A couple of years ago, I sat in the office of Lynn Leany and heard him talk about the opportunity to receive Provenge, then a new drug therapy for men with advanced prostate cancer.
"I'm kind of willing to try almost anything, but this sounds like the right thing to do," he said, forcing laughter. "I've got too much to live for to die. It's like my grandmother said: 'I know what's here. I'm not sure what's on the other side.' "
I felt the pain behind the attempt to make light of his situation and couldn't really respond. Nothing was said for what seemed like a long time.
You see, Provenge sounded like the right thing for him to do, because at the time there wasn't much else he could do.
The former ironworker who founded Century Steel with $8,900 and a dream, whose company provided the reinforcement steel for high-rise condos and casinos that include Mandalay Bay, Treasure Island, Wynn Las Vegas and the Golden Nugget, had just about run out of options.
The man who sold Century in 2008 with $300 million in back orders was again in Dr. Nicholas Vogelzang's office at Comprehensive Cancer Centers of Nevada last week, once more trying to find another drug to beat back death.
Less than two months ago, he was doing the same thing.
In June, he came to think the wonder drug for him was something called radium-233. Administered through an IV, the drug delivers radiation to the bone and prostate cancer tumor. Leany said he felt fortunate that Las Vegas was one of only two sites in the United States to participate in a trial of the drug that had great success in England, increasing survival by five months.
"Before I took the drug, I couldn't walk even 30 feet, and I thought it was time to meet my maker," said the silver-haired 71-year-old multimillionaire. "Yet when I took the radium, three weeks later I was playing golf."
But about a week ago, his energy was gone and he had pain.
"I haven't felt this bad in a long time," he said.
"The cancer apparently repaired the damage caused by the radium," Vogelzang said Wednesday before Leany met with him. "I woke up this morning thinking I had to find something for him to keep him going until around Christmas."
Leany was first diagnosed with prostate cancer in 1994. Surgery quickly followed.
He was cancer-free until five years ago, when tests showed the disease had come roaring back. Ever since, he's been on a treatment roller coaster, where a new drug will work for a while, but then he's on death's doorstep until Vogelzang finds yet another new drug that shows signs of working.
"The journey that stage 4 cancer patients have to take is not for the faint of heart," Vogelzang said. "You can only think short term."
The new drug that Vogelzang has settled on now for Leany is MDV3100, an androgen inhibitor that prevents prostate cancer tumor growth by binding with cancer cell receptors. This trial drug has also improved survival rates by five months.
Largely because of Comprehensive's alliance with UCLA's cancer institute, and Vogelzang's prominence as a world-renowned researcher and clinician - he's the former head of the University of Chicago Cancer Center - trial drugs often come to Las Vegas before other cities.
That isn't lost on Leany, who's researched oncologists around the globe.
"I believe he is the best oncologist in the world," he said of Vogelzang, the first director of the Nevada Cancer Institute. "He'll never give up."
If he can make it at least through the holidays, Leany will be happy.
"I have a grandbaby coming in January," he said.
Should death come, he hopes it comes without the pain that often accompanies prostate cancer.
"The worst pain I ever had from it was like someone pushing an ice pick into your shins," he said. "That's not something I want again."
Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at firstname.lastname@example.org or 702-387-2908.