An hour after receiving my husband Kai’s lung cancer diagnosis, we went outside to walk the dog. The walls of our kitchen seemed far too narrow – the air thick and difficult to breathe.
At first we said nothing. We just held hands like we were clinging to life. On the corner of the street, Kai stumbled a little and grabbed hold of our neighbor’s stone retaining wall. He looked at the November sky, the almost bare trees, the dog.
“Can I make it to 60?” he asked.
The cogs in my head whirled and clicked. I counted in my head, mentally tearing pages from the calendar. December, January, February … June. Less than seven months away. I grabbed his shoulders and grabbed him until he looked me in the eye.
“We’ll get you to 60.”
How logical, confident and sure I sounded. Strong. Responsible.
After months of antibiotics for a sinus infection Kai didn’t have, weeks of headaches and more coughing and a slight fever, a referral to the ENT and prescribing irrelevant treatments, the doctor sent him for a final X-ray. They found the mass in his lungs.
When it was discovered, the tumor was already 14 centimeters in size. And it had metastasized. Kai was a stage IV dead man.
Unlike cancers such as prostate and breast cancer, where survival rates have steadily increased over the past half century due to simple factors such as education and routine screening, lung cancer survival rates are low. The diagnosis almost always comes too late to do anything other than start therapies like chemotherapy and radiation — things that can treat but not cure.
Kai was incredibly healthy for a 59-year-old man. He ate everything right (I know because I was the family cook), exercised every day, went to doctors regularly. As a former football cornerback, he had no known risk factors and no warning signs. In fact, just a year earlier, he had passed a slew of physical exams, X-rays and blood tests in preparation for elective knee replacement surgery.
But the cancer found him anyway. The tumor grew from nothing to enormous, growing an average of 1.16 centimeters per month.
“How long?” We asked the doctor.
We were determined not to use the internet for medical information. We promised each other.
Most of the time I kept my promise. Sometimes I couldn’t help it. I gave in, googled a quick answer just to catch a sentence, gasped, jumped, shut down the obnoxious website that said, “The two-year survival rate is about ten percent; the five years about zero.”
“The average is 18 months,” Kai’s doctor told us. He was quick to add: “But that takes into account all patients, most of whom are much older and sicker, far less healthy than you, with multiple risk factors. We have every reason to believe that you will far exceed the average.”
He added, “Let’s focus on the kind of life you want to live — what you want to do with your time.”
“The tumor grew from nothing to enormous, growing an average of 1.16 centimeters per month.”
On September 12th, the 60thth Anniversary of President John F. Kennedy’s “Moonshot” Speech to the Nation, President Joe Biden announced plans for “another moonshot: ending cancer as we know it”.
Like most of us, Biden is no stranger to the impotent pain of having a loved one suffer from the illness. His son Beau died of cancer in 2015 at the age of 46. The fact of the illness is bad enough, but the complete inability to do anything at all is a feeling of helplessness and loneliness like no other.
The President launched the Cancer Cabinet in February 2022 and in July his priorities included improving cancer screening, reducing the impact of cancer and supporting both patients and caregivers. Specifically, Biden’s moonshot prioritizes biotechnology research and creates a new government agency dedicated to “biomedical innovation that supports the health of all Americans.”
There are more than 100 main types of cancer.
Lung cancer comes in two flavors. Non-small cell lung cancer accounts for about 90% of all lung cancers and itself comes in three types.
Kai, with his squamous cell carcinoma, was one of more than 2 million people worldwide — roughly the population of Chicago, home of his beloved Cubs — to be diagnosed in 2017 alone, and with the disease at an advanced stage, it was too late to post it back to the kitchen: “No thanks. That’s not what I ordered.”
The two treatment options were equally repulsive to him and placed together: the chemicals of chemotherapy through the bloodstream and the X-rays of radiation to a localized area.
None of the therapies differentiate between healthy and cancerous cells; everyone kills both.
But the doctor told us that Kai’s general health made him a candidate for a cutting-edge treatment: immunotherapy. By 2017, it had shown great promise in clinical trials. A moonshot of sorts, albeit on an individual scale.
The human immune system, designed to attack invaders while protecting citizen cells, learns a new language from this treatment. Rather than targeting the cancer directly, immunotherapy bypasses the body’s communication network to activate all defenses against destroying the cancerous, once-normal cells.
It wouldn’t cure him—there was no cure—but immunotherapy could result in long-lasting remission and increased survival.
The cost price, the doctor told us, was about $500, a tiny price for something that might buy more time.
“Yes, yes,” we said, “absolutely yes.”
“How much life is enough if we can’t have it forever? I think the answer, as any toddler would tell you, is more.”
Isn’t that what we all want – both for ourselves and for the people we love? More time? Such a human desire to continue life at all costs. Sparing no expense or treatment, prolonging the inevitable for all of us.
The doctor ordered a series of genetic tests for markers to determine appropriateness.
The bill we received later was closer to 100x the estimate. And it made no difference. Kai’s profile didn’t match. And despite the prognosis – still enough time to live – he died just five months after his diagnosis. Five weeks before his 60th birthday.
He should have made it longer. I said it. The doctor said so. Even the internet said so. But how much life is enough if we can’t have it forever?
I think the answer, as any toddler would tell you, is more. Whatever we get, we want more. That goal is always the moonshot, no matter how ambitious and unsuccessful. We feel we have to try to the last possible Ave Mary Pass. Giving up is the only real mistake.
And we tried, with everything that modern medicine has to offer. Kai’s medical team has taken a moonshot with his weekly chemotherapy and daily radiation, more treatments than most cancer patients can stomach. Kai was so strong that he never looked sick, never stopped eating, and never lost his hair. Until the end, Kai was recognizable as himself: handsome, strong, loving and incredibly funny.
Five years later, I still have so much to learn about who I am as a widow—not as a wife. It’s too late for Kai and for Beau and for the other 1 in 6 people on earth who have already died from cancer – each of them a parent, sibling, child, partner, friend. all loved.
But I hope with all my heart that Biden’s moonshot finds its mark. If some cancers can eventually be cured, and other cancers can be added to the “available vaccines” lineup of diseases like COVID and chickenpox and the flu, maybe we can break some of the stranglehold of grief on us, at least long enough to save ours Wanted to live life fully.
Helene Kiser is the author of “Topography”. Her work has appeared in dozens of literary journals and anthologies and has been twice nominated for the Pushcart Prize. She is currently working on her memoirs. You can find her on Twitter at @HeleneTheWriter.
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