March 16, 2010

Treating cancer with competence, compassion and laughter

— Few places conjure up a more depressing image than a cancer treatment center. Yet in reality, few medical settings are more uplifting than the Maine Center for Cancer Medicine and Blood Disorders in Scarborough.

I know because I've been there.

I have cancer.

The diagnosis -- small lymphocytic lymphoma -- came five years ago this fall.

For most of that time, the good doctors advised a ''watchful waiting'' approach. That meant we'd keep an eye on my ever-growing lymph nodes but wouldn't start actually treating the cause -- an overabundance of B lymphocytes that stick around way beyond their normal life span and thus clog up my immune system -- until it presented a worthy target.

All of that changed in December, when Dr. Helen Ryan, my hematologist, perused my latest CT scan results, looked me in the eye and said gently, ''It's time.''

I hemmed. I hawed. I went ahead with plans for a blissful 10-day vacation with my wife to the Virgin Islands. Then, in February, I listened to John Prine's ''Long Monday'' on my iPod, took a deep breath and followed the hallway arrow to the long-dreaded ''treatment room'' for my first injections.

What I found there, not surprisingly, were sick people -- many apparently a lot sicker than I.

But I also found smiles and laughter and a crew of nurses who bring to their work a perfect mix of competence and compassion.

''I think it's either naturally in you or not,'' said Anita Tomascak, one of the chemo nurses, when I finally asked how they do it day in and day out. ''And we get so much back from everyone we see.''

My treatment -- a combination of the drugs Rituxan and Fludara -- called for five days of injections every 28 days over six months. The final cycle ended last week.

I didn't lose my hair, but I did feel at times like I had no business getting out of bed. I never threw up, but nausea became a frequent companion.

In short, my physical side effects were minimal compared with many others'. As for the emotional fallout -- I've watched my father and two sisters die from cancer -- it could have been far worse.

From the receptionists to the blood technicians to the clinical nurses to the doctors to the physician assistants to the administrative workers to the treatment room staff, I felt nothing but warmth each day I went in. I quickly came to realize that on some days, a smile is indeed the best medicine.

I'd no sooner settle into my comfy chemo recliner when they'd take my drink order. Seconds later, a fresh coffee with just a little milk would appear at my side table.

Some sessions lasted less than an hour. Others, when I'd get both drugs instead of just one, took as long as four hours.

But it never seemed that long. Light-hearted banter filled the 19-seat treatment room as the nurses and other staff went about the grim business of pumping toxic chemicals into the veins of patients with plenty of reason not to chuckle. The cancer, the possible side effects, the risk of infection can all weigh heavily on the funnybone as that chemo drip-drip-drips through the clear tubing and into your bloodstream.

But laughter, I found, is also infectious. A casual remark about the weather would spawn a story about last weekend's trip to the beach, and before long patients up and down the line would be chortling and tossing a tale of their own into the mix. Until you've seen four or five cancer patients, all tethered by their catheters to plastic bags containing God knows what, laughing together at an uproarious wisecrack, you haven't fully witnessed humor's power to heal.

''We get so much back from everyone we see,'' said Nurse Anita. ''It's a gift that people are sharing so much of their lives with us.''

Truth be told, though, things can turn serious -- sometimes frighteningly so.

More than once, I watched as a patient reacted adversely to a new drug regimen. Flushed and gasping for breath, he or she suddenly would be surrounded by a small cadre of nurses, doctors and technicians (How did they all get there so fast?) who would simultaneously administer oxygen, an intravenous antidote to the reaction and, most noticeably, soothing reassurance to the struggling patient that everything would soon be back to normal. And every time, they made good on the promise.

I write this now in part to explain why my presence on these pages has been a bit spotty in the past six months. More important, it's an opportunity to thank and applaud the professionals who devote their lives to helping -- and often curing -- people with diagnoses that can scare anyone to death.

As Nurse Anita noted, ''The people who go into the field of oncology never leave You have to have a sense of faith. You have to believe it's going to work.''

There's no cure -- yet -- for my particular cancer. But it's slow-moving and now that they've knocked it back at least a few years, I've come to have faith that time is very much on my side.

Part of that comes from my preference for optimism over pessimism in matters of life and death. But another part comes from these people who over these last six months managed to slip a little something extra into those ominous bags labeled ''Rituxan'' and ''Fludara.''

It's called hope.

Columnist Bill Nemitz can be contacted at 791-6323 or at:

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