I find I greet the new year with both anticipation and
anxiety–anticipation because it’s the start of a new year, and all that is
coming up–my children’s next birthday, the next Dizon family reunion and
also, all that is possible: submitting a grant, publishing a book, travelling
to a place I’ve never been. Anxiety too, because I realize that all the work
I’ve committed to will become due–papers to be written and talks to be given.
All the while, the clinical practice of oncology never stops. Patients still
get admitted, new patients are still scheduled, and my established patients continue
to be seen in clinic.
This year, however, has thus far been tinged with
sadness. We have seen the deaths of several high-profile figures and their
passing has been marked far and wide–David Bowie, Alan Rickman, Lemmy
Kilmister, and René Angélil.
Each time the news broke, my thoughts
went to the lives each lived, the momentous roles they played in American (and
international) culture, and to their families, knowing each would be missed in
a profound and personal way that only loved ones can experience. At the same
time, I knew each would be celebrated for just how many they touched.
But I realized as well,
patients continue to die due to cancer or its complications, far from the
national headlines. And this was true in my own personal circle. My friend,
Nora, also died of cancer; in her case it was lung cancer. I had tried to help
as much as I could in the three years she was treated–finding a
multidisciplinary clinic in the South Pacific, choosing chemotherapy that made
the most sense for her (and afforded the best chance of survival), navigating
insurance to ensure her tumor was tested for mutations, and then arguing with
them for erlotinib when we found out it harbored an EGFR mutation. Through it all, Nora lived. She never became a
“cancer patient.” Alongside her spouse, Bernie, she prioritized friends and
family, choosing treatment at home on Guam, rather than travel to the
continental U.S. for the “best” treatment, especially if it meant the
possibility of never seeing the shores of the South Pacific ocean once more.
Towards this last year, we had successfully obtained treatment with a PD-L1
inhibitor for her, but unfortunately, it made her sicker instead of helping.
She had become oxygen-dependent, but despite this, continued to live her life
as best as she could–and it was pretty good. No matter what cancer threw at
her, she saw her cup as half-full, never half-empty.
If I could convey how
Nora’s life was lived, it would be to use the widely used term “survivor.” Yet,
the term seems wrong. Nora did more than survive–she lived. She travelled, she
threw parties, she saw friends, and she laughed often. Even when I last saw her–toting
an O2 tank around–her eyes sparkled and she smiled brightly. Even when talking
was hard because she would easily lose her breath, she engaged all of us, and
while her death did not make the front page of any newspaper, it was a profound
moment for all that knew her.
With her passing, I
realized that cancer continues to threaten the lives of many, and deaths from
cancer are going to continue even as we strive for better ways to prevent, cure,
and treat the disease. But my hope for 2016 is that we all embrace a common
wish for our patients and their loved ones with cancer. Let’s help them live,
live well, and laugh often. Let’s understand their goals, their preferences,
and their wishes. Let’s help them prepare for an uncertain future, but learn to
see what is here, right now.
My dear friend Nora Camacho died from lung ca. This wasn't a fight, there was no war. She lived. But she deserved more. #lcsm #SurvOnc16— Don S Dizon (@drdonsdizon) January 18, 2016
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