Chronicles of a
Cancer Patient

Hello everyone -

It’s hard to come up with a good way to say this in an e-mail, especially a mass e-mail, but I thought that perhaps this was the best way to let everyone know. Some of you may know that I’ve been particularly ill as of late, and that the doctors have had a difficult time finding exactly what the disease is. For those of you who haven’t heard any of this yet, consider yourselves lucky that you didn’t have to go through the months of playing the “Disease of the Week” game, where each week I would be whole-heartedly convinced that I had some exotic ailment like Malaria of the p.vivax strain, or the very unlikely Thalysemia, or the almost unknown Whipple’s Disease.

It was just a week ago that the doctors were aggressively testing for one of these strange, mystic diseases – when suddenly the tests all came back wrong and in just a couple phone calls, everything seemed to fall apart. At least, that’s how it felt to me.

A few more tests in a different direction confirmed the findings. I have cancer.

I have a cancer called lymphoma. This is a cancer of the lymph nodes and, I’m glad to say, a very curable kind of cancer. I’m told that with the proper treatment, 97.9% of lymphoma patients survive. Nevertheless, it is cancer and I’ll have to go through all of the cancer rituals to get rid of it. Chemotherapy will begin soon, followed by whatever else it takes to get rid of this.

This is difficult. But I can handle this, I will beat this, and I will come out a better man in the end. I am looking forward to being a cancer survivor.

If I can’t have my health, I’m glad that I still have my family and friends. It is a relief to know that I will have you all with me as I go through this. I understand that it is hard to know what to say in a situation like this, but please don’t be shy. This is a fine opportunity to make jokes about me losing my hair, etc., etc.

I look forward to seeing you all again soon.

Future Cancer Survivor,
Dave Hahn

P.S. – I’m afraid I don’t have the e-mail addresses of everyone that I’d like to send this to. Please feel free to pass this on.

I have Hodgkins Lymphoma, what is also called Hodgkins Disease. This is cancer of the lymph nodes. This is one of the most curable kinds of cancers, as it responds remarkably well to chemo therapy. There are other kinds of lymphoma, all classed as “non-Hodgkins” lymphomas, and, as I understand it, the cure rate for these kinds of cancer is not as good.

There is a great deal of information available on the web about Hodgkins Disease. For an overview, I would recommend the Mayo Clinic’s website: Hodgkins Disease.

One website I’ve found interesting has been Bill Bujake’s Hodgkins Journal, which talks at length about his experience fighting and curing the disease.

Before all this I didn’t really know what the difference between chemo and radiation was, it all just seemed like some nondescript, horrible stuff that I hoped I never had to go through.

But the world keeps spinning, and it turns out chemo and radiation are two different things. I’m still not entirely clear on what radiation is, and I’m not sure I’ll even have to go through it, so I’m happy to just discuss chemo.

Chemotherapy is a treatment for cancer that involves an IV, a lazy boy recliner, and chocolate chip cookies. The lazy boys at the place I go are all green and covered in fake leather. They are lined up against a wall with dividers between them, giving the same sort of fragile privacy that similar dividers provide in men’s bathrooms.

Each lazy boy has a phone next to it. This is in case you are super busy and need to make important phone calls whilst they are pumping you full of the drugs that will damn-near kill you. I don’t know anyone this busy.

Each chair is also equipped with it’s own television that gets poor reception of local stations. This is convenient if you are really nuts about daytime television and you wouldn’t miss your soaps for anything.

The cookies are in the waiting room. I don’t know where they get them, but they are awesome. Clearly the bakery keeps the best cookies for us cancer patients. They probably use a pound of butter in each cookie, but I mean, what do we care, right? What, is it going to give us cancer? Gimme one of those damn cookies, and put more butter in it next time.

The rest of the cancer center is pretty sterile looking. The walls are painted with the soothing, tan color that they always use on those HGTV shows. Hanging in the corner is an embroidered acronym that cleverly uses the individual letters of CHEMOTHERAPY in a sad prayer. There are also small dolls dressed as nurses. This corner freaks me out.

The real nurses sit at a big desk and talk on the phone to doctors. Behind them is a big ice and water machine. The water and ice machine is the biggest piece of equipment in the whole place.

When you come for your chemotherapy session, they first take your blood and send it off to “the lab,” which must be a place very, very far away, judging on the amount of time it takes for things to go and come back from it. You then have to wait a few hours for the far-away people at “the lab” to test your blood.

