two years.
That's where I meet Dr. Jaffe.
- Abe! - Dr. Jaffe!
You look great.
When I first met Abe, he was in a little bit of a down place mentally.
Erectile dysfunction is an extremely common problem.
But many men think that they're done and there are no other solutions for them.
With sensitive things like that,
unless you have a really good relationship with your doctors,
you don't even go there.
Jaffe becomes a very special guy.
He goes, "Abe, listen, trust me.
We can fix you. You're gonna be okay.
I'm gonna give you a penile implant."
A penile implant is a surgical solution for men with erectile dysfunction.
We implant a fluid-filled device that a man can control
to give himself an erection by pumping it up.
Once men have healed up from this surgery, they will have 100% confidence that they can
get an erection whenever they want and keep it for as long as they want.
Sexual function was his primary concern but we also talked about his incontinence.
And in his situation, the best option for him
is something called an artificial urinary sphincter.
This is an implant that is similar to the penile implant in some ways,
but it works for urinary control.
It also has a pump that goes in the scrotum.
So I was talking to Abe at that point about having one pump on each side:
One for his urinary control, and one for his sexual function.
He opened me up and did miracles
because he made it really pretty and fixed it really cool.
After doing that surgery, it changes your life.
You feel whole again.
Knowing that I can give people their quality of life back,
knowing that I can contribute to their happiness
when they've been suffering for so long,
that is the best thing ever.
For many years after my surgery, I was fine.
Last year, I called Jaffe, and they go, "Abe, what's going on?"
One of my testicles was five times the size of the other one.
- When Abe’s CT scan came back,
it didn't show anything concerning where he was having his swelling,
it just showed what's called a hydrocele,
which is a benign collection of fluid around the left testicle.
But there was something unusual near the bottom of his right kidney.
So I recommended that he see one of my partners, Dr. Pierorazio.
- Dr. Jaffe called me and he said,
"Hey, I've got this guy I've been taking care of for years.
He's amazing. I'd really like you to see him."
- Hey Abe, how are you? - How are you?
- Nice to see you. - Nice to see you, too.
Kidney tumors are fairly common.
The vast majority of them are small,
four centimeters or less, golf ball size or smaller.
And that's a really important distinction for us.
Most of those small masses are not dangerous.
Unfortunately, Abe had relatively large kidney tumors,
about eight centimeters in size, which is slightly larger than a baseball.
So the first time I met Abe, I knew we had to talk about something serious.
When he sees the scan, he goes,
“Abe, that kidney has a mass as big as the kidney.”
And it was cancer again.
- What we worry about are the high grade or invasive cancers
that have the ability to leave the kidney and can be fatal.
When I saw this tumor on Abe, I said,
“We've got to get him to the operating room relatively quickly.”
After all I've been through and all the things, now I'm a pro.
Now, open me, I don't care, let's do it.
I go, “Dr. Pierorazio, could we do this on my birthday?”
Bcause he had a couple of conflicts that week,
and he goes, "Abe, if we're doing the 20th of July, I'll be all yours."
I was born again that day, on my own birthday.
It was the coolest thing ever.
Living with one kidney, not such a difference.
No, no, I can probably like feel a little hole in there.
(laughter)
After the surgery for my kidney,
I had to wait four months to see how everything is healing.
We go for a CAT scan again, and the doctor goes,
“I'm sorry to tell you this, but there's like 20 tumors in your lungs.”
I'm sorry, guys, this is very recent, and it still hits me.
He gave me a phone call, and he said, "Gab, it's not over."
I’m like, “What do you mean? How is this happening again?”
It was kind of just like, I feel like he's been put down so many times.
Like, how many more times can someone take before they’re just like, “I'm done.”
Of course you get a little frustrated.
You're like, "Okay, why me, again? Why me, again?
Why can't we stop? Do I get a break?"
You know, so now every four years I'm like this again.
But it becomes part of who you are.
It becomes part of your battle.
And my wife, she's amazing.
She's been battling with me since the first day.
I was more worried about her
because here I go again making your life miserable with this crap.
- It had been difficult because it had been a long road.
He's up, and then he gets sick again.
He's down, he's up. He’s down, he’s up.
He is going through that but we all do it with him.
So it's not only one side, there's two sides.
And we all suffer and feel for him, too.
But I know he's in good hands, and I know everything's going to be all right.
My wife is the one that pushes me.
She's the person that will see me crawling,
literally, crawling out of bed,
and go, “Get up, keep going. I don't want to hear it.
Keep going. Keep moving.
Let's go fix it.”
- Hello, how are you?
Yes I’m seeing Dr. Haas at 1:30.
- Hello. - Hi, Mr. Bren.
- How are you doing? - Nice to see you.
In Abe's case, he has basically these little snowballs
all over his lung fields that we're hoping to someday disappear.
And so his scan will be an early indicator of how he's doing with his therapy.
The patients who have significant shrinkage
of their cancer in the first six months have the best overall survival.
- And your blood pressure's been okay? - It's been fine.
- How about a rash? - No, no rash.
So let me show you your scans.
I just have to find the right button here.
So this is you lying on the table.
That's your chin.
So that's your left side, that's your right side, okay?
And this is the one - that's December - and this is the scan from today.
So you can see that you had this little lung nodule.
So that was 10 millimeters before. Now it's only 6.
So that's an amazing response right away.
And then you have this other one over here, that is 5 and that was 10 before.
So they've all shrunk by 50 percent. So that's really good.
And then this is another one that's lower here, lower in the lung on the right side.
And that was 7 millimeters, and...
Let me see if I can... Yeah, it's 4 millimeters now.
So everything is shrinking.
So that's really good.
And that's a great response for the first three months.
Sometimes we don't see that right away.
Wow.
Generally, patients responding well can live for years with their cancer.
And what I'm hoping for is a home run here,
that everything disappears.
So far he's having a really, really good response.
Abe should feel really positive, really fired up about that
and that's a really good indicator that he's going to be around for a long time.
- He did call me at work and was like, "Gab, they did my repeat CAT scan
and all my tumors are half the size that they were!
Isn't that unbelievable?!"
That's how he's talking on the phone, and I'm like, "Yes!"
I was like, "That's the greatest news I could have heard today, I'm so happy!”
In just a couple of months, those tumors shrunk by half, and there's nothing new.
So it's... it's amazing. It's amazing.
You don't know how happy I am.
It's a great day.
My dad's got nine lives, man.
To see someone go through all these things and
still come out as happy as he is, how excited he is about life...
It's inspiring.
Every day is a bonus.
I want to see my daughters marry and have kids,
find joy in life, and be a lot better than I am.
When your kids become better than you, you got it done.
- Joe Carver.
- Hey man. - How are you?
- We’re still fighting.
- You just keep coming, that’s cool.
My doctors, they're almost personal friends now.
They know me in and out, literally, because they've been inside of me.
It doesn't matter what happens to me medically.
I know Penn and the Penn doctors have my back, no matter what.
- Good luck. - Thanks.
- Love you, man. Talk to you soon, okay? - Love you, too.
They know how special they are to me,
and I send you a huge hug to each one of you.
And I'm so grateful,
so grateful, for saving my life.
And always being there.
Thank you.