by Michelle Cadorette
On July 26th Michelle was admitted to Massachusetts General Hospital to begin the procedure for her bone marrow transplant. After 5 days of preparation the transplant day had arrived. She was so filled with hope that her life would be back to normal. Her excitement at the prospect, and her smile, said it all. Our daughter was well aware of the risks and knew that the treatment would be difficult before any positive results would be realized. Her immune system would be weakened by the procedure, but when the white blood count began to rise she would see improvement. Unfortunately her lungs had been compromised by many surgeries along with radiation over the past 14 years, and her body couldn't compete. On August 28, 2013 she passed away quietly, surrounded by her family and friends, with that ever-present smile on her face.
Here is her story:
A native of Massachusetts,born in 1969, I am now living in Manchester, New Hampshire. My high school years were spent at Marian High School (1987) in Framingham, MA, followed by a Bachelor of Arts degree with a concentration in English at St. Anselm College (1991) in Manchester. After earning a Master's Degree in American Studies at Boston College (1994), Manchester drew me back to begin my teaching career. I taught sophomore American Studies and Senior Seminar Classes at Bow High School in Bow, NH. I have organized field trips, participated on committees, mentored students, and coached track and field as well as cross country running teams. I enjoy walking, biking and water-skiing, reading, mowing the lawn, attending the theater, eating candy, traveling in the U.S. and abroad, visiting with my four Godchildren, and spending time with family and friends.
My journey as a cancer patient started in 1999 with a persistent mouth infection. Symptoms subsided and then returned. Seven months later, after treatment with several antibiotics, special diets, a tongue biopsy and thorough medical tests, my doctors remained stumped.
A referral brought me to Massachusetts General Hospital (MGH) where a chest x-ray showed tumors—on my
lungs and on my heart. That was thirteen years ago; I was 30 years old.
The doctors performed thoracic surgery and removed not only the originally detected tumors, but countless other tiny tumors. Our hope was that they were all benign, but one week later the diagnosis was issued. I was
suffering from an extremely rare form of cancer, already at stage 4A: Malignant Thymoma.
Treatment needed to begin immediately, so I underwent aggressive radiation therapy for 35 days, while also going through four three-day cycles of chemotherapy (about six to eight hours of treatment per day). I experienced all the usual side effects: nausea, physical fatigue, weakness, hair loss, pneumonia…I was away from school and students for a year and a half.
At the time of the diagnosis and treatments, I was teaching at Trinity High School in Manchester, New Hampshire. It would be impossible for me to explain the myriad ways in which the members of my school community showed their love and support.
I was put on a routine of CT Scans and PET Scans every six months and this continued without event for about four years. And then, in April of 2004, almost exactly four years after my first surgery, my regularly scheduled PET/CT scans showed “a little something”. This time, the “something” was on both lungs, not just the left.
Doctors said they wanted to keep a close eye on it, so I returned, concerned, to the hospital in July for more tests and then again in November. There was at this point no doubt that tumors had returned, and that they were growing. Dr. Fidias was consulted, as were Drs. Choi and Mathisen. Consensus indicated the need for immediate action. Two surgeries, a Left Thoracotomy and a Right Thoracotomy, were scheduled: the first at the beginning of January and the second eight weeks after that.
Cancer, Round Two had begun. I was 35 years old.
At this point I was teaching and coaching at Bow High School, in Bow, New Hampshire. Telling my colleagues and students was, again, one of the most difficult things I’ve ever had to do. But, just as I had experienced when at Trinity High School, their support and love helped me better manage this difficult and frustrating experience.
Right after the beginning of the new year I left school for my surgery at MGH. Fortunately, the doctors felt confident that they had removed all of the malignant tissue and I was able to avoid another round of
chemotherapy or radiation. I was able to focus all my energy on recovering, and I was able return to my classroom in the fall of 2005.
The reprieve lasted until August of 2006 when I noticed what I correctly identified as symptoms of Myasthenia Gravis, a condition sometimes associated with Thymoma. My self diagnosis was confirmed in November by doctors who assured me that the presence of Myasthenia did not necessarily mean that cancer had returned. Unfortunately, the following month we were all shocked when PET and CT Scans showed the appearance of a malignant tumor above my left kidney. This led, of course, to more consultations with doctors, and more conversations with family, friends, colleagues, and students.
Cancer, Round Three.
From this time until 2012 I received monthly deep muscle shots of the hormone octreotide to shrink the tumor and discourage the growth of new ones. When, after 5 months, ocreotide alone didn't achieve the expected results, 30 mg. of predisone daily was added to my course of treatment. Within a few months the size of the tumor had decreased considerably, thus allowing a reduction of the prednisone dosage. This regimen has also resulted in diminishing the effects of Myasthenia Gravis.
