Survivor : Taking Control of Your Fight Against Cancer

Book by Landro Laura

Chapter One: THE BAD NEWS

On the afternoon of August 20, 1991 -- my thirty-seventh birthday -- I was in my apartment in New York City, trying to muster some energy to celebrate. For weeks, I had been feeling increasingly tired and out of sorts. My parents were in town to take me out to dinner at my favorite Italian restaurant, and the following day we were planning to drive to Long Island for a family vacation at the beach, a period of rest that I hoped would do me some good. Too bad I'm not there already, I thought. I suddenly had such a crushing sense of fatigue that I decided to lie down for a few minutes.

Three hours later, it took all the strength I had just to get up off the bed again. Something has got to be wrong with me, I thought to myself as I stared at my pale face in the mirror, trying with makeup to cover the dark circles under my eyes.

But what was it that was wrong? Had I been staying out too late, not taking good enough care of myself, working too hard? My job -- managing a dozen reporters and writing about the entertainment industry for The Wall Street Journal -- entailed more than its share of stress, but not enough to make me feel this tired. If anything, life at the newspaper was energizing; I did my best work on the adrenaline of deadlines. I had always been in good health. And though I was no athlete, after years of regular exercise, I had never been in better physical condition.

Like most people, I had my share of modern day health paranoia, illogically wondering if a bad headache could be a brain tumor. Each of my father's four sisters had battled breast cancer. That put me in a higher risk category, and I worried about it. But when you came right down to it, I regarded illness and disease as the curse of the old and infirm, a vague concern for the distant future. I decided whatever was ailing me now must be some temporary aberration, a virus, something I would soon shake off.

The next day we arrived in Southampton to stay at a friend's oceanfront house. I looked forward to being outside every day -- riding my bike, running, swimming laps in the heated pool. But when I tried to exercise, the effort left me winded, gasping for breath. I complained to my mother that I had never felt so run down. As a nurse, she had always been a better diagnostician than the average mother, and she, too, was worried. "You look so pale and tired," she told me as we walked along the beach one morning. "Why don't you see a doctor as soon as you get back home?"

I promised her I would, but after I returned to work in September, things got so hectic that I put off making an appointment. I figured if I ignored it, maybe it would go away. But it didn't. In fact, some mornings, I felt as if I were nailed to my bed, unable to shake off sleep without great effort. There was a nagging ache in my left side that sometimes intensified into a sharp pain. A surge of that adrenaline would get me through the pressure-cooker afternoon deadlines at the office, but I was so spent at night that I would often have to lie down in the back seat of a taxi on the way home.

As if I needed a further incentive to see a doctor, a notice arrived in the mail from Dow Jones, the parent company of The Wall Street Journal, offering to pay for a complete annual physical as part of a new health plan. Finally I stopped procrastinating. On the morning of Tuesday, October 22, I went to see Dr. Steven Marks, who had treated me for the occasional flu or stomach virus, and I told him about my symptoms. "You look fine," he said after examining me in his office. "But let's do some blood work just to be sure."

Two days later, on Thursday, October 24, I was in my office, thinking of little else but a story I was writing for the next day's paper. The newsroom was in its usual state of contained pandemonium, reporters hammering away at their computer terminals, the fax machine spewing out press releases, the phones ringing incessantly. I was still waiting for some sources to call me back with information I needed for my story. On days like this, anyone who called me on unrelated business, including my mother, was usually dispatched with a brusque, "Can't talk now, I'm on deadline."

I picked up the phone at about 3 P.M., blanking on the name for a second when the caller said, "Laura, Steven Marks here." Realizing who it was, I assumed it was a courtesy call from the nice doctor to tell me my malaise was all in my head; I had actually been feeling a little better that day. "What's up, Doc?" I chirped, still mostly focused on the computer screen in front of me. But his tone as he answered was grave. What he was about to tell me would divide my life into everything before this phone call, and everything after.

"Well, your blood tests have come back, and there's a problem," Dr. Marks began. "Your white blood cell count is extremely elevated."

He suddenly had my undivided attention. "Like, how elevated?" I asked, feeling a prick of alarm. Dr. Marks replied that my white blood cell count was close to 75,000, while the normal level was closer to 4,000. My alarm intensified. "But what does that mean?" I asked.

