THE call came Monday, report to chemo first thing Wednesday. I’ll be out the door at the crack of dawn.
This is going to sideline me for a while, but I’ll be back to scribble not much ado of any consequence: motorcycles, Vermont, the woods, the Phantom, and, now and again, things that seriously matter, like the un-American depredations of Mr. Needy, the geriatric enfant terrible.
My oncologist outlined three options: one he liked, one he was okay with, and one he wouldn’t recommend but I could have it, an all-out fight with the most punishing meds available. Somehow that sounded like a terrible idea. I’m chronically rather than desperately unwell, no point falling back to the Alamo. Save that for the day when there are no two ways about it.
He suggested that I trade toxicity for time, go for least toxic, longest duration. I said, Doc, that’s what we’ll do, seeing as how you went to medical school while I was goofing around the country on a motorcycle.
Under the never-say-never rule, I reserve the right, in some entirely different scenario, to feel as if I know more than a doctor.
Among the 80-or-so NHL’s out there, I drew the one they award to lottery winners. You typically die with it, not of it.
You remember the late Johnny Danger. In the last five years, I haven’t faced 0.05 percent of what he stood up to for 17 years, with unfailingly good cheer.
Reared by a fighter pilot and a Rosie the Riveter, my old pal Danger was the real stuff.
I’ll be in the chair once a week for the first month, then once every four-to-eight weeks for up to a year. I’ll be on oral doses of Lenalidomide for a year, in cycles of three weeks on, one off.
No Bendamustine (nitrogen mustard) going in my arm this time, and none of the hard-core options 2 and 3 drugs: Cyclophosphamide, Vincristine, Doxorubicin.
I probably should have gone back into treatment long before this. Since 2023, my scans have shown cancer lighting up everywhere again. Nodes normally as big as raisins are as plump as stuffed olives. The most diseased nodes are pretty deep, hard to biopsy. In October 2023, they tried to get a tissue sample off a node on my aorta with an X-ray guided needle. Missed. (Hit the node but not a part with useful information to yield. The tissue was mostly fat.)
Lately, inflamed nodes have been popping up on the surface. The occipital nodes at the base of my skull are pretty blown up. Time to get this thing under control before I start looking like a Pachycephalosaurus.
I feel the cancer most acutely on my right side, as I did in 2019. When I was on my way home from the Arctic, I stopped and stayed for a while with friends in British Columbia. Knew I really ought to just keep riding, get home and be evaluated. On the day I finally left BC, I had a lot of inflammation going on in the right side of my neck, behind my right collarbone (thought for sure I must have fractured it), right shoulder, weakness in my right arm. When you’re not fit, BC to RI starts to look like a long ride. On a couple of those eastbound mornings I wasn’t sure I wanted to get up off the ground.
Chemo relieved the inflammation almost immediately. I was pretty miserable with side effects but it was nice to see the pain go.
This new treatment looks like chemo, the hospital calls it chemo, but the meds I’ll be getting attack cancer in a way that technically classes them as something else, something not chemo. Whatever they want to call it, the common side effects are the same: headache, body aches, fatigue, cough, nausea, a flu that doesn’t go away, basically. You sleep a lot. Now and again, you’re on your knees trying to raise Raaaaalph on the big white phone. Ralph who never picks up, by the way. Lazy bastard.
At the unlikely end of the list, some potential side effects are as consequential as it gets. I suppose Pharma has to disclose every dire possibility no matter how remote, given that somewhere, just by the nature of things, a baby grand is trailing a parted rope on a fast descent from the 18th floor. By experience, I know that some other slob will be walking down the street when the piano with my name on it slips the hoist.
Since the third quarter of 1969 I’ve been humbled by good fortune on a scale so inexplicable it would embarrass me to give you the details. Even all my adversities—stupid teen folly, dumb career moves, motorcycle bash-ups, cancer—it all happens in the best possible way. I keep landing sunny-side up.
This can’t be an uncommon experience. Whether they know it or not, I have to think most people are better off for having gone through things.
So that’s what I know about what there is to know. The Nickels will likely go dark for a while. Don’t worry about it.
I’m turning off the comments feature because I won’t be here.
Let me try that again: I expect to be “here,” I just won’t be here.
Tony DePaul, February 4, 2025, Cranston, Rhode Island, USA
