Happy Father’s Day to all who are celebrating today, and my heart goes out to all of those who recognize this day, to remember their Fathers, no longer with them, and for those, who through no fault of their own are kept apart. At one point, I checked off all three of those boxes, so I understand all the emotions involved.
As a Dad of two amazing daughters, this is my day, bigger for me than Christmas, birthday, even my once favorite Halloween. But the biggest part of my life, my legacy if you will, is having made the decision, to be responsible for two children, to teach them values, morals, right from wrong, all the while making sure they learned in school, and became responsible adults. Of course, as you know reading “Paul’s Heart”, this has not been easy with the variety of health issues I have faced as a cancer survivor. But this I know, I do not take any day for granted, and I celebrate every new day that I get with my daughters.
But as I said, I checked off more than one box when it comes to today. I lost my Dad to lung cancer eleven years ago, he was just ten years older than I am now. He was not alive to see what I went through as a Dad dealing with the family courts in regard to the relationships with my daughters. Of all the things unresolved with my father (my parents divorced when I was three years old), my Dad was only aware of the beginning of my own divorce and custody fight, as that was when he was just diagnosed. I could not throw this issue on him, while I dealt with both simultaneously. I am hoping, that my Dad is looking down on me and his granddaughters, and seeing how well things turned out with the my daughters and I.
The link above is for a performance for a special piece that I wrote in tribute to my Dad.
However you are recognizing today, I hope it is a good day for you.
When celebrating anniversaries, we make a big deal out of major anniversaries, such as 1st, 5th, 25th, and of course, 50th. In the world of cancer survivorship, many of my fellow survivors and I do the same thing with our anniversaries, though several of us recognize our anniversaries differently. Some will recognize the day that they are told they are in remission, and others, including myself, celebrate the day that I was done with my treatments. The photo above, was taken one year after I was done with my treatment, which means the photo was taken thirty-four years ago. That is right, today I am 35 years in remission!
I think I might actually even look younger today than I did back then.
In November of 1988, I was diagnosed with Hodgkin’s Lymphoma, back then it was called Hodgkin’s Disease. My cancer was staged at 3B, almost as bad as one can have it. I underwent some of the most toxic treatments of chemotherapy and radiation therapy to be able to hear the words “you are in remission.” And though I would get to hear “remission” half-way through my treatments, my doctor wanted me to finish the course, the entire plan of treatments, taking my last dose of medicine on March 3, 1990. That was 35 years ago!
Up to, and including the time I was diagnosed, all I ever knew about cancer, was that people died from it. There was no internet for me in 1988, so all I had to hear about cancer, came from the television news or newspapers, that people died of cancer. You never heard of people surviving cancer. And it was not good enough as a patient to hear about something called a “5-year survival rate,” in spite of this survival rate for Hodgkin’s being well into the mid-80 percentage, at the age of 23 years old, I wanted to live much longer than five years. I believed that I could, especially if the cancer was gone, but I had never heard of anyone surviving long term. At the time, my grandmother was in remission for breast cancer two years, my only reference to anyone surviving cancer. Again, no access to the internet, I had no idea of the inspiration that was out there, people living after cancer, 30, 40, 50 years and more.
But that time would come soon enough, buying my first computer, getting an AOL account, and finding a “listserve” of other Hodgkin’s survivors, some still in treatment, some finished with treatment, and here they were, some who had survived decades. I saw that long term survivorship from cancer could be mine.
There were other things that I learned as time went on, something that even science and medicine were not aware of or prepared for, if we were going to live longer than those five years, that meant that there would be a possibility that we could develop late side effects from the treatments, though what side effects were not known. This was not studied. But this community of survivors I discovered, were sharing this knowledge among each other, and where help with these effects, and doctors who have knowledge of late side effects, could be found. This would come in handy myself, because over 17 years after I finished treatments, the first late effect from my treatments was discovered, in the form of a “widow maker” blockage with my heart, caused by the high dose of radiation that I received. This would be the beginning of many issues that would be discovered over the next 18 years for me. But I want to stress two things, first, not everyone who goes through treatments develops these side effects, and second, as bad as some of these issues got, the proper intervention has given me so many more years, and I have been blessed with so many opportunities and memories.