"It could be an infection, but there's nothing else in the blood test that indicates that," Dr. Marks said. With my reporter's instincts kicking in, I pressed him harder. "Dr. Marks, what else could this be? What is the worst case scenario here?" I asked.

"Well," he said carefully, "I've consulted a hematologist, and he says it looks like something called chronic myelogenous leukemia." I heard the word "leukemia" and a wave of panic washed over me. I felt disoriented, and my heart started to pump faster in my chest. I wasn't even sure exactly what leukemia was, but I knew it had to do with the blood, and that it was a form of cancer. A friend's son had died of it a decade earlier after a desperate battle that took up most of his short life. "Leukemia," I repeated, then asked incredulously, "are you telling me I'm going to die here?"

"Of course not," Dr. Marks said, assuring me I was in no immediate danger. "But a hematologist I work with can see you today if you want. Why don't you get there this afternoon?" I jotted down the name and address he gave me, and told him I would head there straight away.

As I hung up the phone in a daze, I glanced up to see my friend and colleague Alix Freedman, one of the paper's best reporters and an equally good eavesdropper, in my doorway. She had been standing there long enough to hear most of my end of the conversation. "What is going on?" she whispered. I shakily relayed what Dr. Marks had said, and told her I had to leave the office right away. "I'm coming with you," she said, and ran off to call a car service for us.

Mechanically, I made the calls necessary to enable me to walk out of the office in the middle of a really important story, which suddenly didn't seem so important anymore. I called Marty Schenker, the national news editor, and told him a medical emergency had come up; he would have to find something else to fill the big space where my story was supposed to go. Something in my voice told him not to argue with me. My deputy, Dennis Kneale, agreed without question to edit any other stories that broke that afternoon. Finally, I called the executive who was the main subject of my story and told him it was on hold for today.

I gathered my briefcase, coat, and purse, and walked out with Alix to the waiting car. We headed up the FDR Drive, the quickest route to the upper East Side from lower Manhattan. Mercifully, for once there was no traffic. I stared out at the sun glinting off the familiar city skyline, the tugboats pushing barges down the East River, the graceful bridges linking Manhattan to Brooklyn and Queens. It was a perfect day, but to me everything seemed unreal. I couldn't stop tears from welling up in my eyes. "I can't believe this, I just can't believe this," I kept saying. Alix clutched my hand, trying to reassure me.

In twenty-five minutes I was in the Park Avenue office of Dr. Mitchell Gaynor, a young, soft-spoken hematologist with a calm, reassuring manner. "I'm going to repeat the blood tests and I'll need a bone marrow biopsy," he told me as he ushered me into a large examination room with a wide table in the middle. After taking off my clothes and donning a paper robe, I climbed up on the table and lay face down. Dr. Gaynor warned me that I might feel some pain, as he injected me with a local anesthetic.

Moments later, he plunged a long needle deep into my lower back at the iliac crest of my pelvic bone, then twisted it like a corkscrew to extract the marrow he needed to confirm the diagnosis. I felt a sense of extreme pressure, and despite the anesthetic, a sharp pain shot down my leg. I shuddered at the grinding sound of metal into bone; my leg jerked involuntarily.

As he worked, Dr. Gaynor asked, "Do you have any brothers or sisters?" I told him I had two younger brothers, thinking he was making polite chitchat. He swabbed antiseptic over the biopsy site, then applied a big gauze bandage, warning me not to take it off for twenty-four hours.

Wincing as I sat down in his office afterward, I listened as he told me that he would know more in a couple of days, but was fairly sure that I had chronic myelogenous leukemia. "CML is a more indolent form of leukemia," he explained; as Dr. Marks had said, the danger was not as imminent as some of the more acute forms of the cancer, and I had several options to consider for treatment. He mentioned interferon, an immune-boosting drug he had been working with that put some patients into remission. He also mentioned a bone marrow transplant, a procedure I was only dimly aware of, as something to think about down the road. He was glad to hear I had siblings; we would need to test both my brothers to see if they could provide a "match" that would make a transplant possible.

My head was spinning as I tried to take in all that he was saying. The incongruity of it struck me as almost comic. A few hours earlier, my biggest concern had been getting my story into the paper on deadline; now I was focused on the reality that I probably had leukemia, and might need a bone marrow transplant, whatever that entailed. Would they have to suck marrow out of my bones and inject my brother's, assuming it matched? I had no clue. I wasn't even sure what bone marrow had to do with anything.

