I received many responses to my last blog wishing me good luck and sending me prayers, best wishes and positive energy. I am so very grateful for these blessings, and for my supportive friends and colleagues. But I realized that a number of folks were new to my blog and were reading my last post as a current event. If you are in that group, please accept my deepest apologies. This blog is focused on telling the story and sharing the lessons I learned during my battle with cancer in 2017. I have had clear scans since the fall of 2017 and I am currently cancer free.
If you haven’t done so, please do read the “About” section of my blog. And if you haven’t done so, please do check out my earlier posts. And now, back to the journey.
On March 1, 2017, the day after the appointment at our local medical center with the resident Oncologist, I went to work. I had been serving as an executive advisor to a consulting client for about 10 months, and I had been away for a couple of weeks. We had a lot going on and I was eager to catch up on progress and see how things were going. I couldn’t think of a better way to spend the day. Of course, I knew I would need to share what was happening with regard to my health and medical journey. Frankly, I preferred to talk about the initiatives we were working on, but caring people want to know, and my clients are caring people.
It was great to have a day back at work as a buffer between my first and second consultations with Oncologists. It made real my strong belief that life would not stop just because I was faced with a cancer diagnosis. I had things to do, people to meet and commitments to fulfill. I knew that treatment would eventually take up an increasing part of my schedule, and that the side effects would slow me down. But not just yet!
On Thursday, March 2, 2017, Debra and I drove to the Abramson Cancer Center at Penn Medicine in Philadelphia. I had been familiar with the area where the center was located, as I had attended The Wharton School at the University of Pennsylvania more than 3 decades earlier. But so much had changed. What had years ago been a convention center was now the site of a state-of-the-art medical center, including but not limited to the cancer center.
Before heading to Penn Medicine, I told Debra that it was my intent to process what we learned and make a decision by Monday. I felt I needed to be deliberate and did not want to rush too quickly into a treatment commitment. I told her I wanted the weekend to think through the options. Debra had already determined that Penn Medicine was where I needed to be. But she did not push that perspective ahead of time.
When we checked in for my first appointment, I was overwhelmed by the magnitude of the operation and the sheer number of people in the waiting room. Wow! There were so many people battling cancer. I didn’t yet feel like I was one of them. I was new and not yet a member of the club.
I had appointments with a medical oncologist and a radiation oncologist. Because of Debra’s persistence, and the great recommendations from friends, I would be seeing the best doctors for my cancer.
The first appointment was with the medical oncologist. This is the doctor that serves as the quarterback, the overall coordinator of your care and treatment. The medical oncologist pays attention to your overall well-being, your body chemistry and the functioning of your organs. He or she also is also responsible for the chemotherapy and/or the immunotherapy aspects of your treatment regime.
I very much liked the medical oncologist the moment I met him. He was no nonsense and very much to the point, but at the same time was quite personal and empathetic. By the time of our first meeting, he had reviewed the PET scan from my local medical center. He explained that there were four tumors, not just three as I had been told. In addition to the tumors on my pyriform sinus and lymph nodes, there was a tumor on my left tonsil. Ugh. So far, not-so-good. He then stoically explained the nature of my cancer, the likely treatment regime, the probable long term effects, and the odds of a full recovery. The seriousness of my disease was made very clear. It was Stage IV because it had already spread to multiple sites. He said this was an aggressive form of cancer. He was particular concerned about the fact that the cancer had already spread through the thyroid cartilage
He said treatment would be a combination of intense radiation and chemotherapy over a two month period. The details would be worked our over the next couple of weeks after more testing. The doctor placed the odds of a complete healing at 50%. I asked how we could increase the odds of a complete and total cure. The doctor explained that we could increase the probability best through radical surgery to remove the voice box and all affected tissue. I asked: “How much would the probability of a complete cure be increased?” The doctor replied: “well, probably 5-10%.” I told the medical oncologist that I did even not want a surgeon on the team. The removal of my voice box would be reserved as a last course of action. The doctor clearly understood and did not debate my view. He made a note: “no surgeon on the team.”
Shortly after, we met with the Radiation Oncologist. The type of cancer I had would require major radiation treatment, according to all medical experience to date. “Evidence-based” is the term used in the medical work. So the appointment with the radiation oncologist was very important. I would be meeting with a radiation oncologist who specialized in head and neck cancer. (The oncologist I had met with at the local medical center was a head-to-toe generalist.) I liked the idea of working with a head and neck specialist. And when I met him, I was immediately comfortable with him. The quality of the discussion was great. He exuded confidence while maintaining a realistic perspective. He shared insights from his experience working with many people with cancer similar to mine. And his examination was conducted in a manner that gave me and Debra confidence is his abilities.
Selecting your medical team and choosing a cancer center is a difficult and critical part of anyone’s cancer journey. It is both an analytical and emotional decision. As I mentioned earlier, it was my intention to spend the weekend analyzing the options before determining where I would pursue medical treatment. Well, it didn’t work out that way. Halfway through the appointment with the radiation oncologist, my wife and I looked at each and said: “this is where we need to be.” It was clear that we would have depth in defense at Penn, with a breadth of capabilities availability at only a few facilities in the world. We were fortunate. We were within driving distance of a cancer center that many people traveled from all over country and around the world to access. The decision was made on the spot: so much for my weekend deliberation plan. My medical treatment would happen here at Penn Medicine.
Coincidentally, I had committed to serve as a guest lecturer at the University of Pennsylvania in the graduate program for Environmental Sciences. I began this in 2016, and very much enjoyed the opportunity to teach at this level. The same day I met with the oncologists at Penn Medicine, I would be teaching a class across the street on Radiologic Risk Management. I was more knowledgeable about radiation than the average cancer patient, and so the radiation oncology and I enjoyed an esoteric conversation about dosage and targeting. That evening, during my lecture, I was able to use myself as a case study when we talked about medical uses of radiation. What an unusual and ironic coincidence. Do you believe in coincidences?
All in all, it had been a good day. When I turned to my 5 Minute Journal that evening and reflected on the day’s events, I made the following entry:
What was great about today?
Today was awesome because if Now have a plan and venue for treatment.
The outpouring of support [from friends and colleagues] and offers to do anything to help.
Debra was awesome
Class was successful
Safe and timely travels
What would have made the day even better?
Not having a sore back and knee
Not learning about the cancer on the tonsil and the cartilage infringment