The fascinating thing is, over 35 years, I have been witness to progress, actually getting to see it, how Hodgkin’s get diagnosed, no more destructive and invasive staging procedures. The toxic and extreme treatments that I and many others were exposed to back in the 1960’s, the 1970’s, 1980’s, and 1990’s, with medicine’s knowledge, those very treatments had a good possibility of killing us, are no longer being used. I can tell you that treatments today are just as effective, and though still not pleasant, are more tolerable and safer. I have gotten to witness this progress.
The best part of my 35 years of survivorship, has been having the opportunity of being Dad to the best daughters a Dad could ever hope for. They were not around for my battle with Hodgkin’s Lymphoma, but from the first appearance of a late side effect, they have been my motivation and inspiration to not give up. There has been so much that I have gotten to experience with my daughters, now both in college, I really did not ever think I would see this day, yet here I am.
I cannot recognize today however, without recognizing others in my Hodgkin’s family over these thirty-five years. First, all of my new Hodgkin’s friends currently going through treatment yet. I hope that whether you hear of me through “Paul’s Heart”, or have read my book, “Paul’s Heart – Life As A Dad And A 35-Year Cancer Survivor,” follow me on TikTok, YouTube, Facebook, or Instagram, I hope you being able to follow someone who has been a survivor for four decades to be inspiring to you, that you too will have a long and fruitful life ahead of you.
Then there are all of the survivors that have come into my life over all of these years. I have known many of you nearly my entire survivorship. And even more inspiring to me, is that so many of you have survived even longer than I have, forty and fifty years or more! I do not take any day that I have for granted, but seeing how far you have come, gives me hope that I can see that longevity also.
If there is one thing that remains so cruel, sadly, there are some that are not here with me to recognize this day. Some, their bodies just no longer able to take the trauma of decades of late side effects, and even one, barely getting to enjoy a few months out of treatments. I miss you all to this day. I remember you all and the joy you shared with me while we were able to survive together. I wish there was a rhyme or reason, why we do not have a 100% cure rate when we are so close right now! Though progress has been made in safer and more effective treatments, it is not good enough.
The counter on this page now is set for March 3, 2030, which will mark 40 years as a cancer survivor. That is a milestone I want to reach, and likely, with my daughters, hopefully not the only other milestones I get to witness.
The year is 1988. Popular music back then was “Faith” by George Michael, “Dirty Diana” by Michael Jackson, “The Flame” by Cheap Trick, and “Nothing’s Gonna Change My Love For You” by Glenn Medeiros (whose daughter loves trolling him on Tik Tok). Chuckie scared the crap out of us in “Child’s Play” in the movies. “Cheers” was the television show to watch. The price of gas was $.90 per gallon and a bottle of Coke was $.35 for a 16 ounce bottle. I remember everything from back then, clear as day.
But there was something even more memorable that occurred thirty-six years ago this week, I was diagnosed with Hodgkin’s Lymphoma (back then it was called Hodgkin’s Disease). The week before Thanksgiving and the start of the Christmas holiday season, and in less than a month, my birthday, I was faced in the fight of my life, cancer. I will not rattle off the entire history as it is not pertinent to this post. I have written enough about what happened and how I got through it on this blog, as well as publishing my book, “Paul’s Heart – Life As A Dad And A 35-Year Cancer Survivor”, available on Amazon (see the link below).
Instead, I want to focus on the progress that I have been fortunate enough to have witnessed over the last four decades. Cancer patients often are led to believe that there is nothing to really look forward to much beyond a magical five-year mark of remission. It is almost as if, once that 5th year hits, and the cancer patient gets “discharged” by the oncologist, the rest of survivorship is unknown. And until recently, it was.
I almost feel like a time traveller, having travelled into the future from the years 1988-1990. I have seen the progress of diagnosing one of the more treatable forms of cancer, with a remission rate well into the 90% range. Back in 1988 (and beyond), biopsies and barbaric surgeries and tests (the staging laparotomy and the lymphangiogram – look them up to see what is no longer done) were used to diagnose and stage the Hodgkin’s. Today, a scan or a combination of scans are used, no longer requiring recovery time.
With such a high treatment success rate, it may not make sense to work on better and safer treatment methods, since the success is already there. But the truth is, the extreme high dose level of radiation that I was exposed to, and the extremely toxic chemotherapy drugs that were used on me, as well as most patients during that time, and previously, were known to be just as lethal as allowing the Hodgkin’s to just run its course. So, we were given the treatments, as what did we have to lose? Medicine would learn over the decades, that they could have the same success rate of remission, if not better, by using less radiation, and lower dosages of certain drugs, and omitting other drugs. The treatment plan used on me, is no obsolete. And the treatment plans today, as I said, are producing similar or better results of remission, just with less toxicity and lethality.
