How Cancer Saved My Life

How Cancer Saved My Life

 

Dr. Michael Garko, Ph.D.

Nationally Syndicated Host-Producer of Let’s Talk Nutrition  

 

Suggested Citation: Garko, M. G. (2017, January).  How cancer saved my life. Health and Wellness Monthly. Retrieved (insert month, day, year), from www.letstalknutrition.com.

 

On October 5, 2016, at approximately 5:00 p.m. my life changed dramatically. That was the moment when I was diagnosed with cancer.

Although it is a bit extended, I encourage you to read the narrative below in full because each and every person in the general population, including you, is a potential candidate to become infected with HPV (human papillomavirus).

Becoming informed is a first and important step in preventing disease. Within the context of my challenge with cancer, the narrative is intended to educate from a medical perspective what HPV is, the risk factors associated with it, its means of transmission, treatment options, among other important information about the virus. Again, please take a moment to read the entire narrative in that it could help you prevent from becoming infected with HPV.

 

Diagnosis – A Twist of Fate

I have been diagnosed with metastatic, moderately differentiated squamous cell carcinoma or put another way squamous cell carcinoma of the cervical lymph nodes. Human papilloma virus 16 (HPV16) is the cause of the cancer. Dr. Matthew Fink, my oncologist, wanted to move carefully but swiftly in making his diagnosis. Hence, the diagnosis and cause of the cancer was determined within 30 days using blood tests, a PET scan and three episodes of being under general anesthesia for biopsies. All the while, I continued to do produce and host Let’s Talk Nutrition five days a week and kept my cancer diagnosis private until three weeks ago, when I informed several people here at the station and the audience of Let’s Talk Nutrition.

Doctors Matthew Fink, Harvey Greenberg and Jonathan Forman (my team of doctors) are of the medical opinion that I most likely got infected with HPV16 decades ago (maybe even in childhood or high school) and the virus went latent in oropharengyl area of my throat, most likely the tonsil area.

Oropharyngeal cancer is a disease in which malignant cells form in the tissue of oropharynx, which is the middle part of the throat that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx.

In terms of risk factors, it is popular to talk about HPV being the most common sexually transmitted infection (STI). A person can get HPV through vaginal, anal, or oral sex with someone who is infected with the virus. Further, HPV can be transmitted even when an infected person has no signs or symptoms.

The actor, Michael Douglas, brought attention to HPV when he contracted the same cancer I have. Unfortunately, in trying to educate people, he announced on the Guardian website that he became infected with HPV16 by performing cunnilingus on his wife, all of which led to a considerable amount of misunderstanding about the virus. As it turns out, HPV16 can be transmitted from open mouth kissing or exchange of saliva by drinking from an infected person’s glass or simply an infected mother kissing her baby.

Here are some key facts about HPV as reported by World Health Organization

  • Human papillomavirus (HPV) is a group of viruses that are common worldwide.
  • There are more than 100 types of HPV, of which at least 13 are cancer-causing (also known as high risk type).
  • HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity.
  • Cervical cancer is caused by sexually acquired infection with certain types of HPV.
  • Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions.
  • There is also evidence linking HPV with cancers of the anus, vulva, vagina and penis.
  • Cervical cancer is the second most common cancer in women living in less developed regions with an estimated 445 000 new cases in 2012 (84% of the new cases worldwide).
  • In 2012, approximately 270 000 women died from cervical cancer; more than 85% of these deaths occurring in low- and middle-income countries.
  • Vaccines against HPV 16 and 18 have been approved for use in many countries

(see http://www.who.int/mediacentre/factsheets/fs380/en/).

It is important to know that oropharyngeal cancer is uncommon and typically involves patients in the fifth through seventh decades of life, with men being afflicted three to five times more often than women. In terms of oropharyngeal squamous cell carcinoma (SCC) significant risk factors for the development of oropharyngeal cancer include a smoking history of more than 10 pack years, being infected with the human papillomavirus (HPV), especially HPV type16 (also known as HPV-16) and similar to other cancers of the head and neck, using tobacco use and drinking alcohol heavily. Incidentally, I neither smoke nor drink heavily and have not done so throughout my life.

