Struck by Cancer Three Times . . . and Living to Tell the Tale
This excerpt is reprinted with permission from “No Such Thing as a Bad Day” by Hamilton Jordan, published by Longstreet Press. Jordan, former chief of staff for President Jimmy Carter, is a business executive in Atlanta.
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In the United States and most Western cultures, the word “cancer” is synonymous with death--sometimes harsh and swift, sometimes long and drawn out, but almost always fatal.
Yet 50% of all cancer patients in the United States are cured of their illness. I am a triple winner--I have survived three different cancers.
I have had a lymphoma that led to my taking experimental, industrial-strength chemotherapy; a skin cancer that was dealt with simply and swiftly with a flick of the surgeon’s knife and a couple of stitches; and a bout with prostate cancer, which required major and delicate surgery. All came before I had reached the age of 50.
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I tried to enjoy the view of the ocean, but could not help myself as I paced back and forth on the wooden deck during our beach vacation in 1995, anxiously awaiting a call from my doctor.
It had started earlier that week during my annual physical exam. Among other things, I had a digital rectal exam of my prostate, which was normal, and also had a simple blood test called a PSA (for prostate-specific antigen), useful in detecting prostate cancer.
A day after my exam, the nurse called to give me my report: “Everything looks good.” I asked specifically about the PSA since it had edged up slightly in the past couple of exams. “Your PSA is 3.9--within the normal range.”
While I understood it was technically “normal,” I also knew that it had shot up a full point since my last checkup. I had read a study from the Mayo Clinic in Rochester, Minn., that indicated a rise of more than .75 in a year was considered abnormal. Mayo had also developed an “age-adjusted PSA” that meant this new PSA was actually slightly elevated for a man my age. Acutely aware of my own cancer history, I was not about to sit back and relax.
I had called Paul Hatcher, a urologist I knew when we lived in Knoxville, Tenn. I described my situation and asked him if I should have an ultrasound, which would allow him to “look” at the prostate. He agreed and also suggested a needle biopsy to sample the prostate. “It’s the only way to know for sure if something is going on,” he said.
While I awaited the biopsy results, however, I tried to rationalize my situation--going over and over again the same facts. Hatcher had found no “suspicious areas” with the ultrasound. Only one out of three men with elevated PSAs has prostate cancer. And what are the odds of a person having three different cancers by the age of 50? I calculated it must be one in 100,000.
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But these mental gymnastics provided little comfort. Despite the seemingly favorable odds, I had a strong premonition that I had another battle to fight with cancer.
The phone rang around 10.
“Mr. Jordan, this is Dr. Hatcher. . . . Sorry, but I do not have any good news for you. Your pathology is back, and you do have prostate cancer.”
He told me I needed a CAT scan and a bone scan to see if there was any evidence cancer had spread outside my prostate. My father had died of prostate cancer that had spread, and I remembered his doctor telling us, “The horse is out of the barn.” I made plans to leave the beach that night to return to Knoxville for my tests. During the afternoon with my wife, Dorothy, and my three kids, I found plenty of excuses for extra hugs. As I watched my children, I wondered if they would grow up without a father. How many more beach vacations would we enjoy together?
Waiting for doctors to read your X-rays must be like waiting for the jury foreman in a capital punishment trial to read your verdict. Someone you hardly know is about to tell you whether you are going to live or die.
Hatcher was matter-of-fact as he examined the X-ray films one by one. “There is no evidence on the bone scan or CAT scan that your cancer has escaped the prostate. This means that we have probably, and I stress probably, caught it early.”
I breathed an audible sigh of relief. Calmly, he outlined the best options for cases like mine, in which the cancer appears to have not spread beyond the prostate:
* Irradiating my prostate over a period of time in hopes of killing all of the cancer cells.
* Implanting radioactive pellets in my prostate, which would have the same effect.
* Removing my prostate through surgery.
Hatcher explained that many patients considered the radiation options the “easy” choices, as they avoided the surgery and some of its possible complications. Yet, he pointed out, there was no long-term evidence--over 10 years--that radiation or implants were as effective as surgery.
“Doctor, with three young kids,” I told him, “I need a home run. . . . Tell me more about the surgery.”
“The operation to remove the prostate is major surgery,” he said. “But the good news is that if the cancer is confined to the prostate, once the prostate is removed, you are cured. Short term, you’ll have some incontinence problems as a result of the surgery. . . . Long term, you should have none. There is a significant risk of impotency, which is greatest in older men.”
I had missed my flight back to Atlanta but was anxious to get home, as Dorothy and the kids were driving in from the beach. I was determined to be waiting for them in the driveway to share my good news.