I rejoined an anxious Alix in the waiting room, and we walked to my apartment four blocks away on Ninetieth Street and Madison Avenue. The afternoon had grown colder, and we dodged children on their way home from the half-dozen schools in the neighborhood. As we parted at the entrance to my building, she begged me not to be too worried, and reminded me of the words Dr. Gaynor had said as he ushered me out of his office: "You'll be fine."

But in fact, I wasn't fine. I stayed home the next morning to wait for his call, and at 11 A.M. Dr. Gaynor called to confirm that his diagnosis was correct. I was soon to learn that this form of leukemia, indolent as it might be for now, could kill me within one to five years. Nothing would ever be the same again in my life, nor in the life of anyone who cared for me. Everything I had taken for granted -- my daily concerns, my work, my well-being, my sense of my place in the world, and even my physical appearance -- was about to be taken away from me. My own mortality, something I had never seriously considered, was suddenly staring me in the face.

Though I didn't know it yet, my only chance for survival would be a radical and painful therapy that was itself potentially fatal. What I did know was that I had to find out everything I could about the disease that had invaded me, and figure out what I could do to stop it from destroying me. I was starting from nowhere, complete ignorance. I had never before been so grateful for all my years of journalistic training. There was an investigative story here, and my life depended on getting to the bottom of it.

After absorbing the news that you have cancer, the next hardest thing is telling the people who love you. You are about to rock their lives to the foundations, and drag them along with you into this uncharted territory. There's no easy way to break news like this. Trying to keep your own emotions in check while you do it can help keep the panic level down all around. If your family thinks you are dealing with it, they will at least try to deal with it too, for your sake.

My immediate family was a tight-knit unit composed of my parents, Beverly and Sylvester Landro, and my brothers, Arthur, thirty-five, and Christopher, thirty-two. I had always thought of us as an average, happy family until I met so many people who had grown up in dysfunctional homes -- then I realized just how blessed I had been. My father was cool, funny, collected, and quiet; I never even heard him raise his voice in anger. My mother, by contrast, was passionate, emotional, and enthusiastic about things. Both grew up in small towns in western Pennsylvania, my father one of nine children of Italian immigrants, and my mother an adopted only child with some Scotch-Irish roots. Thanks to the GI Bill, my dad, a veteran of two wars, got his education and a way out of what might have been a dead-end job in a coal mine. My mother, I am certain, could have become a doctor instead of a nurse had the opportunities been available to her in the 1940s.

My parents had no wealth, family connections, or friends in high places. What they did have was an unlimited reservoir of love for each other and for us, a strong sense of ethics and fairness, and a desire to see their children grow up happy and successful. They always told us that we were special, and that there was nothing we couldn't accomplish on our own if we put our minds to it. "Remember who you are," was my dad's favorite admonition.

We grew up in the middle-class suburb of Fair Lawn, New Jersey, where I graduated from high school in 1972. A few years later, when the electronics company my father worked for was sold, he decided to start his own business back in Pittsburgh, where most of our relatives still lived. There was nothing keeping him in New Jersey; Chris, the youngest, was off to college in Ohio, Art was in the Air Force and stationed in South Dakota, and I was already living and working in New York.

I still missed having my parents accessible to me in a quick trip over the George Washington Bridge, and now I had to break their hearts over the phone. On Friday, shortly after hearing from Dr. Gaynor, I dialed their number. I took a few deep breaths to try and steady my voice, worried that the minute I heard my mother's voice I might burst into tears. She answered on the second ring, delighted as usual to hear from me. "Blackie, pick up the phone, it's Laura!" she called out to my father, using the nickname that had stuck to him since World War II, when he had a thick mane of black hair. When I heard his voice on the extension, I just started talking. "Listen, please don't worry, I've got some bad news, but I'm not sure what it all means yet."

As I told them that I had been diagnosed with leukemia, my mother gasped. Recently she had become even more specialized as a nurse, going to night school for her bachelor's degree and becoming certified in oncology. In her current job, helping to run a hospice and home-care clinic for the terminally ill, she had seen some leukemia patients die. "Please don't let that ever happen to my child," she had often said to herself. Now she struggled to recover from her shock that it indeed had happened to her own daughter.

Determined not to let me see how afraid she was, she shifted into her ...