During the process of diagnosis, the PET scan also identified a lesion on my left lung. The concern was that it was a metastasis related to the cancer in my neck. Fortunately, it was diagnosed as an adenocarcinoma (pulmonary adenocarcinoma), a common histological form of lung cancer. It is separate from the squamous cell carcinoma of the cervical lymph nodes on the right side of my neck. Dr. Fink was encouraged that it was not a metastasis derived from the squamous cell carcinoma of the cervical lymph nodes, which translates into a better cure rate. It is Stage 1A.

In an ironic turn of fate, Dr. Fink said that the neck cancer most likely saved my life because the adenocarcinoma of the lung would probably have gone undetected and developed to Stage IV. So, it was paradoxical “bad-good” news in the sense in that I contracted cancer so as to save my life and not die from cancer, as Dr. Fink explained it. You just cannot make it up.

The plan is first to treat the squamous cell carcinoma of the cervical lymph nodes and then have Dr. Summers, a world-class surgeon using robotic surgery to remove the lung lesion, which should be reduced in size with cisplatin used in chemo therapy. Dr. Fink mentioned that people come from all over the world to have Dr. Summers do robotic surgery. Further, the chemo therapy I am receiving now will serve as treatment for or otherwise go after the lung lesion. If necessary, Dr. Summers would go in and clean up the lesion so to speak at the end of chemo therapy. To his wisdom and experience as a physician, Dr. Fink insisted all along that I have a lung biopsy done. He said, “It is a wild card.” At the time, I was unsure what he meant. Now I know. He shared with me that when he was on vacation in Miami he received the biopsy report and said how happy he was to learn that it was not a metastasis from the squamous cell carcinoma of the lymph nodes and was an independent primary lesion caught in the earliest stage and curable.

Treatment

The treatment for the squamous cell carcinoma of the cervical lymph nodes is chemotherapy with cisplatin one day a week for four hours and radiotherapy five days a week. The treatment for the adenocarcinoma of the lung is cisplatin and surgery (if necessary). My treatment includes chemo one day a week for 4 hours and radiation 5 days a week.

I am currently in my fourth week of treatment. Six weeks of chemo and 33 days of radiation is the protocol. I am still on-the air daily producing and hosting Let’s Talk Nutrition. There are a number of treatment-related side-effects, ranging from constipation to cognitive/brain fog. However, chemo mucositis is a side effect that has been the most challenging. It occurs when cancer treatments break down the rapidly dividing epithelial cells lining the gastro-intestinal tract and oral cavity, making the mucosal tissue vulnerable to ulceration and infection.  Oral mucositis is probably the most common, debilitating complication of cancer treatments, particularly chemotherapy and radiation. It can leads to incessant pain to lesions in the mouth and throat, nutritional issues as a result of an inability to eat, increased risk of infection due to open sores in the mucosa and difficulty in talking. My vacation begins December 22nd. If I can make it to then by managing the constellation of side effects of the chemo and radiation, I will be grateful. I love the audience and hosting-producing Let’s Talk Nutrition, all of which provides unending inspiration and purpose, thereby, being therapeutic.

Prognosis

Dr. Fink is treating me with “curative intent” as he puts it. He has conveyed to me that the prognosis is good in terms of achieving the goal of curative intent. My intention is to take things as they come and take it one day at a time, to be grateful for each day and be the best person I can be, while all the while continuing to help others with their health, wellness and wellbeing on Let’s Talk Nutrition or whatever other appropriate means of communication exist.

 

Conclusion

For those of you with whom I have shared my health situation in conversation, you have been wonderful in your caring and support. It has made all the difference in ways that are hard to put into words. I am so fortunate to have friends and colleagues such as you. Taking a cue from Matthew 9:35-38, makers of the film Gladiator, have Maximus Meridius, commander of the Roman armies of the North, General of the Felix Legions and loyal servant to the emperor, Marcus Aurelius, say to his troops before going into battle with the last of Germanic tribes, “What we do in life echoes in eternity.” Fortunately for me, your kind words and support echo in my life each day and will continue to do so through eternity.

 

Suggested Citation: Garko, M. G. (2017, January).  How cancer saved my life. Health and Wellness Monthly. Retrieved (insert month, day, year), from www.letstalknutrition.com.