I rented a red convertible with a tape player, bought a handful of “golden oldies,” grabbed a Big Mac and fries, and hit I-75 South. I put the top down, turned up the volume, and sang at the top of my lungs all the way to Atlanta. I woke up that morning thinking that I might die. While there were no guarantees, I knew now that I might live--that was something to celebrate!
Back at home, I began my research to determine if surgery was the best option and, if so, where to have the operation. I called a number of medical institutions, talked with 15 or 20 doctors and researchers, ordered books and tapes, and had printouts of medical studies from online services scattered all over the floor. Dorothy started calling me “Dr. Jordan.” Eventually, I decided that, for me, surgery provided a better prospect for a long-term cure than did radiation, and chose Patrick Walsh, at the Johns Hopkins University Hospital in Baltimore, to perform the operation.
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After immersing myself in the subject, I became convinced that a lot of men who should have prostate surgery avoid it because of a general fear of the operation and the highly publicized risks of impotence and incontinence--which are seldom explained or quantified. When I weighed my enormous obligations to my family against the possibility of physical inconvenience or compromise in my own personal pleasure, there was really no decision to make. It was more important to be alive and to have at least the possibility of a long life with my wife and children.
As I told Dorothy: “I can’t have sex if I am dead!”
For the remainder of the summer, we tried to live a normal life while waiting for my surgery. We didn’t keep my cancer a secret, but neither did we broadcast it or let it dominate our lives. I didn’t want to tell my friends until we had a more definitive, and--we hoped--more optimistic prognosis.
Finally, Dorothy and I traveled to Baltimore for my surgery. The night before my surgery, we tried hard to have a “romantic” evening with a seafood dinner at a cozy restaurant in Baltimore’s Inner Harbor and a boat ride back to our hotel. While unspoken, the next day’s event weighed heavily on us both.
I got up around 4 a.m., gave myself the required enema, and checked into the surgery waiting room at 6:30 a.m. The atmosphere in the small room was strained--some people struggled to make small talk to pass the time while others just sat there alone with their thoughts. It was the longest two hours of my life, and I was relieved when a nurse finally called my name, led me into the “prep” room and handed me the green hospital gown.
While I have the distinct memory of being awake for major parts of the surgery, I remember almost nothing about it. Later, one of the young doctors enjoyed telling me that throughout the surgery I had mumbled statistics on prostate cancer. “About half of them were accurate,” he kidded.
They wheeled me into the recovery room, where I dozed off and on. I was aware for the first time of all the tubes running in and out of my belly. I felt my hand being squeezed and knew instantly that Dorothy was there. I opened my eyes to her smiling face and started firing questions: Had she seen Walsh? Was the cancer confined to my prostate? Were my lymph nodes negative? She told me that everything was “great” and was still trying to calm me down when Walsh appeared in his surgical garb with his mask pulled down, smiling.
He grabbed my hand and told us that my surgery had gone “extremely well”--the lymph nodes were normal and the cancer appeared to be confined to the prostate. He said it would be several days before the final pathology reports were back.
I dozed off and on in my hospital room for the rest of the day. Dorothy said I slept with a smile on my face.
My hospital stay was “textbook,” with no setbacks or complications. I got up and walked the morning after my surgery. Although I was slightly dizzy at first and a bit wobbly, it was a victory for me just to shuffle down the hall.
*
Walsh walked into my room beaming on my third day after surgery and told me, “Clean margins, no lymph node involvement, I was able to save both nerves that control sexual potency and no sign in the pathology of any presence of cancer cells outside of the prostate.”
We checked out of the hospital five days after the surgery. I was eager to get home, but sensitive about how I would appear to my children, hobbling around with the Foley catheter (my constant companion for several weeks), which allowed the urine to flow from my bladder into a plastic bag while my urethra was on the mend. I didn’t quite know how to explain this to my children, but 3-year-old Alexander obviously got it because he told his classmates that “Daddy went on a trip and bought a tee-tee bag.”
Four weeks after surgery, my catheter was removed. Although we had bought a good supply of adult-size diapers, I only needed them for a few days before regaining nearly total control of my bladder.
Ten weeks after my surgery, I had a PSA test. When I got the message from the nurse, I was all smiles.
“Your PSA is 0.00 . . . perfect. You’ll need another one in three months.”
Although I have had three different cancers by age 50, I do not feel cursed or put upon. Instead I believe that I am very blessed and just plain lucky to be alive.
While the memories of my three cancers are still vivid today, sometimes unsettling, and occasionally even frightening, I never want to forget the raw fear of cancer and the prospect of death. If I am ever able to simply block out those memories and set my emotions aside, I will lose the ironic blessing, the sense of purpose and the focus that cancer has given my own life.
