Goodbye Andreas

My friend, my patient, my kindred spirit born within a few weeks of me in 1951, Andreas in Greece and me in Canada, is gone.

He passed yesterday at home just minutes before Patty and I arrived to say goodbye and be with his family.

He passed from complications of mantle cell lymphoma, a meaner cousin of CLL and mostly from an aggressive and secretive second cancer – CUP or carcinoma of unknown primary.

CT and PET scans could find no primary source of the cancer and the tissues from the biopsies of the painful metastatic disease in his bones suggested, on deep genetic statistical analysis, that it might have come from his gallbladder. But the images showed nothing growing there and the cancer laughed off any and all treatments aimed at that organ or other related cancers.

Testing also revealed no “actionable” genetic markers. No helpful clues as to what we should target.

Potent gut-wrenching chemo cocktails did nothing. Immunotherapy did nothing. Targeted therapy did nothing. Off-label use of drugs made available for compassionate use and fights with the insurance company and the “right to try” legislation did nothing. The cancer just marched on, seemingly getting stronger as Andreas got weaker and weaker.

I achingly remember when I met him, this formerly Adonis like man (his justly chosen personal avatar), sitting in a wheel chair in excruciating pain being admitted to the hospital and he asked me, his friend, his family doctor, if he would ever have another good day.

He sort of had a couple of good days when one of the treatments paused the relentless tumor growth ever so briefly.

Patty and I visited with him later at another hospital admission, and she sang songs by Leonard Cohen in his room and it cheered him up for a few minutes. Thin and frail and running out of options, he remained sure he would beat his hidden yet brazen beast within.

He pushed so hard. We researched and got second opinions across the country and he never gave up.

He resisted and finally accepted hospice care. Thank goodness. Though the transition was not easy for him or his family, it was made better with the love and attention and morphine that he received at home from his loved ones and the hospice team.

To see him pale and sallow and wasted by the emperor of all maladies, to see this bright and generous man lying lifeless, breathless, was so sad, so unfair, so senseless, so cruel, so hard.

He was a good man and a good friend, and I will miss him.

Cancer sucks.