Paul's Heart

Life As A Dad, And A Survivor

Archive for the tag “cancer-survivorship”

36 Years In Remission Of Cancer


Nowhere near my next age milestone of 40 years, but I realize being in remission for cancer for 36 years is nothing to sneeze at. In fact, advice that I often give to new patients and survivors, in dealing with remission and survivorship with all the anxieties and concerns of relapses, is to take it, yes I know this will be cliche, one day at a time. And quick math, my 36 years comes to 13,140 days, and that is a long time. When I say it gets easier as time goes on, I mean it. I remember every day of my cancer journey as if it just happened. While at the same time, these 36 years seem to have flown by.

In the 36 years of my remission, the diagnostics used to diagnose Hodgkin’s Lymphoma, no longer used. The methods used to stage Hodgkin’s, such as the laparotomy and the lymphangiogram, are no longer used. The high dose, “scattered field” approach of using radiation therapy to treat Hodgkin’s, is no longer used. And the treatment used before the current standard of chemotherapy, a hybrid, MOPP-ABV (now used ABV-D), is no longer used. I have been in remission long enough to witness all of this progress.

Over these 36 years, I have been discriminated against for employment before the Americans With Disabilities Act was passed making that practice illegal. I struggled to get health insurance due to my pre-existing condition of cancer until the Affordable Care Act was passed requiring that acceptance.

I got married twice, and also divorced twice. I am blessed with two wonderful daughters, now in their twenties, over half of my survivorship, one on the verge of graduating college. I bought a house with a fence, just not white picket, which allowed the dog I always wanted, a golden retriever, to be able to run and play safely in the yard. I had a nice career working in of all occupations, medical research, even handling one of the chemo drugs I had been given. I participated in two school board campaigns as a candidate, the only time I have ever run for a public office. I have travelled to all four corners of the country, and around the world.

I have written and published many stories and publications, and two years ago, published my first book, “Paul’s Heart – Life As A Dad And A 35 Year Cancer Survivor” available on Amazon. I have had one of my stories acted out professionally by actors. And I still have many works in the process.

Music was always a huge part of my cancer journey, but also my survivorship. Whether I was disc jockeying (which I did for 40 years), or performing live vocals, it was the one time I could forget that I had cancer, or at least not think about it. I picked up the guitar and keyboards again, the first time since high school. And of course, I have a huge catalogue of music of all genres to listen and disappear to.

These 36 years have not been easy, or without price. Because medicine never studied what could happen if cancer survivors lived long term, more than the five years we are always quoted, and because we do, for many cancers now, late side effects from the treatments appear in some, not all, cancer survivors. The problem was, there was no plan for this and if it happened. And for those who did develope these issues, decades ago, could not find the care to help with these odd issues, or even how to treat them. But with the coming of social media and the internet, it would be other survivors, and eventually doctors catching on, now finally getting the attention to survivors, that we all should be followed up after five years, not necessarily by the oncologist, but at least by a primary care physician, to watch for something to develop if it does. Again, this is not guaranteed to happen, but if it does, it is important to be dealt with sooner than later. My health history on this page is filled with details of issues I have faced.

And one of the coolest experiences, was getting to reunite with my oncology nurse, my counselor, and my radiation tech, decades later, so that they could see the great thing they did. I know that not all of their stories had happy endings, but for a brief moment, I gave them one memory to remember they saved a life.

And then finally, and as important as my survivorship experiences, are the hundreds of patients and survivors who have crossed paths with me, either through peer to peer counseling, social media, or even happen chance meetings. Each and every person I have met or talked to, is a part of my success of 36 years. There is one downside, I have had to say goodbye to some of my fellow survivors, many way too soon, their bodies no longer able to handle the lifetime of trauma from their experience. Everyone, living and those gone, are all so important to me in my survivorship.

I am hoping, and according to my counter on my main page, that I will have another four years in me, to reach the 40 year milestone of survivorship, after which I will reset my counter to 50 years. I am still hoping to experience so much more. At least that is my plan. I know there is so much more for me to experience.

I cannot donate blood or organs because of my treatment history. I will not discover any cures or treatments, and financially I am not able to give back. So this is why I do “Paul’s Heart.” This is my way of giving back, sharing my private experiences, one reader or follower at a time, hopefully giving the inspiration that I looked for decades ago, and could not find, forcing me to take my fight against cancer on my own. And I hope my story does make a difference.

Stick around, there is going to be a lot more to come.

What Does Ai Have Against Cancer Survivors?


(image courtesy of SciTechDaily)

It was a simple and innocent enough question I entered. Given my personal status, and my knowledge, I thought for sure, asking Ai would give me at least a similar or more accurate response to my question. But might I actually know more than Ai? Or might I just have the one characteristic that Ai lacks, the ability to care about the impact of the question?

“What is the average lifespan of a Hodgkin’s Lymphoma survivor?” It is a simple enough question, and if you have followed “Paul’s Heart,” you know at least one Hodgkin’s survivor of at least 35 years. And you would think medicine and other advocacy groups would have some sort of statistic to reflect others like myself, and there are plenty more, at least a thousand more that I am personally aware of.

I do not chase after this statistic constantly. The last time I looked, still the only number when it came to cancer survival rates, was still being based on a 5-year average. Sure, it gets acknowledged that survivors of Hodgkin’s Lymphoma can live longer, but there still is not any kind of verfiable or concrete information, mainly because it has never been tracked. A patient hits the five year mark post treatment, and then gets released by their oncologist, in theory, never to be heard from again, alive or deceased.

