Introducing the Elephant…

Randy Pausch is a computer science professor at Carnegie Mellon who was diagnosed with pancreatic cancer in September, 2006. During his now famous ‘Last Lecture‘ at Carnegie Mellon (an incredibly inspirational lecture), Dr. Pausch says that, “When there is an elephant in the room, introduce him!” Here is what he said in an Email when telling his friends and family of his diagnosis:

I have recently been diagnosed with pancreatic cancer (adenocarcinoma).The good news is that I’m one of the 20% of pancreatic cancer patients who are viable for surgical removal of the tumor, and I’m scheduled for surgery. It’s a major surgery, where they will remove the tumor (which is about 3mm in diameter), my gallbladder, part of my pancreas, part of my small intestine, and possibly part of my stomach. I will be in the hospital 2-3 weeks, and then another 4 weeks of bed rest at home. At that point, I’ll be physically 100% again. If the surgery removes every last cancer cell, I win. Otherwise, eventually the cancer will recur. Statistically, the long-term prognosis is not rosy; only 10-20% of people who have the surgery survive to five years. Needless to say, I intend to be one of the lucky ones who sticks around! The median age for this disease is 66 and so there is some reason to believe my odds will be better than the typical patient’s (I’m 45 and in good physical shape), so they can hit me with more aggressive chemo and/or radiation after the surgery.

The similarities between me and Dr. Pausch are eerie. He was 45 when he was diagnosed; I am 42. His tumor was 4.5cm in diameter, mine is 3.7 cm. While I am not currently a candidate for surgery, I am getting ready to begin chemo/radiation therapy to reduce the size of the tumor so that I will be a candidate for surgery. Despite traditional methods of staging cancer, Dr. Josh Larson, one of my radiologists, said that there are really only 3 stages of pancreatic cancer: 1) operable; 2) potentially operable; and 3) non-operable. This is consistent with information presented on the Cancer Supportive Care Programs website. Based on my scans, Dr. Larson said he thought I was somewhere in between the operable and potentially operable stage. So as with Dr. Pausch, I am likely to be a candidate for surgery. Moreover, there is no evidence of metastasis and there is no evidence that the cancer has spread to the lymphatic system. But in the end, as Dr. Pausch says, the prognosis is not rosy. According to WebMD, less than 5% of the diagnosed pancreatic cancer patients survive past 5 years (corroborated here), though contrary to what Dr. Pausch reports, the percentage that survive to 5 years after surgery may be higher if surgery is successful.

I expect that, like Dr. Pausch, I am at an advantage with regard to this disease as I am in reasonably good health and 20+ years below the median age of diagnosis for this disease. So I am younger than most people diagnosed with pancreatic cancer and I am not symptomatic (many cases of pancreatic cancer are diagnosed when the disease had progressed so far that it caused significant symptoms).

I would argue, using this figure as a representation, if “Population 2″ represents the typical pancreatic cancer patient, I am more likely a member of population 1.

Reading Dr. Pausch’s website, I found a link to a paper related to statistics and cancer by Dr. Stephen Jay Gould. Upon learning that he was diagnosed with mesothelioma, Dr. Gould did research and learned that the median survival rate for his form of cancer was 8-months and he reasoned that this means that, “…half the people will live longer; now what are my chances of being in that half?” Similarly to me, Dr. Gould concluded,

…I possessed every one of the characteristics conferring a probability of longer life: I was young; my disease had been recognized in a relatively early stage; I would receive the nation’s best medical treatment; I had the world to live for; I knew how to read the data properly and not despair.

As reported by Dr. Stephen Dunn, “Dr. Gould lived for 20 very productive years after his diagnosis, thus exceeding his 8-month median survival by a factor of thirty!” As I have stated, I, too, am young; my disease was diagnosed in a relatively early state; and I have lots to live for. Like Dr. Gould (and Dr. Pausch, for that matter), I fully intend to beat the statistics.

I am focusing on the present; I am not worrying (trying not to worry) what may happen in the future. Today, my younger son asked me to come to his last day as a fifth grader (tomorrow is field day), and while I took for granted my older son’s field day, I do not plan to do so with my younger son. Although I do not have a lot of leave available, I think it’s more important to spend time with my son tomorrow than it is for me to get the analyses for a paper (or any other stuff I need to do for work) completed. I hope that my colleagues in DVP will understand.

I’ve been told by various people that they have been moved by my posts. If nothing else, I hope you take away this important message: Do not take for granted what you can enjoy today; the options tomorrow may be entirely different than those available today.

Join me as I relish the joy(s) I have today.

Merle

To Merle & MaryBeth’s friends…

The following was posted as a comment on my blog by Marina:

For the local ATL friends who are interested in helping with child care or meals, please let me know at marina@merlehamburger.net and I will include you on the Hamburger Care Team e-mail list and share upcoming opportunities. Note: your name will be vetted by Merle and MB to ensure that no wacko sociopaths (emphasis added) are brought into the caring circle :)

peace and love,
Marina

As I said, I really appreciate that Marina is doing this for us, though I did say that eliminating wacko sociopaths will significantly limit those who CAN be brought into the caring circle.  ;-)

I will post a more substantial blog later, but I have to say, it’s the little things in life, often, that have the largest impact.  Last night my 4 year old daughter was scared to sleep in her own room.  When I went to check on her, she asked if I would sleep that night in her room.  I agreed and she was reassured and fell asleep quickly.

It’s pretty powerful stuff when just agreeing to be there for someone is enough to chase away fear.  My daughter’s request is also a metaphor for life in general.  (Wow, that turned out to be WAY deeper than I expected — originally, this was intended to be a post about staying present and enjoying the simple moments.  Who knew I could wax so philosophic?)

Merle