Silent Cancer

This is a story about a cancer that was once rare. Not any more. It’s caused by the HPV virus. About 14 million Americans are infected with HPV every year and it now accounts for more cases of some throat, tonsil and back of the tongue cancer in men than smoking and alcohol. It’s the kind of cancer Michael Douglas had. So did JPMorgan Chase CEO Jaime Dimon and former Minnesota Senator Norm Coleman, who’s now being treated 5 days a week at the Mayor Clinic. According to oncologist Dr. Roger Cohen of the University of Pennsylvania Hospital, these types of head and neck cancer have reached epidemic proportions.

HPV is best known as a sexually transmitted disease that can cause cervical cancers in women. Most people over 26 have it and mostly, it’s harmless. We understand that this happens in women but we don’t know much when it comes to men. HPV can spread through oral sex … kissing and other skin-to-skin contact. Most people survive this type of cancer. My brother-in-law Joel was the unlucky 1 out of 10 who didn’t make it.

One day Joel woke up with a swollen lymph node. Four years later he was dead. I started the tape recorder from the time he was diagnosed and didn’t turn it off until he died. Until after he died.

Chapter 1

Who is Joel? The trauma of discovering you have a potentially deadly disease and what followed. Surgery, radiation, chemo.

Joel was a true character, a chiropractor in Philadelphia. He raised pigeons, was a sailor, a star gazer, a Zydeco dancer (Excerpt 2), a guy who had a reputation as a ladies man. Joel got married 3 times and had two children, Zeke and Eli (Excerpt 8).

Chapter 2

Joel gets married for the first time.

He builds a house in Woodstock, New York with his friend Jeff, two hippies who have never built a house before. Joel’s new wife Annette lives in a commune 45 minutes away. For 6 months Joel is so busy building his house in the woods that he only visits Annette on weekends. She takes up with another guy from the commune and ends it with Joel. Joel is heart broken.

Joel meets Jeanne, wife number 2 (Excerpt 5). They move to Spartenburg, South Carolina where they embrace a hippie, back to the land lifestyle before deciding to go to chiropractic school together. Joel raises Birmingham rollers, pigeons that fly from the roof and roll over backwards in flight, looking like they’ll fall out of the sky and kill themselves before they right themselves and head back home.

Joel gets homesick and tells Jeanne he’s leaving her. He moves to Philadelphia and opens a chiropractic office.

Chapter 3

Joel’s life in Philadelphia.

Joel doesn’t want his patients to be bored while they’re in the waiting room. He hires a woman who happens to dress in a nun’s habit as a receptionist. No one knows whether she’s ever been in a nunnery. People throughout the story weigh in on whether she’s for real or just another one of the odd characters Joel seems to collect.

Joel meets Rachel, wife number 3 and gets a new flock of Birmingham rollers. Rachel and Joel have two boys, Zeke and Eli (Excerpt 8), who wind up being star football players and champion wrestlers in high school.

Joel and Rachel fight a lot and split up when the boys are little. They have joint custody.

Joel meets Brenda, the nephrologist (excerpt number 1) and Melissa, the decorator. Both of them want to be his girlfriends and vie for his attention. Melissa is the jealous type, throwing stones at Joel’s window to let him know she doesn’t like him hanging around with Brenda. Melissa wins out. The two are an on-again, off-again couple until the end.

Chapter 4

Diagnosis and treatment.

Joel sends an email dated September 26, 2008 with the title Bad News. “Got it but it seems to be contained. Tonsil & lymph node, Squamos cell C. Surgery, radiation & maybe a touch of chemo. Good chance I’ll be ok when it’s done. Oy vey.”

Joel undergoes extensive surgery. He is fed through a tube and cannot eat solid food for months. On tape, he demonstrates all the finer points of ingesting dinner through a plunger. In a raspy voice, he jokes about it. “Look at how much money I’m saving on restaurant bills.”

Chapter 5

The trauma of living with a deadly disease.

Joel is in remission for 6 months before the cancer shows up again. He has gone through all the traditional treatments. He enrolls in a clinical trial that does nothing for him. Then he tries alternative therapies, traveling to Mexico for chelation treatments that involve coffee enemas. He doesn’t get better.

Chapter 6

Joel’s doctors assured him that 9 out of 10 people who get this kind of cancer recover. Joel says, “Who knew I’d be the one in ten?”

He posts on Facebook that he has cancer caused by the HPV virus that was sexually transmitted and advises his friends to give their kids the Gardasil vaccine. Melissa’s teenage daughter is appalled. She says her mother’s boyfriend has made her a pariah in the eyes of the world.

On a Saturday in May, Joel has a raucous 60th birthday party with his favorite band Johnny Ace playing in the backyard. It’s a day when I’m in the midst of my own cancer scare. After my pulmonologist noticed a spot on my lung, he sent me to get an MRI but I wouldn’t get the results until after the weekend. Maybe I had lung cancer and Joel and I were both on the road to death. I was too nauseous to eat a thing from the picnic table piled high with mac and cheese and birthday cake. All I couId see was me, my eyes fluttering on my deathbed.

Joel, Steve (my husband and Joel’s older brother), Joel’s son Eli and my two boys Jon and Gabe, sail Joel’s boat down the East River to Long Island. On the way, Joel and Steve bicker about whether they’re passing the Manhattan or the Brooklyn Bridge.

We all go to Peter Luger’s to eat steak.

Three months later Joel is dead.

Joe Biden (Excerpt 9), who has lost a son to brain cancer and is raising millions for his cancer Moonshot, weighs in. He says this is the heartbreak of cancer. All the support in the world can’t take away the pain of losing someone you love to such a horrible disease. One thing he always wanted, he says, was to be President at a time when doctors found a cure for cancer.