The C Letter Word

The “C” letter word—a 6-letter word that has the ability to render one terrified, uncertain, and seeking assurance of cure. Cancer is something I never feared. In fact, when I initially accepted the position as Education Program Coordinator for the Hematology-Oncology Fellowship Program at Beaumont Health System, I felt like I was finally doing something to fight the very disease that took 2 of my grandmothers, as well as other relatives, from me way too early. I enjoyed being a part of a team that would educate future physicians who sought to cure others’ grandmothers as well as conduct research in the hopes that one day a cure could be found. This position was a “big picture” calling for me, and one that I embraced wholeheartedly. Little did I know that soon I would be hearing that 6-letter word as a patient, not just as a program coordinator.

For 13 years, I have seen fellows come and go through our program. I enjoy seeing them learn the essentials of what it takes to become a compassionate and successful hematologist-oncologist. Even though most days I feel like a paper pusher or the annoying coordinator whom fellows love to avoid because I am always after them for paperwork, I never forget my small role in the big picture. However, that perspective changed abruptly the day I woke up from a procedure and a doctor looked at me and said, “We found a tumor and we think it is cancer. You need to have a scan right away to see if it has spread anywhere else, and you need to see a surgeon as soon as possible!” My first thought as I struggled to come out of the anesthesia and make sense of what I was hearing was, “Put me back out. Give me more anesthetic because this must be a nightmare!” I had no idea, then, what the coming months wo uld bring.

Besides the personal fears and struggles I faced due to being diagnosed at age 36 with colon cancer, I wondered how I was going to relay this news to my program director. We have worked very closely together for 13 years, and we make a great team. I knew he would be just as devastated as I was when he heard the news. Despite this internal struggle, my ultimate desire was to run to him as fast as I could for help. After all, we are in the cancer business. He and all the faculty members, fellows, and staff are the best at what they do. Our team is involved in cutting-edge research and treatment; for example, team members discuss recent publications at journal club and present on the latest research at our conferences. I could not think of going anywhere else.

The faculty that I respect so dearly conferred and decided who would be in charge of my care. To this day I tell my wonderful oncologist that I feel bad that she drew the short end of the straw in being chosen to follow my case. Fortunately for me, she sees it differently, and treats me like family. With my permission, the program director and I immediately met with the fellows to share the news with them. This is a journey that I did not want to keep private. I wanted the very best people on my team. The 6 fellows in my program rose to the challenge and began to offer words of support and encouragement. They also shared research knowledge, connections they had to data and other physicians around the country, and biblical scriptures. Additionally, they were there to answer any questions I had about my cancer, treatment, and side effects.

After surgery to remove the cancer, I was treated for 6 months with chemotherapy. All the fellows would periodically check on me to make sure I had not passed out at my desk from fatigue. They also took up a collection and gave my family a gift card to assist with meals. Our fellowship clinical navigator with whom I work so closely offered me rides to and from home for times I did not feel up to driving and would come and sit with me during my chemotherapy treatments. She and the chief fellow really stepped up and assisted with several of my job duties while I was incapacitated or not at work due to surgery and treatment. Even though it was stressful for them to do extra work, they never spoke a word of complaint to me.

One day, during the course of my treatment, my program director sat down on the floor in my exam room, as there were no chairs left. He looked up at my husband and told him not to worry. He gave my husband his personal cell phone number and encouraged him to call anytime with questions or concerns. He told us not to listen to advice or any of the “cancer gone bad” stories that survivors or their families love to relate. He reminded us that the team I had in place was composed of experts in the field. Traveling this cancer treatment path is something they do every day, and they have the knowledge to answer any and all questions. My dear faculty member, who became my oncologist, sat with my parents and spent a lot of time answering their questions and calming their fears.

I remember the fellow who came to my office and comforted me by saying that no matter what the cancer type or stage, we can always try something, and advised me not to become disheartened or give up. Then, there was the rest of the faculty, fellows, and our Graduate Medical Education director and staff who were so busy, but still took the time to swing by during my chemotherapy treatments to share a story, a joke, or a word of encouragement. When my final treatment was finished, like me, they all rejoiced. I remember walking into our June fellowship graduation dinner, which was shortly after my last chemotherapy treatment, and the entire room of fellows, faculty, and staff stopped to clap and cheer for me because it was a victory we all shared together. The future was suddenly looking a lot brighter.

A month later, I had a follow-up scan to make sure the chemotherapy had done its job. To my dismay, the cancer had recurred in the same location where it was initially discovered! This was devastating because it meant yet another cancer surgery. Another surgery was not on my personal radar!

I wanted to get back to my full-time job assisting faculty and fellows by fighting cancer as a coordinator, not return to being a cancer patient. Unfortunately, I became the rare statistic. I was the 36-year-old cancer coordinator who got a cancer diagnosis and a recurrence less than a year from my initial diagnosis. Now, I found myself in patient mode again and an interesting case study to boot!

I volunteered to have my case presented at the tumor boards. There was a big debate on whether to administer more chemotherapy or just monitor me closely. Naturally, I was thankful to hear that after many scans, exams, and tumor board discussions, my team decided that close monitoring was the winner.

Now, almost a year later, I am happy to report that I am cancer-free. I believe it is because of the ongoing relentless support from my medical team, as well as that of my family, my church, my friends, and my co-workers. The only way I felt I could ever repay each of them was to get back to work and do a great job as program coordinator for a group of individuals I admire and have grown to love. I will never forget all of the amazing things they did to help me on my cancer journey. I now serve in my role as a coordinator with a greater passion, seeing that these oncologists and fellows do not just “talk the talk” but that they also “walk the walk.” They are compassionate and knowledgeable, and they proved it through the care I received when I needed it most. They walked with me through the gloomiest season of my life, and they renewed my passion for the big picture of why we do what we do every day in the Hematology-Oncology Fellowship Program. In this program, we are changing lives—we are holding the hands of those traveling through the darkest valleys they have ever known, and no matter how big or small our role may be along the journey, we are giving hope to those who have recently heard that 6-letter word themselves.

Theresa Marcus is the hematology/oncology fellowship coordinator at Beaumont Health System in Royal Oak, MI. During the development of this article, she received editorial support from Judy Whitfield, a medical services manager at Cancer Care Associates, PC, in Royal Oak, MI.