From Miracle to MOPP

Hodgkin’s lymphoma spared my grandfather in 1959. Today, it’s cured in 80% 0f cases.

 

By Brooks Eisenbise

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October 1, 2018

 

“…at that time, that was a death sentence. I mean, they didn’t do anything. If they found you had Hodgkin’s, you just died.”

 

She sat across from me in a well-worn easy chair, back a little hunched, hands a little folded, eyes a little distant. The words rang off her tongue and hung in the air like bits of dust in sunlight. She said them again, quieter this time, like an echo:

 

“You just died.”

 

It was the first time my grandmother, Nancy, had spoken to me about the disease, or what it was like to share a home with it, what it was like to share a husband with it. Growing up, I had heard an abridged story from my mother, a quick snippet about how Pop-pop had gotten sick before she was born, how he’d been thought a dead man walking and how he’d recovered. How his life—and, by extension, hers—was a modern-day miracle.

 

My grandfather was diagnosed with Hodgkin’s lymphoma in the summer of 1959, three years after he and Nancy were married. They had nothing to worry about but kids and mortgages and where they were going to display their wedding china.

 

That is, until Charles went away to the University of Maryland and discovered a lump under his right arm.

 

“He called me one day on the phone and he said, ‘You’re gonna have to come get me,” Nancy recalled, describing the university doctor’s reaction: “‘You’ve got to go home right away, and you’ve got to see a surgeon right away,’” Charles was told.

 

The biopsy came back with horrific news: my grandfather had Hodgkin’s disease, a cancer of the lymphatic system that had rarely been treated and had never been cured. But instead of patting Charles on the back and saying, “Better luck in your next life, champ,” Dr. Tyson, the surgeon in question, had an earthshattering idea. “[He] believed that, to treat Hodgkin’s, you should remove the tumor.”

 

My grandfather was on the operating table for eleven hours. The disease had spread from the lymph nodes under his right arm up his auxiliary muscle and to his trachea, where they could no longer operate. By the time Dr. Tyson broke scrub, Charles was left without a right pectoral and Nancy was left without much hope the cancer would ever subside. In what seemed like a last-ditch effort, an alternative was proposed, what my grandmother referred to as “massive x-ray treatment.”

 

“…they gave him massive radiation, just zapped him, because they didn’t know how to give it, and Dr. Tyson felt, He doesn’t have a fighting chance.” Her eyes grew wide and her weathered handles balled into fists that exploded open with each zap! I had to stop myself from wincing, keep myself from imagining how painful and haphazard the radiation therapy would have been.

 

My grandmother was right, of course: in 1959, no one really knew how to administer radiation therapy as safely or effectively as it is practiced now. While historical records of Hodgkin’s disease treatment acknowledge that radiotherapy was first utilized in this context in 1902, its use was not well known or documented until the mid-1960s. This suggests that radiation therapy was a rare and highly experimental method of treatment, making it unregulated and risky to perform and undergo.

 

Still, it proved effective: Charles’ outlived his “six weeks to eighteen months” prognosis by weeks, then months, then years. Even the doctors were flabbergasted, according to Nancy. “Dr. Tyson said, ‘I can’t believe it!’ You know, this was a miracle.”

 

Luckily, with the strides cancer research has made in the last half-century, we don’t have to depend on miracles anymore. The American Society of Hematology cites the cure of Hodgkin’s lymphoma as “one of cancer’s big success stories.” As chemotherapy made its way onto the oncological scene in the 1960s and 1970s, a cocktail of four chemotherapy drugs (mechlorethamine, vincristine, procarbazine, and prednisone, also known as MOPP) proved to be the perfect concoction for essentially curing Hodgkin’s disease, a feat once thought impossible.

 

Treatments have only improved. The newest chemotherapeutic combination with which to treat Hodgkin’s disease is a combination of doxorubicin, bleomycin, vinblastine, and dacarbazine called ABVD. The risk of patients developing secondary cancers after this treatment can be as low as 1%.

 

It is astonishing to consider the near-miraculous circumstances under which Charles was spared from Hodgkin’s lymphoma, especially in his era.  Still, the entire scenario seems to be a bit of a double-edged sword. Yes, radiation therapy likely saved my grandfather’s life. Even so, he can no longer play tennis, his favorite pastime, largely because of muscle and joint damage sustained from radiation. He has frequent, sometimes worrisome, bouts of skin cancer. He is limited to a restricted diet because of his dangerously high iron levels.

 

I asked my grandmother if she was ever told her husband would be alright, if he ever officially went into remission.

 

“No!” she exclaimed. “His case is written up as unexplained…the disease was ‘arrested.’ They never have said he’s cured.”

 

“So how many years did you go thinking he could die at any moment?”

 

She looked off into the distance beyond her feet, and replied nonchalantly, “Forever.”

 

“Forever?”

 

“Forever.”