Wednesday, April 11, 2007

TO SURVIVE CANCER, FIGHT THE DEATH OBSESSION

The revelations about the reoccurrence of cancer in Elizabeth Edwards, wife of John Edwards, candidate for president, and the spread of the disease in Tony Snow, George Bush’s press secretary, has brought the disease front and center to public attention once again. This attention has forced me to think once again about my own battles with the disease.

One of the many excellent articles on the subject appears in the latest issue of Newsweek Magazine (April 9, 2007, page 30ff). This first person account by Newsweek writer Jonathan Alter contains many echoes from my own life. Like Jonathan Alter I was diagnosed with lymphoma, a cancer of the blood system, in fact with the same variety of the disease, called mantel cell B. In my case, the diagnosis came at the very beginning of 2002, and by the end of that year I had undergone a bone marrow transplant at Johns Hopkins Hospital, Baltimore, Maryland.

Initial Chemotherapy, Then Transplant

Like Alter, whose diagnosis came over two years after mine, I was found to have a tumor growing in my stomach region. Like Alter, my course of treatment consisted of an initial assault with a transfused chemotherapy called CHOP, an acronym for a witch’s brew of chemicals used to treat a number of cancers. And like Alter, I was then transfused with Rituxan, considered a pharmaceutical wonder at the time.

Unlike Alter, however, I did not need surgery to remove the tumor; chemo did the whole job for me, but while I did not have to put up with surgery, anyway for tumor removal, I did have to put up with pneumonia and a prolonged recovery from it, a byproduct of the CHOP. My bone marrow transplant, designated as autologous, the same procedure that Alter went through, was followed by transfusions of a whole lot more Rituxan in hopes of knocking out the agent or agents that caused my illness in the first place. (In an autologous transplant, the patient is his own donor. The alternative, an allogenic transplant, requires a separate donor.)

No Evidence of Reoccurrence

Now five years and several checkups later, the medical community is still not able to find evidence of the disease in my system, but like Alter I will not use the term “cure” and not even the term “remission” in describing my situation. I am cancer free at the moment, and that is all I will say on that subject.

One reason that I feel I need to temper my optimism is because mantel cell B lymphoma is not the only major cancer I have suffered in my life. And when I say that, I am not counting skin cancer, specifically basal cell carcinoma, for which I have also been treated. Basal cell carcinoma is usually classified as “minor.” No, I’m talking about thyroid cancer.

Lumps Seen in a Mirror

About 40 years ago, I was shaving at the bathroom mirror of my fourth-floor Brooklyn walkup, when I noticed two golf ball size lumps projecting from either side of my neck. The cause of these strange lumps was determined only after one of them was surgically removed and a section of it put under the microscope. The lumps were evidence of thyroid cancer. In subsequent surgery, my thyroid gland, which sits in front of the throat, was removed along with the second lump and all the lymph nodes the surgeon could find in my neck.

Being diagnosed with thyroid cancer at the age of 26 was a total shock, in fact even more of a shock than being diagnosed with mantel cell B lymphoma at the age of 62. The first shock was a total coming to terms experience, that is, a total coming to terms with the denial most of us feel about death, especially when we’re young. I was 26 years old. I was newly married, my wife was expecting our child, and I was going to live forever, right? Wrong!

Facing Cancer as Young Person

I was mortal, and I was capable of coming down with cancer. That I could suffer such a gross disease meant that I was going to die. Maybe not from the thyroid cancer. Maybe not right away, but someday, and that was that. Hence when I heard the diagnosis of mantel cell B lymphoma for the latest health crisis, my dominant initial emotion was “not again.” But that thought was followed by a surge of strength. “You beat thyroid cancer, and you will beat mantel cell B lymphoma,” I told myself.

Yes, I read all I could find about this variant of the disease on the Internet, and, just as Alter found in his own research, what I read did not sound good, but I refused to take the bleak accounts as an automatic and immediate death sentence. I would fight this thing. I would do what the doctors told me to do, and I would see what happened.

I had gotten through the thyroid cancer, I told myself, and I knew that it would be better for me if I took the attitude that somehow I would get through this latest crisis as well. That I was going to die someday was already accepted. I had dealt with that reality 40 years before at an age when it was much less customary to think about life and death issues. And now faced with the new diagnosis I knew I had to work against allowing myself to feel that my death was imminent.

Five Years Out

So now I am five years out from my bone marrow transplant, and I am still here.

Because I was trying to keep my mind focused away from the notion that my death was just around the corner, I kept reminding myself to make sure that I was living my life not as a dying man, but like someone with many more years of active life ahead of him. First I began planning with my wife a move coincident with our retirements from jobs in the ever more congested Washington area and to the mountains of southwestern Virginia. The idea that I would be moving to a more healthy environment had a lot to do with our decision.

Moving to the Mountains

As residents of the mountain, we decided to lead as healthy a life style as possible including a regular program of exercise and being more mindful of what we were eating. We decided that we needed to be more aware of what was going on inside our heads as well. That, for example, is why I joined a meditation program, and it had a lot to do with why I started this blog. Then some months later, we decided to make room in our lives for a puppy.

Yes, the thought would dawn on me occasionally that this very intelligent, energetic and mischievous little dog might outlive me and my wife, but I made myself put that thought aside. No, I had to restrict the amount of time I spent thinking about my death and allowing thoughts of death to influence any of my decisions. Death is a given, as it is a given for all living things, but I was going to live my life as fully as possible. Meanwhile, care of a young dog has forced me to be even less focused on myself, and that is a good thing.

My efforts at putting thoughts of death aside is not perfect, of course. Like Alter I still go through a lot of anxiety whenever a periodic medical check up is in the offing, but most of the time I am happy and optimistic and excited about the work I want to accomplish in my life.

ABOUT MIND CHECK

Thank you for tuning into Mind Check, a biweekly effort to prove that we are what we think and that clear thinking leads to effective action and to a better world. Mind Check is intended to serve as a bridge between the realm of the human spirit, that center of our energy, mental and physical, and our rationality or reason, of which the scientific method is an excellent example. Mind Check is also intended to prove that the ideas of right and wrong are innate, not exclusively inherent in the situation or the whim of the moment.

To communicate with the author of Mind Check, please write to stephen.saft@gmail.com. For examples of the writer’s other writings, see the website http://www.iwillmeanpoetry.com. The author is also preparing to launch a site of podcasts consisting of spoken poetry, essays and short stories. Be on the look out for it.

Copyright (c) 2007 by Stephen Alan Saft

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