Surviving the Perfect Storm: A Journey of Cancer Diagnosis and Treatment
Louis Schwarz refers to his experience with cancer as a “perfect storm.” That compelling image – of a series of unlikely events coming together to produce a very powerful outcome – perfectly describes what led to his diagnosis and successful treatment for throat cancer.
Flash back to December, 2005. While showering one morning, Schwarz noticed a swelling in one of the glands in his neck. He had a doctor’s appointment scheduled for the following week, so he made a mental note to have it checked. His doctor thought it might be an infection, but suggested he see an ear, nose and throat doctor, so Schwarz went to an ENT specialist who performed a needle biopsy of the node.
Some suspicious cells were identified, so he had the lymph node removed. The diagnosis of cancer was a shock.
“At 66, I’m a relatively healthy non-smoker with no family history of cancer. Your first thought is: ‘what the heck do I do now?’ I was told I had cancer in a lymph node in my neck, but not where the cancer was coming from. That would come later,” he says.
Enter Schwarz’s brother, Bob, a financial advisor with Merrill Lynch who happened to be familiar with a company that had recently developed a new technology for radiation therapy. They immediately put in a call to Varian Medical Systems and the two brothers had a 20-minute telephone conference call with a company representative. “She told us that the University of Maryland Medical Center (UMMC) was one of only two hospitals on the East Coast that had the very latest technology called Trilogy, capable of delivering very powerful doses of radiation to treat cancer in sensitive areas of the body.” Schwarz knew right then that he wanted to be treated at the University of Maryland.
Still reeling from the news of his cancer diagnosis, he continued to reach out to family and friends for advice. “When something like this happens to you, you start talking to everyone you know,” he recalls. Through his wife’s relatives in Virginia came another piece of information that would prove vital. A family member’s colleague passed on the request for a recommendation to a local cancer doctor, who highly recommended Scott Strome, M.D.
So it was that Schwarz came under the care of Dr. Scott Strome, chair of the Department of Otorhinolaryngology and a nationally recognized head and neck surgeon at the University of Maryland Marlene and Stewart Greenebaum Cancer Center (UMGCC). He had an appointment to see Dr. Strome within the week.
Dr. Strome found a primary tumor located at the base of Schwarz’s throat and diagnosed it as a Stage IV cancer, meaning it had spread beyond the primary site. He explained to Schwarz the various options available to treat his cancer, which included surgery or a combination of chemotherapy and radiation to shrink the tumor and kill any stray cancer cells elsewhere in his body. Since cancers of the head and neck often involve critical structures such as the tongue and voice box, planning a treatment approach that would preserve his speech and swallowing was a primary consideration.
Dr. Strome called his colleague, Dr. Mohan Suntha, an expert in radiation therapy and a member of the multidisciplinary Head and Neck Cancer program at Maryland, and arranged for Schwarz to see him immediately.
Dr. Suntha explained the strategy that he would use to attack the tumor with radiation. Says Schwarz: “I’m thankful that I was able to be treated with the latest technology available. The collateral damage of treating a cancer of the throat like mine can be terrible; the radiation can destroy healthy parts of your body along with the cancer. The Trilogy machine can do what they call image-guided radiation therapy (IGRT); it takes images of the affected area of your body at each treatment session, so the collateral damage is reduced. In my case, my taste buds, saliva glands and all my teeth are still in tact following my treatment, and I am able to eat and drink normally. That’s a huge positive lifestyle outcome for me.”
A third specialist would also be instrumental in Schwarz’s care. He was introduced to Dr. Kevin Cullen, director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center (UMGCC) and a medical oncologist who specializes in head and neck cancer. As part of the multidisciplinary head and neck cancer treatment team, it was Dr. Cullen who would plan and oversee the chemotherapy part of Schwarz’s treatment.
The team of specialists met to review all of the scans and carefully plan a comprehensive approach to the treatment. Once again, Schwarz would benefit from yet another fortunate circumstance. After thoroughly evaluating him, Drs. Cullen and Suntha explained that Schwarz was a candidate to take part in a clinical trial using an experimental drug along with chemotherapy and radiation.
The new drug, called cetuximab (erbitux), had been used successfully in combination with radiation in patients with colon and esophageal cancer, and showed great promise in stopping the spread of cancer. Dr. Suntha was now leading an investigational study to see if it worked as well for head and neck cancer.
“Not only did I have access to the best technology and the top doctors in the field, but now I found out that I might be able to benefit from a brand new drug as well,” says Schwarz.
The treatment process was challenging: eight weeks of radiation, along with a combination of three different chemotherapy agents. “It was a long, hard journey,” he recalls. “Your body gets worn down by the treatments. But I had a tremendous medical team supporting me, as well as a wonderful caregiver, my wife, Vicki. In addition to my excellent doctors, the nurse practitioners and nurses were amazing. No matter when we had a question, they were there for us, offering suggestions and remedies to soothe the side effects of treatment, whether it was trouble swallowing and eating, running a high fever or the temporary acne caused by the drugs I was taking.”
Once the radiation and chemotherapy regimen was complete, Dr. Strome performed a neck dissection, a surgery to examine Schwarz’s throat, tonsils, and lymph nodes to be sure there was no more cancer. A PET scan was also done to check for any remaining malignancy. The results of both were good news: no cancer found anywhere.
“I feel as if the gathering of the “perfect storm” was overcome thanks to my having found a team of world-class experts to handle my care, all located under one roof here at the University of Maryland Medical Center,” says Schwarz. “My medical team was the best there is. You don’t run into folks like them every day.”
When asked how the experience affected him, Schwarz is thoughtful: “I’m physically recovered now, and extremely thankful for the love and support of my family, especially my wife, and my friends. It changes you, though. Once you’ve had cancer, you’re always looking over your shoulder. So, you work to cut the odds as much as you can, and you keep asking questions of the doctors.”
Today, Schwarz keeps a positive attitude and savors each day with this wife, four grown children and four grandchildren. He feels healthy, has his strength back and is looking forward to springtime, when he’ll be able to get back outside and do the things he loves, like working on his house and lawn and playing a little golf.
“I know that I had the best that medical science can provide and the best doctors taking care of me. What more can you ask for?”