In the Office with Dr. Marshall Posner

Dr. Posner is Professor of Medicine at the Icahn School of Medicine at Mount Sinai, NY. He is the Medical Director of the Head and Neck Oncology Program, Associate Director of the Center for Personalized Cancer Therapeutics, and co-Director of the Cancer Clinical Investigation Program for the Mount Sinai NCI – National Cancer Institute designated Cancer Center.

On October 26, 2018, at 9:36 a.m., I received an entirely unexpected and highly personal gift. Slightly larger than an American dime, this gift’s most interesting aspects included an irregular shape, an uneven texture, and a random color pattern. The gift was accidentally discovered by my dentist and then confirmed by numerous doctors after they analyzed multiple imaging tests and two neck biopsies. The process of locating the site where my stage four squamous cell head and neck cancer originated reminded me of a childhood fortune hunt. Only now the hunt focused on me and my misfortune.

Once the tumor was precisely located, I knew it was big trouble, and I was scared. As I sought to better understand my cancer, I began to perceive some interesting benefits it might offer, and soon I developed a new perspective. I began to realize that my gift might have good, if hidden, aspects. Either way, cancer was about to unquestionably change my life forever. It was time to focus on the positives.

And so it began. I rejected the bad, the scary, and the unknown, focusing my efforts on one positive thing after the next. Yes, the negatives were all there staring me in the face day after day, but I refused to allow them to control my life. Slowly my feelings recalibrated, and now I understood with a new intensity how precious life is and that each moment truly counts. My faith has been enhanced, and this gift has given me a keen, focused approach to my days. I only wish I had attained this level of personal introspection long ago.

I also gained exclusive access to a special place that  was so visually stimulating to me and high-tech that I marveled at the design each time I entered that room. The gracious and highly trained hosts tasked to guide me through my radiation treatments led me to my special place, where they encouraged me to relax and put myself in a restorative position similar to a yoga pose. I was encouraged thirty-seven times to lie down for that special savasana session. This luxury occurred five days every week over seven weeks.

This gift kept right on giving. Every day challenged, inspired, motivated, and humbled me. Able to express my emotions, I learned that crying privately was not a bad thing. I was blessed to have the love and support of my wife and our five children and six grandchildren. Naturally I had challenging days. Truthfully, my treatment was beyond brutal—almost tortuous—but it was worth the pain. Chemotherapy and its side effects became the true life test, shaking me to my core.

Thankfully, steroids and anti-nausea drugs lessened the effects. Chemo pushed me into a world of confusion and fog. My sense of time seemed out of sync. I developed a love-hate relationship with my chemotherapy. I define the love part as being able to fall sleep at a moment’s notice, knowing that conserving my energy would help fight off disease. The hate side of chemo was the way in which it made my body feel electrified and jumpy, causing frequent waves of nausea to wash over me like a tide during a storm. I also lost all taste for food—it was horrible, now something to avoid.

It was humbling to lose my sense of taste but interesting as well. I am thankful for the experience because it has taught me to appreciate the simple pleasure of eating and tasting food. My doctors explained that this problem will improve over time, perhaps taking a year or more. So far I have recovered 60 percent of my ability to taste. Swallowing was a totally different animal. Six weeks into my radiation, with seven more treatments to go, I hit the wall. My pain level rose to a ten, and I could not swallow anything. Dealing with this much pain was impossible. I crouched on the floor, my body rocking back and forth, while desperately trying to sip water and Ensure. Each breath and swallow felt like a thousand shards of glass were being pushed further into my throat. I spent three days under palliative care with IVs for hydration. Gone was the morphine that had ceased to work. I now had a fentanyl transdermal patch to get my pain under control. This was supplemented with dilaudid transmitted through my IVs every four hours. I came home with the fentanyl patch, the dilaudid, and Tylenol and Motrin around the clock.

I hope you now understand the positives and negatives of receiving the gift of stage four squamous cell HPV head and neck cancer. The treatment from my amazing medical team worked, and today—cancer free—my prospects are bright.

Cancer is now a permanent part of my legacy and knowing this I plan to remain in control of my cancer—I am determined that it will never control me.

As for fragility and mortality, I know they are always going to be there, but I am moving away from both, at least for now. It’s not my time. But I’m grateful to have been forced to confront what is inevitable in life.

What I hope to impart is that the next time you are surprised by an unexpected and challenging event consider that it may be a gift in disguise.