An order is then sent to “the pharmacy,” another place in a far-off land, where they measure out and mix the drugs that they will be giving you. The drugs have to be measured exactly, based on your height and weight that day.

Meanwhile, you are still sitting in the lazy boy, watching your soaps and eating your butter cookies. The nurses hook up an IV to the port that was surgically implanted in your chest and give you huge amounts of “saline.” “Saline” is something that looks like water that is apparently not water that makes you have to go to the bathroom a lot.

Before the drugs come, the nurse, who in my case, is sort of cute, puts several drugs through your IV. First, she puts in a steroid called Decadron. This is to bolster your system before the other drugs destroy your system. Having Decodron is a lot like having a direct IV drip of pure, liquid caffeine.

Then the nurse puts Benedryl through the IV, which makes you extraordinarily tired. You might fall asleep at this point, but as you are unable to stop moving from the Decadron, sleep is not really an option.

Then the chemo drugs come. Their are four different drugs that need to go into you before you can leave. The first one is colored like red Kool-Aid. It’s a little frightening to see the red liquid floating down the IV tube towards your body. You think, “OH GOD, here it comes!” And the nurse is looking at you, and you are looking at the nurse, and suddenly it seems like all the other patients are looking at you, and you are looking at them, and the red stuff is coming down the pipe, and the nurse is looking at you, and you can’t stop fidgeting, and the room is getting smaller, and it’s coming and it’s coming and it’s coming!!!!

But then it’s not so bad. It doesn’t feel like anything. One by one they put all the drugs into you and it doesn’t feel like anything. You might as well just watch your soap operas, because it’s not exciting. I bring my laptop or my iPod and watch movies and listen to music.

Then they give you a few shots that will, again, help fix the system that the drugs just screwed up. By this point you are pretty sick of being stuck with needles and you have had your fill of butter cookies. They take out the IV and they tell you to go home, that’s it.

I’m glad so many of my friends have come to read and comment. That’s good, because I need to make a small announcement:

Remember all that weight I lost last year? Well – funny story about that – it was apparently not due to what a hot stud I was, or to eating better, or to working out, or to anything else that I might have bragged about during the past year of grinning and gloating.

Therefore, as I do not condone the use of diseases to lose weight, I retract any dieting advice, especially all the dieting advice, I doled out during the past year.

And I’m not saying I necessarily will, but just for you sticklers out there: I reserve the right to stop being such a sickly-looking thing and to get good and fat after all this is over. Pass me another cookie.

In case anybody is throwing a sweet party anytime soon and you need some new music, my favorite cancer song (yes, I now have a favorite cancer song) is “Chemo Limo” by Regina Spektor.

Chemo Limo, Regina Spektor:
Song Clip
Lyrics
Artist Website

1. (Zool.) A genus of decapod Crustacea, including some of the most common shore crabs of Europe and North America, as the rock crab, Jonah crab, etc. See {Crab}.

2. (Med.) Formerly, any malignant growth, esp. one attended with great pain and ulceration, with cachexia and progressive emaciation. It was so called, perhaps, from the great veins which surround it, compared by the ancients to the claws of a crab. (1913 webster)

So far, I think the worst thing about having cancer was finding out that I had cancer.

Since then, I feel like it’s been nothing but good news. My bone marrow is clean, I’m not going to die – then the chemo isn’t (so far) as bad as I expected – then my pulse goes down, my cough is gone, my blood tests are better, the nurse is cute, the cookies are delicious (my appetite is back), and I feel more energetic. I mean, even the drought seems to have stopped since they told me I have cancer. I made it rain people! I made rain!

Now, surely there have been things that could be called bad news since the diagnosis – my website got hacked, the cancer is in a later-stage, Comedy Central changed the set of The Daily Show and gave Adam Corolla his own time slot, etc. Certainly all tragedies. But give me a break, nothing compares to that call from the cancer doc.

In 1996 an international study identified 7 factors that consistently predicted the probability of remission in Hodgkins Lymphoma patients. (Well, actually, they were looking for the probability of what they called the five-year “Freedom from Progression of Disease,” or FFPD. I interpret FFPD to basically mean remission.)

The probability of remission is much different than the probability of survival, so you have to be careful not to read the results as such. It’s easy to get carried away with cancer statistics.

The 7 factors include things like age, sex, and the measure of certain chemicals in your blood. As I understand it, a patient without any of these 7 would have a remission probability of 84%. For every factor you have, you lose 7%.