Major changes in support have also occurred over the decades. When I went through my Hodgkin’s, there was no Facebook or social media. I was not able to connect with anyone else who had gone through Hodgkin’s. I had a therapist I was able to talk to, but that was it. Today, there is a world wide web, connecting people with Hodgkin’s all over the world, talking about topics not just Hodgkin’s directly, but all of the sub issues that arise because of the cancer, such as financial support, fertility, and employment. In spite of family and friend support, please do not take this the wrong way, it is often not enough, because there is no way for family and friends to truly understand what we are experiencing. Today, there is no reason for a cancer patient to feel alone.
And perhaps the biggest progress, and maybe even the most important progress, is since Hodgkin’s survivors are living longer (I am in remission 34 years), some into the 40th and 50th years even, medicine has learned that for some of us, survivorship has come at a price due to the extreme treatments that we underwent. Again, I have documented often on this blog and in my book, the various late side effects that I developed as a result of my treatments. And as I always stress, NOT EVERYONE DEVELOPS THESE ISSUES! But because there is no way to know who will and who will not develop late side effects, it means that a cancer patient’s health needs to be watched, even after hitting the five-year mark. An oncologist should remind a cancer patient to continue seeing their primary care giver at least annually, using a guideline established by the oncologist and the treatments undergone, to figure the surveillence needed and how often, first establishing a base line measure for body systems such as cardiac and pulmonary. Information on potential side effects can be found on the Children’s Oncology Group page at http://www.survivorshipguidelines.org/ and also at Hodgkin’s International at https://www.hodgkinsinternational.com/ . I am not sure what the statistics are, with how many of us are impacted by late effects, as medicine has never really studied survivorship in this detail. Many may never develop any issues. Some may never realize issues they have are related to their survivorship. The point is, progress, driven by my fellow survivors are doing what we can to get the word out, to take care, and follow up for these potential issues as I deal with.
These thirty-six years have not all been about cancer. Sure, as an advocate, I made an active choice to help and support patients and survivors, albeit on a micro level, one person at a time with issues such as information, support, comfort, and direction. But I have gotten to experience so much in my life, not only not having anything to do with cancer, but in spite of having had cancer. My life has not gone the path that it was headed back in 1988, and there is no way of knowing how it would be today had I not had Hodgkin’s. I can tell you, my life has gone the way that it was meant to. It has not been smooth by any means. I had a great career. Took two swings at marriage (both ended in divorce). I am blessed with the most wonderful daughters a father could ever ask for. My daughters missed my Hodgkin’s days, but have been there through all of my late side effect issues and are the main motivating reasons that I am still here today. I have so many memories over these thirty-six years, again, some not so good, but others… wow. I have been all over the United States and twice travelled to China. I had the best dog for nearly fourteen years, who also played a key role in my healing.
The only thing about survivorship that is scary, is not knowing how much longer. As I said, I know many survivors well into their 4th and 5th decades. I know many “newer” survivors having just reached remission or some hitting their early milestones, one year, five years, and ten years. The hardest thing about my survivorship, are the many survivors that I have had the blessing of meeting, some are no longer here today. I think of them as often as I do the other survivors that are still with me. No fault of their own, their bodies just could no longer take the trauma that was done to their bodies, whether undergoing corrective surgeries, or perhaps a spontaneous event, left to be handled by doctors without the knowledge of how to handle our unique medical histories and exposures.
As I mentioned, I have a birthday during this season, next month. And I expect to celebrate that birthday, with my daughters for the first time in eleven years (because of the divorce), and I hope to have many more. Longevity does not bode well on the paternal side of my family, my father passing at the age of 70. The late effects and their impacts on my body may effect my longevity. We do not know. But I do not take any day for granted. I go to bed each night, with plans for the next day. And when I wake up, I plan on taking care of everything I set out to do the night before. And if for some reason, it does not happen, then there is nothing I could have done about it.
But my plan is to reach not only my 35th year in remission milestone, but the 40th, and perhaps the 50th. And if I am able to do that, not only will have more progress to share in the world of Hodgkin’s Lymphoma, but I will have many more experiences to share of my life as a father, and perhaps grandfather.
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