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Adapting to the Path of Cancer My Misbehaving Cells I began seeing a doctor in early May 1996 because of recurring pain in my bones. It would appear in one spot (a rib, a shoulder blade, or the rim of my pelvis), linger for some five days, and then vanish for two or three weeks. All the rheumatologists who looked at me confessed that they were baffled by my migrating symptoms, but we found that the pain did at least respond to medication. Because I was also anemic, my doctor sent me for an endoscopic examination of my colon in May 1998. We drove off immediately afterward for a relaxing vacation in Florida, a time spent swimming, building sand sculptures, and teaching Andrew (Shaf’s and my ten-year-old) how to sail a catamaran. I came home to word that my colon was clear, but they would have to go in again and biopsy “abnormal-looking” tissue in the last part of my small intestine. I sensed what that wording probably meant. The procedures were scheduled for June 24, the following week. On June 23, and not wholly by accident, I bought my second volume of Deng’s work. It would be a suitable book to read during my anxious wait. On July 1, my doctor called me to say that an appointment had been booked for me the following day with an oncologist at Ellis Fischel, our state cancer hospital, a mere six minutes’ drive from our home. So it all began. Dr. Michael C. Perry, head of the Division of Hematology and Medical Oncology, took on my case. He was a gem. To be sure, he was 211 brisk and painfully precise, but how reassuring it was to be in the hands of a perfectionist. Diagnosis and assessment of the stage of the cancer were based on the biopsy, blood tests, a CT scan, study of my bone marrow, and a general physical exam. It was serious. There were many lymphomas in my abdomen and one under my arm, two cancers in my spleen, a cancerous wall in my small intestine, plus cancerous bone marrow throughout my body. This spread, both above and below my diaphragm, told us the disease was well advanced. While it was a “slow-growing” cancer, which sounds reassuring, it was a kind that could not be eradicated. At best, it could be pushed back from time to time. I was fifty-nine, with a young wife and a child, making the situation consequential for us. We were all staggered for the first few weeks, including Andrew, who had recently lost a warm kindergarten teacher to cancer. Not surprisingly, Andrew asked me earnestly for straightforward information; I honored his request . The details of the treatment are of less interest, I suspect, than the results . I will, at least, outline the former. There have been four rounds of treatment so far, each with its own character. First, I had six doses of chemotherapy with CVP (Cytoxan, Vincristine, and Prednisone) that reduced the cancer mass by 50 percent. Cropping my hair short the day before it began, I escaped most of the usual hair loss. Short hair is not as easily pulled out. And the bone pain I’d had for more than two years vanished! It must have been due to my bone marrow cancer. Just over a year later, in October 1999, pressure on my bladder and kidneys told me that the cancer was building up again. A CT scan con- firmed it. “Dr. Gardner, you don’t cry wolf,” Dr. Perry said, leaving me feeling like a useful participant. This time, I received two doses of Fludarabine chemotherapy. It had little apparent effect, so we went immediately to a third kind of treatment—eight doses of Rituxan, cloned antibodies of cancer cells. These took hours to administer, and I had to be watched throughout, due to the possibility of a shock reaction to the foreign protein in my blood. It was, however, easier on my body than chemotherapy had been. For a few days after each treatment I had mild flulike symptoms, but my immune system was undamaged. As with CVP, there was marked reduction of the cancer, and a second relatively comfortable year passed. By January 2001, I sensed pressure building up once more and with greater speed than previously. I was right. This time the cancer had 212 Journeys to the Edge [3.15.46.13] Project MUSE (2024...

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