News today that Presidential candidate and former United States Senator has been treated for indolent lymphoma adds to the visibility and impact of cancer diagnoses and treatment in the current Presidential campaign.
First, we wish Senator Thompson well in his journey with his illness. He is another example of how people with cancer continue to live their lives with vigor and expectations.
As with the recent announcements from Elizabeth Edwards and Tony Snow, we once again see someone who is determined to move forward with life despite their illness, just as millions of people surviving cancer do every day in this country.
The American Cancer Society estimates there will be 63,190 cases of non-Hodgkin lymphoma diagnosed in the United States in 2007. An estimated 18,660 people will die from this disease. The International Lymphoma Classification Project estimates that about 22 percent of lymphomas are of the follicular variety, the one most likely associated with Senator Thompson’s illness.
Not all non-Hodgkin lymphomas are the same. Some are more aggressive, some less so. Some can be treated for cure; others are less responsive. In one particular paradox, treatments for the less aggressive lymphomas are less likely to result in cures. That said, these lymphomas are usually associated with long survivals.
Many patients who are diagnosed with this lymphoma have no symptoms and are otherwise healthy. This is one of the situations where doctors frequently advise no treatment for the disease.
Some patients, such as the Senator, opt for treatment for various reasons, including personal choice, or perhaps because they have decided to participate in a clinical trial.
No matter the choice of no treatment or treatment, it is clear that initial treatments in this disease should be the least compromising and toxic as possible, in order to preserve the most serious treatments for possible use in the future when they may be most needed.
This type of approach is indeed consistent with the usual natural course of the disease and accounts for the use of the term “indolent” in describing the Senator’s current situation.
Our thoughts and prayers go out to the Senator, and we applaud him for making his situation known to the public.
By doing that, we once again are reminded of the ubiquity of cancer in our lives.
Because of our investments in research and better understanding of how to treat cancer, we know that cancer patients now have the opportunities to look forward to vigorous, involved, and committed lives.
I want to add an additional comment about survival statistics in this disease, since it will inevitably come up in many of the news reports regarding the Senator's illness.
If you go to the American Cancer Society Cancer Facts and Figures 2007, you will see a statistic that the five year survival for non-Hodgkin lymphoma is about 63%.
As was the case with Elizabeth Edwards, this number has no meaning in Senator Thompson's situation.
The published five year survival number is a compilation of data of all types of lymphomas, from the most indolent to the most aggressive. As noted above, follicular lymphomas comprise about 22% of that number, so their impact on survival statistics is modest.
Senator Thompson, based on the information released today, has an excellent outlook given the type of lymphoma he has and the apparent characteristics of that lymphoma at the time of his diagnosis.
I am reminded of a young lady I treated when I first started my practice in Baltimore. She was a hospital employee and one of my first patients. She was very special to those who worked with me in my practice (as were many of our patients), and was always grateful for the life she was granted.
This young lady had a follicular lymphoma. We treated it occasionally with mild chemotherapy and she did well. When I left my oncology practice about 12 years after I first saw her, she was still doing well, working everyday, enjoying her life, and committed in her faith.
A small piece of paper she handed me on day remains on my desk blotter to this very day. When I become frustrated or distraught, I still look at that note she gave me many years ago. It says, "Thanks to you I am doing fine."
I must admit that I cannot take the credit for her success. I was able to make cautious treatment decisions because that is what her illness warranted.
My hope and that of many others is that Senator Thompson will also do fine, just like my patient in Baltimore (who, by the way, was the rule and not the exception).
No matter where we stand in the political spectrum, we are all enriched by our diversity whether it be our cultural differences or our political opinions.
These fine people who are in the policitical limelight share a common illness but do not share political viewpoints.
Together they represent the spectrum of our politics, our culture, and now the commonality of our lives.
We wish them--and all of the cancer survivors who share the same experience of their illnesses--the very best that life can offer.