So since medicine and society do not have any solid stance on my question, I put it to Ai. The response was based on twenty-one sources, including ASCO, City Of Hope, NIH, ACS, NCI, Blood Cancer United (formerly Leukemia And Lymphoma Association), Lymphoma Research Foundation, NHS, Cleveland Clinic, and more. “While there is no single “average lifespan” for a Hodgkin’s Lymphoma survivor, most patients have an excellent prognosis, with long-term survival rates approaching those of the general population” was the answer. I guess “general population” refers to those with no history of cancer. Ai also does not seem willing to commit to any kind of number, whether it be by years of survival, or by the percentage of those having long term survival. Ai does admit to several factors influencing survival from age of the patient, stage of the cancer, and of course, treatments administered. But I already knew that.

My Ai search went on then, with the usual “survival measured in five-year and ten-year” relative survival rates (an improvement from just five-year), based on data from 2015 to 2021. Again, keep in mind, data was not kept on those of us treated in the 20th century and at least the first decade of the 21st century. Ai does admit that many live decades beyond their diagnosis, and that is because of documention by the medical community of survivors like myself, but there still are no solid numbers other than what has been documented over the last ten years. And I know there are other Hodgkin’s survivors out there in the world.

Age is recognized as one of the factors that impact survivorship. It took a long time to give myself credit for survivorship longevity as long as I have, but I am still so inspired by those in their 40, 50, and 60 years of survivorship. And if you are saying “WOW!”, you bet WOW!!!. These survivors were more likely diagnosed in their early childhood or teen years. But that does not mean that those diagnosed as adults cannot have longevity. It just means that the trauma to their body is affected differently by the already aged and susceptible issues of an older human. I was 22 years old when I was diagnosed, turning 60 at the end of this year. And I know many who were diagnosed in their 30’s and 40’s, now in their 70’s. But why isn’t this information coming up in my searches, even with the assistance of Ai?

The other major factor recognized by AI impacting survivorship, treatment complications. For those of us treated prior to the mid to late 1990’s, it was possible we were not even expected to survive the toxicity of the treatments, let alone worry about survivorship. But as medicine continued to advance and find better and somewhat safer treatments, its toxicity still exists today, however with increased survivorship numbers.

Here is the problem, and Ai does not even seem to have a grip on this situation. What happens to those survivors who develop treatment-related complications such as secondary cancers, cardiovascular disease, pulmonary disease, as well as other issues? Ai’s answer for this is less than a hundred words, lifestyle and medical surveillance. And I would bet donuts to dollars, being monitored following the five-year mark is still not mainstream advice to Hodgkin’s survivors.

Science and medicine knows this monitoring is crucial to survivorship. Well at least those that treat survivors like me, impacted by our treatments. Thirty-five years out, my treatments have had a lifetime impact on my heart, my carotid arteries, my lungs, my thyroid, my esophagus, the muscles of my upper torso, my spine, my pancreas, fertility, and of course dealing with several emotional issues, one being survivor’s guilt. So I am quite lucky, I have been monitored since 2009 following the discovery of these late effects, but still, this was thirteen years after my “five-year graduation” from cancer, unsurveilled, and clearly lucky, with the first issue I developed was caught just as I was about to have a fatal heart attack. Had I been followed up sooner, the situation would not have been as dire.

And there are many others, as I have said, at least more than a thousand that I personally know who did not have the monitoring until it was either near too late or just oncoming. So does everyone develop these issues? According to Ai and its resources, that number is “not definitively established.” And figuring this out is as difficult for humans as it is for Ai. With evolving treatments, varying studies, and longer latency periods, a bigger factor impacting this is human, and that is the ability to connect the health history of a Hodgkin’s survivor to any particular issue that has come up. But without a Hodgkin’s patient being told about later risks, and many still are not, survivors simply go on with their life, after Hodgkin’s, never giving it a second thought. And unless you are dealing with a known issue, you do not seek out that help, and that can erroneously affect statistics, diagnosis that make no sense for demographics, like when I was diagnosed with a widow maker heart blockage at the age of 42, due to my radiation treatments. Even the operating room was shocked to see someone “so young”. Medicine and science knows to look out for these things, yet it is not common recommendations to follow up lifetime with every cancer survivor for these types of issues.

And then there are those survivors who will simply bury their heads in the sand, like ostriches, ignoring the potential for problems or pretending it does not exist. After all, if you cannot see it, does it really matter? All a cancer patient wants is to live a long life after cancer, without cancer. Why doesn’t society and medicine recognize and more importantly celebrate when survivorship does happen? I am talking going beyond “ringing the bell” at the completion of treatment(which I never got to ring back in 1990 as this was not a thing back then). Our society frequently announces those who are diagnosed or battling cancer, and of course there are those that do not survive. But think about it, how many “celebrities” can you name who have survived cancer, let alone those personally in your life? Why do we not celebrate and recognize those survivors, giving inspiration to those newly diagnosed or currently in treatment, looking for support that there is so much to look forward to?

When I was diagnosed in 1988 at the age of 22, besides the chances of me beating cancer, my next question was how long I could expect to live after that? Would I live a long life? I have been writing “Paul’s Heart” nearly fifteen years, so you have seen all of my milestones and achievements so far in my survivorship. And I still have many more that I want to reach. But I am just one survivor. I love being able to share stories of other survivors and I have done this many times on this page. If you would like to share your story of survivorship, I would like to post it here, so that others could see more than just one survivor story.

Even if medicine and science never catch up, I have hopes that maybe Ai will.

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