Stories of Hope

I was 62 in 2001 when a suspicious fuzzy spot in a chest x-ray turned out to be a 25 cubic centimeter tumor when checked by a CT scan. It was diagnosed as small cell carcinoma from a biopsy taken during a bronchoscopy. I had smoked for 40 years, having started in the army in order to get the hourly break instead of the hourly extra chores. No doctor had ever told me before then that there were truly effective ways to treat the physical addiction when one stops. None of my ancestors back to 1620 had ever died of cancer, so I thought I was safe. But that’s its own story. Anyway, I quit.

Small cell carcinoma typically has begun to spread by the time the primary tumor has reached on cubic centimeter in size, so an operation is generally not done. I expected to die, and prepared for it. But I was treated with a lifetime allowance of radiation and the “maximum tolerated dose” of chemotherapy, after brain and bone scans had indicated the cancer was apparently limited. This was not the most enjoyable experience in the world, and although I tried to continue to work, every attempt was accompanied by more unpleasant effects, like shingles and blood clots, so work had to wait until I had recovered from all therapy. That the cancer hadn’t spread was one miracle, that I could hold up through the treatments and stay on schedule was another, and that my company held my job while this was going on was a third! I have to believe some intervention was made on people’s hearts, among other things.

A couple of months after therapy ended I had CT and PET scans. They could find no trace of remaining tumor or sign of it having spread. A few months after that I fulfilled a life-long dream that had been my mother’s before me and her father’s before her, and visited Ireland. Truly a land of magic.

I held a party when I hit two years after the original diagnosis, at which everyone in my extended family donated to a fund split between the American Lung association and the national Cancer society. There was still no indication of the cancer reappearing anywhere, and I learned that 90 percent of the people who will have a recurrence will have had it by then. Then soon before I would have been a three-year survivor, I started a cough that wouldn’t go away. Nothing could be seen on an X-ray, probably because there was a mass of scarring from the previous radiation. Even a PET scan was inconclusive. But another bronchoscopy and biopsy was quite clear – the small cell carcinoma had returned, in the same place it had been originally. Another bronchoscopy in a different hospital with a difference pathologist checking the biopsies confirmed the diagnosis. The normal, recommended treatment for a recurrence of small cell carcinoma is palliative treatment only, because

• the recurrence is expected to be more resistant to chemotherapy than the original
• it has almost always spread by the time it is discovered
• they can’t give any more radiation to that area

Once again I was prepared to die.

Final miracle: The tumor did shrink in response to a different chemotherapy drug than the combination I had received three years before. CT scans, another PET scan at the last minute, and lymph node biopsies confirmed that by every appropriate test, the recurrent tumor had also not spread yet. The lower and middle lobes of my right lung were surgically removed. Lymph node biopsies were taken all around the lung at the beginning of the operation and found to be normal. The tumor itself, examined by the pathologist in the removed lung parts, appeared to be surrounded by a tight wall of non-cancerous cells. The margins of the removed areas were clean. If that wasn’t a full-fledged miracle, I don’t know what is; no, I know of another – that I was guided to the right doctors.

At the time of writing this, it is nine months from the time that persistent cough led to the discovery of the recurrence. I am not quite finished with the follow-up chemotherapy that is done to make sure any tiny pockets of cancer cells too small to be visible, are eliminated once and for all. I believe the cancer is gone. Throughout this experience, I was receiving assurance directly, by telephone, by card, and by email, that there was a very large group of my family, friends (including many I didn’t know I had!), coworkers, and church members, that they were all praying for me. I believe when you get to the bottom line, that is what makes all the difference.