Cancer: Back from the Dead, Twice

Hope is a word which gives us strength and courage. A word which makes us resolute and prepares us to face any hurdles, which life throws at us. People believe in hope, even if they know they are going to lose the battle, but still they believe. Martin Luther King Jr. phrases it aptly ‘we must accept finite disappointment, but never lose infinite hope’. Hope overcomes everything, Cancer too. Cancer is one such deadly disease, where patients have to fight their own battles. Many cancer surviving patients pray that they defeat cancer and may lead a peaceful and healthy life. Many loose the fight, but many still carry on. Their conflict with cancer evokes a sense of fearlessness among us, doesn’t it? The stories of cancer survivors are nothing less than a miracle. Let’s hear one such story of a hero who fought in many battles, but his war with cancer is the one which made him indestructible.

Tom Jacquot, a US war veteran who faced countless bullets in the jungles of Vietnam, had to survive cancer not once, but twice. Imagine fighting a dreaded disease and that too, not once but twice. The strength and commitment coupled with the love of his family and the care of the doctors saved his life. After leaving the army in the late 1960s, he joined a bowling league and it later became a way for him to bond with his daughter. He would spend every Sunday morning at the bowling alley, after having coached his son’s baseball teams.

One day, Tom developed a purple itchy spot on his back, and after taking into consideration the opinion of his doctor, he was confirmed that what he had was blastic plasmacytoid dendritic cell neoplasm (BPDCN), which is a rare cancer involving the skin, the bone marrow and the lymph nodes. The first case of BPDCN was reported in 1994, and since then only a few hundred cases have been recorded. When he was diagnosed with this rare and extremely aggressive cancer, he knew what he wanted. He knew he wanted to be treated at a world class cancer center and he wanted to be near his family.

He approached the Veterans Affairs (VA) Comprehensive Cancer Centre in West Haven under the direction of Michal G. Rose (MD), and to Smilow Cancer Hospital, under the care of Iris Isufi (MD), Asst Professor of Medicine (Hematology). Not much data was available due to the rarity of the disease, and how to approach it and how to find the best treatment options. It was up to Dr. Isufi and her team to come up with the best care plan for tom. The doctor knew there was a high risk of recurrence with the disease, so it was suggested that he undergo an allogenic stem cell transplant, where cells are transferred from a donor. After arriving at Yale, Tom was treated with an aggressive leukemia chemotherapy regimen shortly. The treatment required several hospitalizations and was challenging, but he responded quite well to chemotherapy.

After following a one-month hospitalization under the care of a specialized stem cell transplant team, Tom’s care continued in the smilow outpatient transplant clinic. After the transplant, he lost the donor stem cells, and further arrangements were made for his donor to give more stem cells, and he underwent additional chemotherapy. This pursuit was successful, and he has had 100% donor blood cells since then. Tom was relieved and satisfied that he had dodged this bullet of cancer too, but fate had some other plans. Five years later, he again encountered another unrelated health issue including a minor stroke and diagnosis of giant cell arteritis (inflammation of the lining of the arteries). Following a scheduled routine for an endoscopy to monitor his esophagus, he was dealt with another blow- a diagnosis of stomach cancer.

After having gone through Tom’s case at their weekly tumor board and taking into account his current health and the fact that he had received a transplant earlier, the team of doctors once again set to work creating a personalized treatment plan. After going through the side effects of chemotherapy which he started with Dr.Rose, the team discussed his case with Dr. Charles Cha, MD, FACS, Associate Professor of Surgery (Oncology and Gastrointestinal) and decided that Tom was a candidate of surgery. It was expected that Tom had to remove 90% of his stomach, by undergoing a laproscopic gastrectomy, but after removing 70% of his stomach and some surrounding lymph nodes, Dr.Cha was confident that he had removed all of the cancer and that Tom won’t have to worry about further treatment.

Dr. Rose often hooks up with Smilow physicians to coordinate care for warhorses. She commented that on average veterans have high burdens of comorbidity and environmental exposure. It can be predicted that during tom’s tour in Vietnam, a chemical named ‘Agent Orange, a powerful herbicide which was used to eliminate forest cover, might have exposed him to such to cancer. That chemical is an established risk factor for many conditions including several cancers such as lymphoma, myeloma, lung and prostate.

For the Duration of his treatment and travel, Tom’s girlfriend margaret remained by his side as she travelled every few weeks to be with him while he received treatment and cared for him at their home in North Carolina. Tom’s Family supported him in each and every moment, at every appointment and when he was in the hospital. His sister Catherine took care of him for two years as he moved in her home. His sister Miriam also helped when she could, and his three children were always checking in.

Tom never gave up; he knew he could defeat cancer and would emerge victorious. The spirit of a soldier still lingers in Tom. Death is overrated. Ask a soldier, what death is, he knows better. The constant thought of death hovering over one’s head, petrifies a person, but not to a soldier. Tom is a living testament of the idea that cancer can be defeated, not once, but twice. His remarkable story has inspired many and will continue to do so. Tom believes in hope and says that hope is the one thing a person should never loose. As is said about hope, ‘keep your eyes on the sun and you will not see shadows.’