GLIOBLASTOMA is brain cancer. Radiation and chemotherapy fight it. Darren Daulton beat it! Blah, blah, blah.
The doctors at Jefferson - oncologists, glioblastomists, radiation shooters - are nothing but sunshine.
I am a journalist. Sunshine is boring.
"I understand how most patients view a fatal illness," I told my medical group. "But bad news doesn't bother me. In fact, the more detail you give me - bad and worse - the happier I will be."
Happier on the story. Not on my mortality.
Hospitals and doctors get shouted at and sued too much. If they gave the average patient what I wanted, the lawsuits would double.
"I'll sign a paper that says you can tell me the scariest, most hopeless, stuff and I will neither sue nor complain. In fact, I'll praise you!"
They looked at each other. A couple of them smiled.
"I'm at the Daily News," I said. "Tabloid stuff."
The meeting broke up. A couple weeks later, I saw a doc again. It was Dr. Lyndon Kim.
"I love the racetrack," I told Kim, an oncological expert. "Do you enjoy odds? Can we handicap my glioblastoma?"
Kim smiled. He didn't speak.
"OK, the morning line says the average glioblastoma patient age 60 and older [I'm 68] averages 18 to 24 months of life. So 18 to 24 is even odds. But I love long shots. How many live three to five years?"
Kim smiled again. "Ten percent, maybe."
"Ha! Now we're talking," I said. "I'm 10-1 if I win. That is a big-time payoff, but not a super longshot. A longshot that's long, but reasonable."
Kim smiled. He lets me say anything.
Health-care provider-patient talks are important and sensitive matters. One size doesn't fit all circumstances, particularly when the information could be devastating, says David E. Loder, a lawyer at Duane Morris who represents doctors and hospitals.
"While it is critical that the health-care provider convey necessary and accurate information to patients concerning their health condition, it is also important to remain sensitive to the patient's interest and willingness to hear such information," Loder said. "Thus, there are occasions where less is more, or, in the case of the author [of this column], more is more. . . ."
Good point. Doctors - and patients, of course - don't much like to talk about Mr. Death, despite his significance. I first saw him in an Ingmar Bergman movie decades ago. Max von Sydow was a knight playing chess on the beach with Mr. Death.
A few years later, Mr. Death on The Twilight Zone was much better. Robert Redford played him. He pretended to be a wounded cop trying to woo the careful elderly lady into rescuing him. She finally opened her apartment door. Redford then took her on the post-life journey. Could be worse, right?
Understandably, most folks think immortality. So the docs lean that way, even though they are experts on mortality.
Dr. Maria Werner-Wasik is running Jefferson's part of a national study that hammers volunteer GBM patients [including me] with extra radiation, taken with chemo. Can it add time to one's life?
"Most patients are sad and tearful at the beginning," Werner-Wasik said. But my "accepting and cheerful attitude did surprise" her.
Werner-Wasik is a doctor and an excellent professor. She didn't miss an edge that sneakily supplied optimism in me. I didn't have "severe debilitating symptoms" from my tumor, such as inability to speak, walk or write, she observed.
Plus, I have to admit, the war on cancer is gaining strength. A few things:
* Vice President Biden's "National Cancer Moonshot Summit" is being held this month. It's aimed at Biden's final-year push to double the pace of research toward curing cancer. His son Beau died of brain cancer last year.
* A poliovirus treatment of brain cancer designed by Duke University was last month awarded a rare "breakthrough therapy" status by the Food and Drug Administration. The clinical therapy showed a 20 percent three-year survival rate in patients with GBM - double the current amount.
* The world's largest cancer conference began June 3 in Chicago. A Canadian study discussed there found that older people with GBM (like me!) lived about 50 percent longer if they took chemo and radiation together from the start. That's just like the national study Jefferson has me in.
GBM cases are diagnosed about 12,000 times a year, only 15 percent of brain-tumor cases. GBM survival is 14.6 months. About 10 percent might live five years.
Brain cancer knocked on my door last September. Dr. James Evans cut the tumor 98 percent out, but the cancer interweaves with real brain cells and you can never get 100 percent out. Cancer always grows. That's why everyone is a longshot. No favorites in this race.
Tony Roberts, a clinical research coordinator who is my messenger to the doctors, finds it amusing when I mention marijuana's role. He calls me a "refreshingly quirky man."
I hope the Belmont on Saturday is just as quirky as I am. That could get us a 10-1 winner.
I'm on the backstretch now, and the docs are looking at me through binoculars (magnetic resonance imaging). Everything looks good.
It's early. The far turn will show more. The near turn, even more important. Then, down the stretch usually gives the answer.
Impossible to predict, of course. Think of Barbaro. Won the Kentucky Derby. Died soon after.
If you want answers, you can get them, but they're opinions. Odds, not facts. If you want reality, you move forward and pay attention to details.
That gives you a sharper idea of when you'll meet Mr. Death. But don't feel bummed out. Everyone will meet him. Think Redford.