According to this test, my probability of remission is around 60% for the next five years. That means, according to whoever these people are that developed this project, that I have a 60% chance of losing this cancer and staying cancer-free between now and 2010.

But why stop there? Since we’re discussing statistics, I should mention that progressive heart disease is much more likely in Hodgkins patients following chemotherapy. Moreover, patients that receive chemotherapy treatment for Hodgkins Lymphoma are 4 times more likely to develop lung cancer, and are at an increased risk to develop leukemia within the first 10 years following treatment. In fact, according to the National Cancer Institute, the number one cause of death among Hodgkins patients is second cancers that develop following diagnosis.

Be that as it may, the Dave Hahn Institute of People Who Are Nuts says that if you don’t take the chemotherapy to cure your Lymphoma, you have a 100% chance of being an idiot. If it happens, you should feel lucky that you lived long enough to develop a second cancer, heart disease, or whatever else.

Realistically, I think these numbers – and really, any cancer statistics – should mean very little to an individual cancer patient. There are just too many factors involved to make any of these statistics worthwhile. Every individual responds differently to the treatment of cancer, and considering all the things modern medicine still doesn’t know about this thing called cancer, there’s really no way to know what will happen.

So, while these numbers are, I suppose, impressive or intimidating, they don’t effect me much. The really valuable thing that can be taken from all this is that tomorrow is not guaranteed, and you better not let today pass without making the most of it.

Revenge of the Vinblastin

Today was the second chemotherapy treatment. Peanut butter cookies today. I wasn’t as excited about that. Anyway, I’ve put on 9 lbs. in two weeks, so maybe that’s ok.

The cookie selection was really the most interesting part of the whole session. There wasn’t much to it. They took the blood tests, I saw the doc, they pumped in the drugs and there were no problems. I watched a movie and listened to music.

And I’m glad I’ve got my headphones (thanks Cindy) with me, because I kind of wanted to tune out the Room. Say what you will, but the community atmosphere of the Chemo Room isn’t really my thing. Picture it, the poor guy next to you is having trouble as the chemo burns away his veins, everybody in the chairs – especially the older ones – are pretty hard up and not in the talking mood, the nurses are going on and on about hemoglobin and saline drips, and somebody down the way is trying to drown their troubles in Oprah. I’m not saying that I really have a problem with being there, I guess I mean that I don’t want to be there anymore than anybody else would want to be there. My parents sat by me the whole time reading the paper, and I assume, listening to the cancer chatter of the Chemo Room. My poor parents, I don’t think I could read the “feel-good” Chicago Tribune and soak in the vibe of the Room’s suffering all at once. I was happy to escape.

The doctor was quick today. There is a Chemo Room in his office that is way worse, I think, than the place I go. He mentioned in passing today that I should maybe think about switching Chemo Rooms to come to his. A little marketing on the doctor’s part – very clever, pal. In his Chemo Room, all the recliners are facing each other, there’s no dividers, there’s one TV in the corner blaring daytime TV for the blue-haired, early-bird-special kind of clientele. There, I picture myself in forced conversations about youth and future plans, and possibly being awkwardly introduced to grand daughter’s when they come to pick up Grandma. Don’t get me wrong, I’m a social guy, and I’m usually golden with the blue-hair club, but when I’m at chemo, I just want to blend into the fake leather and watch my sappy movie.

I also heard from doc today that it’ll be more like 6 months of chemo instead of 4. Bring it on, doc.

The results from my heart scan are back. I have a mild enlargement of the heart (the left side for those of you studying for the test). This is called Left Ventricular Hypertrophy. The nurse says that it’s likely from both being anemic and the tumor being wedged up against the heart for so long. I don’t know much about it, but it’s mild, and it doesn’t sound like that much of a problem.

Mom and Dad took me home and I climbed up into my hammock between the trees (thanks Rick) for the rest of the afternoon.

And I went to work tonight and played piano. There was really no reason not to, and I like my job – playing piano and surrounded by people. I do find that my fingers are not as coordinated as before chemo, but it’s a very minute amount (that might be more related to a lack of practicing lately and perhaps not the chemo), and its probably imperceptible to people listening. Or maybe it’s not and people are being kind. Either way, it’s not a problem yet, but I have heard of this kind of thing happening later in treatment. No worries, future bosses, it goes away.

Ok, I know this flies by harmless self-absorbtion and lands squarely in exhibitionism, but come on! You know you wanted to see it.

This is a photo from the PET scan I took. That black thing is not my heart, that black thing is the problem.

UPDATE: See also, PET Scan Before and After Photos