What Do I Do? Stage 3: Dale’s Story
Dale Smith is a strong man – technical, business-oriented, pragmatic – someone who attacks an issue and finds a solution, someone on whom everyone else can count. Bedrock.
That’s why he saw cancer as just another job to be accomplished, one that he could essentially do without troubling his family and friends. Not once, but twice. Ultimately, though, he discovered that cancer revealed possibilities and connections that he had never anticipated.
Nearly 20 years ago, in 1994, Dale was diagnosed with testicular cancer, found as part of a routine screening before his transfer to England by AT&T. The move was put on hold while he addressed the cancer, including an operation to remove lymph nodes that left him with an extensive scar from sternum to gut. Thankfully, since no nodes were involved, Dale and his wife Elaine left for England eight weeks after surgery. His U.S. doctors connected him with a British specialist who checked his health with monthly CT scans, the normal post-surgery monitoring process. Beyond that, he didn’t think much about this incident; he and his wife settled into their new life.
That summer, the CT scan showed two spots in his lungs; the testicular cancer had metastasized. Dale began a chemotherapy protocol that required a weekly trip to London, with every third week being a three- to-four-day hospital stay. Because London was a two-hour journey from his home, treatment became a time-consuming challenge.
For the first time, cancer ceased being an inconvenience; it became a stalker, a disease whose job was to introduce Dale to his vulnerability. “I was driving to work one day,” he brushes his hand across his short-cropped white hair, “and was really tired. I pulled over and slept at the side of the road for two hours. That’s when I realized that this was serious and major league.”
With the chemo completed, Dale continued having CT scans. The two spots in his lung had responded to the treatment and became scar tissue, which his doctors recommended removing. “I was a little more scared with this surgery, and asked my sons to fly over to be with us.” Dale adjusts his wire-rimmed glasses.
In 1996, he and his wife returned to the States, where he resumed care with his oncologist. The initial every-three-month CT scans became every six months. After five years, his doctor advised him to have scans every three years just as a precaution, since the testicular cancer had been successfully handled.
“I said, ‘I’ve had cancer, but I will die from something else,’” Dale says softly.
He was satisfied, especially as the every-three-year scans continued to be normal.
In October 2007, he requested that his oncologist schedule a CT scan; again, all was normal. In October 2010, the scan indicated a spot on Dale’s kidney, confirmed by a PET scan. In light of these new findings, the radiologist reviewed the 2007 scan, and noted, in retrospect, that there was, indeed, something on the kidney that had initially not been “remarkable”–hence the all-clear three years prior.
Dale shrugs, “It is what it is.” He is not one to dwell on the might-have-beens. He is one to focus on the issue, look to the future, and find a solution.
To address this kidney cancer, Dale’s oncologist recommended a surgeon who specializes in partial nephrectomy. There was a strong likelihood that part of the kidney could be saved, especially since the growth was so small. He planned his surgery for after Thanksgiving. But he was more worried about this operation than he’d been before. He wrote letters to his wife, brother, and sons, letters that he called, “In Case of Emergency.”
Although surgery was a success—only 10 percent of the kidney was removed—there was a complication; the pathology of the removed tissue indicated a Stage 3 cancer, not the Stage 1 that Dale had hoped for. With Stage 3 cancer, he felt vulnerable—more vulnerable than he’d felt when he pulled over for a nap in England, more vulnerable than when he found lesions on his lung.
“Stage 3…now what do I do?” he asked himself.
Dale was accepted into a blind clinical trial of a Stage 4 kidney cancer drug, Sutent, being tested for Stage 3 patients. He is now in the next phase of the trial.
But for Dale, cancer has been life-changing in more ways than the physical.
A year before his kidney cancer diagnosis, a young pastor had been called to Dale’s church. Dale bonded with Rev. Tony, who talked quite openly about his own kidney cancer. With Dale’s new diagnosis, he quickly met with Tony, and found that he would be treated by the same surgeon as the pastor.
“Speaking with Tony was very reassuring about the course of treatment and the recovery,” says Dale. “And, then, when I met with the surgeon before kidney surgery, he looked at my scans, and asked who had initially treated me. When I told him, he smiled, and said, ‘I recognize his work. I was on that team 16 years ago.’” Dale blinks rapidly. “To me, these were all signs that God is working in my life.
The connections among the people in his life–doctors, caregivers, his pastor–moved him. It was not just that he would survive his treatment, but that he would be able to count on others.
Dale’s research led him to the Cancer Support Community in Bedminster, NJ, near his home. ”I went to a kidney cancer support group, one of the few I could find. Through that group, I spoke to another survivor about the clinical trial drug. I also found the Cancer Support Community’s online resources to be excellent. The on-line chat groups are scheduled once a week. For the chat group I was in, the facilitator was from San Francisco with participants from New York, Atlanta, Phoenix, and Washington State.
“The Cancer Support Community also has an on-line bulletin board forum where people can ask questions and others can comment. This, too, was very helpful for me to be engaged and support others in the forum. Part of my recovery was checking in and being part of groups. Making those connections was very helpful,” Dale notes.
In the spring of 2011, he came to the Cancer Support Community of the Greater Lehigh Valley’s Cancer Transitions workshop for those whose active treatment was ending. Twenty people gathered weekly.
“We’d talk about what was going on, but there was also the elephant in the room: the realization that we could die. We finally talked about it in the support group one evening. The caregiver and the patient have a delicate balance to be strong for one another. If the subject of death comes up, our significant others would brush it off,” he comments. Although he no longer attends the support groups because he no longer needs them, he knows that “the Cancer Support Community is here. What a gift, to patients and caregivers!” he says.
“Over the years, there has been much progress in cancer treatment. I am fortunate to be a two-time cancer survivor, but this is a life-changing disease.” Dale concludes. “Being Patient Active and deliberately paying attention to the spiritual, emotional, family, and community connections makes all the difference in coping and recovery.”