“I’m sorry, but you have cancer.” There are probably no more frightening words than those. And everyone feels like a potential victim. After all, if one doesn’t die of heart disease or Alzheimer’s or in an accident, then chances are it will be one of the many forms of cancer.
Brian Craig, a seemingly healthy man, was told he had prostate cancer. His physician recommended surgery to remove his prostate gland. While in a hospital in New York, he underwent a series of tests prior to surgery; he learned that doctors discovered some abnormalities on his liver. An ultrasound examination was called for.
The good news was that his liver was fine. The bad news was that he had a tumor on his pancreas. The tumor was malignant. Anyone who has read about pancreatic cancer or known someone who has been afflicted with it knows that the survival rates for pancreatic cancer are dismal. At best, treatments are able to prolong life by months; however, it is not unusual for victims to succumb to the disease within weeks of diagnosis, for the cancer is usually discovered after it has advanced to the point of producing symptoms.
The tumor on Brian’s pancreas, which is next to the liver, had been causing bile to back up into the liver. This was what had alerted Brian’s doctors to the abnormalities in the liver.
While it has been suspected that excessive alcohol consumption, obesity, diabetes, and smoking may be causes of pancreatic cancer, none of those applied to Brian. He neither smokes nor drinks, is neither obese nor diabetic. Look at Brian and you will see a healthy-looking, physically fit man in his middle years.
A top surgeon judged that Brian’s tumor was resectable (i.e., removable), and so Brian was a good candidate for an operation known as a Whipple. It is an extremely complicated and dangerous surgery. Not only is part of the pancreas removed, but so is the duodenum, gall bladder, part of the jejunum, stomach bile duct, and lymph nodes near the pancreas. Brian was under the surgeon’s knife for seven hours. When he awoke, he felt as if his entire body was permeated with pain; yet, soon thereafter, the pain was controlled by an epidural catheter supplying morphine. Three days later, Brian went home.
One month after the surgery, Brian had a CT scan and an M.R.I. He had prayed that the cancer was gone, that there were no more tumors. Instead, he learned that he now had four lesions on his liver. Brian said: “My medical team — oncologist, radiologist, and surgeon — thought that these may have been metastasized P.C. and that chemo, rather than more surgery, would be appropriate. This was the most troubling period in my whole experience. The original diagnosis and surgery happened so fast, and with such good results, that the negative possibilities and implications didn’t really have time to set in. This, however, was very bad news.”
Brian’s doctors were willing to try something that was fully tested and approved by the Food and Drug Administration but was not part of the normal protocol of treatment. He was given a cocktail of four different chemotherapy drugs. Over a period of about four months, he had six infusions, which meant eight-hour sessions at a hospital. One chemo drug, however, required a 48-hour delivery period, and so Brian had to wear a portable pump that delivered the drug after its primary infusion. He disliked wearing the pump, but he had no choice.
Because Brian is not overweight, does not smoke, and is not diabetic, he was able to withstand the highly aggressive levels of chemo. To reduce the likelihood of infection, Brian was given the drug Neulasta, which boosts one’s white blood count. It’s an expensive drug, costing several thousand dollars for each injection. Fortunately for Brian, his medical insurance fully covered the cost.
In December, Brian underwent another series of CT and M.R.I. scans. To his relief and the delight of his medical team, he was completely free of tumors. In addition to the scans, he was given a blood test to determine if he had any protein markers that would indicate the presence of malignancy. For pancreatic cancer, blood markers are normal from 0 to 35. Above that range suggests the possible presence of pancreatic cancer. Just prior to Brian’s surgery, his markers were about 1,500! His markers that December were 25. A subsequent blood test in January showed markers at 27. Both levels are well within the range of someone without pancreatic cancer.
I asked Brian how he had dealt with the worst news of his life: that he might die within months of his diagnosis. He said that he had “wonderful support from family and friends, and from my faith. My spouse, Michael, was present throughout and provided tremendous support. I also was lucky enough to have access to some of the best physicians in the world. And, I had faith that God would help me through this, as I do not feel I’ve finished whatever it is I need to get done here on earth.”
Brian does not need any additional treatments of chemotherapy. He and his doctors believe that he is now entirely free of tumors. He will be checked every six weeks for the next year. If his health remains normal, there will be longer periods between checkups.
Brian further summarized his future: “I am hopeful that my results will continue to be positive. As you have probably read, pancreatic cancer is very aggressive and spreads; it is statistically likely that it will show up again. If so, I’m sure I will face more chemo — as it worked — and who knows what else. My prognosis is that I very well may be among the very, very few who beat this. There is no evidence of any malignancy. I also believe that incredible progress is being made in the field of oncology, and the longer I stick around, the better chance there is of amazing new treatments.”
“My life has changed in that I’m far more focused on making good use of the time I have, however long that is. And that is the message I would want to share with people. No matter how long or short your life is expected to be, all we have is one day at a time. Make sure you live during those days, enjoy life, make a difference. Be thankful every day you wake up and see the dawn, and make use of the day. Do not give in to any illness — you must control your own life even if it is from a hospital bed. Recovery from chemo, or surgery or radiation or many other insults we must face, isn’t easy, but you must focus on staying in control of how you spend your days. And remember that your friends and family and faith will help you. Don’t be afraid or embarrassed to ask for help — friends and family will want to help you.”
Brian Craig lives in East Hampton. Jeffrey Sussman, the author of 10 nonfiction books, is writing a book about cancer patients, of which this is part of one chapter. He is the president of the New York City marketing and public relations firm Jeffrey Sussman, Inc., and has a house in East Hampton.