Our center has started a new therapy with an injectable radionuclide that targets GEP-NET tumors in the bowel- often metastatic to liver. Patient have therapy for years that just controls symptoms, but this is the first targeted agent that can reduce tumors. The injection is IV and requires hours of amino acids infused to protect kidneys from the radiation damage as the drug is excreted. Patients come for 4 doses 8 weeks apart. They sit in a chair for about 6 hours. I personally infuse the radiation part of the therapy for 30 minutes. During these sessions we get to know the patient very well. These lengthy episodes lead to all sorts of discussions. There is no pain and little if any side effects so patients are not put to sleep like with benadryl for chemo or hyped up on steroids to avoid issues. What happened this week is worth sharing.
“Doc, I don’t know why I am doing this”. I knew Lou didn’t need more instruction about the treatment so I waited. “I am really here for my wife”. Lou is widowed 4 years- we found that out the last treatment. “It’s crazy but I find myself doing alot of things because of her. I pick up my clothes even though she fussed at me for years. I load the dishwasher her way. I get the dog groomed, I even go to church. There is so much I rebelled against when she was alive. I criticized her cooking or made fun of some things she didn’t understand. Now Doc I am not proud about any of this. Maybe this is just time for confession”. I offered, “Lou, getting cancer treatment can be an emotional time and its not unusual for people to reflect on their lives as they are trying to save them. Its perfectly normal, but I am impressed that your wife lives in your mind. It must have been a great marriage”. Oh, Doc, No. Sometimes it was the worst! I am not easy to live with- just ask the dog, but I realize I did love her and wish I behaved better toward her.”
Not sure how to ease Lou’s mind and heart, I just said, “Lou, you wouldn’t be here now if not for her, so I’d say she would be proud and probably forgive you”. His eyes brightened behind the mask. “You really think so?” I was surprised at this need for validation. “Lou, do you really think you came up with this whole confession thing on your own? I doubt it- she’s here with you for sure. Frankly you are not that self aware”, I teased him. We both chuckled and he settled back with a sigh. I don’t know which therapy was the most effective for Lou today.
PS: Very often our actions, as with Lou, are for others. Surprised there is still a need, I want to plead with you on behalf of so many doctor, nurse and hospital colleagues who battle everyday, for the patients, our loved ones and friends who have passed, for other cancer patients who now are restricted from getting biopsies and surgeries due to overwhelmed hospitals (yes all non-emergent procedures that require an overnight stay are on hold.) Please be sure that you and your family are vaccinated. That is a small but incredibly critical part for you to play in our world of wellness. Thank you.