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By Dr. Dave Watson (Published 5/04)
"You want to say hello to him?" she asked me over the phone. My mind told me no, he won't know it's you, but my mother lightly cajoled, saying "Please do, he needs to hear from you." Panic nearly overtook me as I stumbled over what to say to my dad. Until very recently he had been among the sharpest critics, and yet biggest fans, of this column. Lung cancer has stolen him away with a speed no one, not even his doctors, could have foreseen. "Sure, put him on, Mom" I intoned, with far greater ease than I really felt.
It started innocently enough, little more than a year ago, with an early morning phone call more angry than scared. "Dave, this crazy doctor just called, and she says I've got lung cancer," Dad complained. "They can't look at a simple chest x-ray and diagnose something like that, can they?" he asked, rather more pleadingly than I thought necessary. "I don't think so Dad, it's just a shadow or something." He had been feeling great, he told me, following bypass surgery and a pacemaker installation; ready for another 100,000 miles he reckoned. "She says I should have a biopsy done; that's not really necessary, is it?" I told him that, yes, for simple peace of mind he ought to do the additional testing his doctor was recommending, even though he hated the thought of more needles. More test results came back, and each time the news was the same; lung cancer, sure enough. "I guess I've got the big C," he told me without rancor, "but I'm gonna fight this thing, and I won't give up." So the battle was joined.
As I often do for this column, I went searching for information on a dreaded and deadly opponent. What I've learned I'd like to share with you, because if even one person benefits from it, I will gain some comfort in an otherwise disconsolate time. Lung cancer is simply the uncontrolled growth of abnormal cells in the lung. It is the most common type of what is a highly diverse group of diseases. In fact, nearly 175,000 new cases of lung cancer will be diagnosed this year, or about 13 % of all cancers. 160,000 people will die from it in 2004, or some 28 % of cancer deaths. It is the number one cancer afflicting both men and women; it kills more men than prostate cancer, and more women than breast cancer (in fact, a brand new study in the Journal of the American Medical Association shows that the rate of lung cancer in women has surged fully 60 % since 1990). 85 to 90 % of lung cancer is directly attributable to cigarettes, and nearly 30 % of all cancer deaths nationwide can be connected to smoking (because there are links between this habit and other cancers as well). The National Cancer Institute (and therefore the government itself) is unambiguous in its condemnation, stating that "...tobacco use, particularly cigarette smoking, is the single most preventable cause of death in the United States."
Is there any good news in all this? Because the risks (not just of cancer, but also of cardiovascular problems) associated with smoking are cumulative (as with e.g. radiation exposure), quitting is always a positive step. Smokers who stop before age 35 can reduce their risk for tobacco-related diseases by 90 %, and even those who give up cigarettes before age 50 decrease their likelihood of problems. Quitting is hard, though, really hard. Ask any smoker. Dad did try, many times, but a habit he solidified while serving his country in Korea eventually took twenty years or more away from him.
"Who's this?," he babbled into the phone, giddy from the medicine that stands between him and the pain caused by metastatic liver and brain tumors. "Dave," I said. "Oh I know, the doctor," he gurgled. In the background I could hear my mother say "he thinks you're his doctor" (which is Dad's physician's name, yes, but also his nickname for me ever since I finished graduate school several years ago). Maybe, I thought hopefully, he does know it's me. I asked, and he reassured me, that my mom was holding up okay (but how could he really tell, I wondered, in his condition). Not knowing what else to say, and fearing he might be drifting off, I summoned up my remaining courage and blurted out (for possibly the first, last and only time in my life) "I love you, Dad." Using up what might have been one of his last fragments of lucidity he quickly replied "I love you too, son." So he knew.
Goodnight Dad.
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Dr. Dave Watson is InDyne, Inc.'s Program Manager for Peer Review for the National Space Biomedical Research Institute, as well as Adjunct Associate Professor in the Department of Microbiology & Immunology at the University of Texas Medical Branch in Galveston. In his free time, Dr. Dave serves as a member of the Board of Trustees of the Pearland Independent School District, where all four of he and his wife Fay's children are currently students.
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