THE LAST WORD

Remission! What Surviving Cancer Has Taught Me

 

Months of brutal chemotherapy will teach you a few things about yourself, your calling, and your community.

Fam Pract Manag. 2017 Sep-Oct;24(5):oa1-oa2.

Author disclosure: no relevant financial affiliations disclosed.

I have felt true jubilation a handful of times in my life. The first was when I received my admission letter to medical school, even though I was an atypical applicant. (It was the day Neil Armstrong walked on the moon, July 20, 1969.) The next was when I met my wife-to-be at music night at the Caspar Inn, and later when my two children were born. Most recently was when I found out that my positron emission tomography (PET)/computed tomography (CT) scan from thighs to eyes showed “complete resolution of abnormal metabolic activity previously noted to be above and below the diaphragm with no metabolic evidence of recurrent or residual malignancy.” My cancer was in remission.

Surviving cancer has taught me several things.

1. It’s really expensive to get sick. My original PET/CT scan, when I was first diagnosed with lymphoma, showed “Metabolic lymphadenopathy seen above and below the diaphragm including involvement of the mediastinum, bilateral axilla, chest wall and pleura, retroperitoneum, peripancreatic lymph nodes, mesenteric lymph nodes, inguinal lymph nodes, and iliac chain lymph nodes,” in addition to “bilateral hydronephrosis due to bulky retroperitoneal lymphadenopathy and likely partial bladder outlet obstruction.” That’s a lot of tumor, but it’s amazing what today’s drugs can do. It’s also amazing what they cost. One of the meds that boosted my white blood cell count to normal in three to four days after chemotherapy, instead of waiting for my marrow to do it in seven to eight days, was billed at $17,000. Medicare allowed $5,000 and paid it. When I asked my oncologist why, he said that if I was admitted to the hospital with a life-threatening infection between days four to eight, it would cost them a lot more. That made sense and made me glad I was over 65 when I got cancer and had insurance that paid everything. I almost never saw a bill, and when I did it was in error because the provider hadn’t billed my secondary or my secondary

About the Author

Dr. Brown is a solo family physician living in Mendocino, Calif., and a long-time contributor to Family Practice Management. His “Practice Diary” ran in FPM from 1999 to 2005.

Author disclosure: no relevant financial affiliations disclosed.

Editor's note: Read more of Dr. Brown's story in “Keeping Your Practice Going When You Can't,” FPM, May/June 2017; “How a Doctor Acting as His Primary Care Physician, With a Little Luck, Tracked Down His Own Cancer,” FPM, May/June 2017; and “The Key to Getting Through Chemo,” FPM, July/August 2017.

 

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