Symptoms in the spring and throughout the summer of 2009 led to a diagnosis of Pure Red Cell Aplasia, a rare condition which is sometimes associated with thymoma. Taking a new medicine twice a day, making trips to MGH for transfusions every other week, and meeting regularly with a hematologist were all part of the effort being made to address and diminish this condition. Finally, in January of 2010, I spent a week at Massachusetts General Hospital so that I could receive infusions of "Atgam" (horse serum) designed to "kick start" my bone marrow into making red blood cells. The treatment was successful, and I was feeling less tired, dizzy and light-headed than I had for over a year.
In the summer of 2010, after returning from a fantastic trip to France, my symptoms of fatigue, dizziness and lightheadedness began to get more pronounced. We were (unfortunately) correct in assuming that the Pure Red Cell Aplasia had reared its ugly head again! After receiving a few blood transfusions to "tide me over", I was admitted to MGH for another five-day stint of in-patient "Atgam" treatment in late November. As winter turned to spring, we learned that the tumor had continued to grow slowly , despite the monthly Octreotide shots and the daily Prednisone pills, now responsible for the broken bone in my right foot and the muscle tear in my left leg. After consulting with my Oncologist, my Hematologist, my Oncology nurses and other health care professionals at MGH, we decided that I would receive the chemotherapy regimen called "C.A. P." (Cytoxan, Adriamycin, Cisplatin) in August. After a wonderful July full of trips (Aruba, Ireland), BBQs and birthdays, and for once devoid of hospital visits, I began my chemotherapy on 2 August 2011. Unfortunately, the regimen was very strong and had serious, negative effects on my mouth infection and my white blood count. It prompted the onset of Neutropenic Fever, causing me to be hospitalized at MGH for a week. I lost all of my hair and about 15 pounds, but not my fight or my sense of humor! And if you have read this far, it proves that you've got fight too. Thank you for supporting me and all who suffer from cancer by visiting this website.
From about 2009 on, however, the pain / pressure in my left side had become more “compelling”. After consulting with Dr. Mathisen (my surgeon in 2000 and 2005) in the fall of 2011, I decided that, despite the many potential risks, I would pursue surgery. After my surgery in 2005 it had been my understanding that, were more tumors to grow, the tumors would be “inoperable”. However, I learned that while it was dangerous and impossible to resect the entire tumor, it was possible to “de-bulk” it in certain areas.
Cancer, Round Three, continued.
Early January 2012 found me once again at MGH, continuing to pursue better health. Dr. Mathisen, in a long and complicated surgery, removed two very large tumors and quite a few small malignant thymoma tumors from my chest cavity. No organs had been invaded, and we were all thrilled that the surgery was quite a success. Despite the extensive nature of the resection, I was able to recover well (a week in the Grand Cayman Islands helped!!) and only some small malignant tumor tissues remain.
As I have been for the last thirteen years, I continue to be humbled and amazed at the efficiency, compassion, personalization, excellence and comprehension of care that I receive, no matter what building I’m in, what unit I’m on, what nurses and doctors attend me. My faith in the expertise and success of the physicians and staff at Mass. General only continues to grow over time.
In June of 2012, it was once again “back to MGH” for an in-patient stay of one week to treat my Pure Red Cell Aplasia symptoms with another dose of horse Atgam serum. Although we teasingly referred to it as my “Triple Crown”, unfortunately, the benefits were fleeting, and my blood counts continued to decline steadily during the summer. This necessitated ANOTHER week of in-patient care at the beginning of September, this time with “rabbit” Atgam serum. In early October intense chest pains, difficulty breathing and dizziness sent me to the Emergency Room at my local hospital, whereupon I was transferred by ambulance to MGH for a week of in-patient treatment for myocarditis, cardiac arrhythmia and pneumonia.
Unfortunately, all these experiences convinced me that dealing with my health and teaching full time were mutually exclusive activities. By the middle of October I applied for Disability Leave. It was a painful decision, but I know that it was the right one. So now I wear my school clothes whenever I go to the hospital, because taking care of my health is my full time job!
In November, we consulted with a Bone Marrow Transplant team at Mass General Hospital, led by Dr. Yi-Bin Chen. We decided that because the pure red cell aplasia seems to have become a rare blood condition called Aplastic Anemia, affecting not only my red cells but my white cells and platelets, a transplant was in order. (How ironic that my malignant thymoma tumors are hardly an issue right now!)
Our search for a matching donor was rewarded in April 2013 when I was notified that a 9/10 match was found. This person is, and will remain, a complete stranger to me – I am grateful and humbled every day that this person volunteered to be a bone marrow donor and is willing to complete the process. The past few months have been, I admit, a bit arduous. Trips to MGH twice a week became daily trips to MGH in May so that I could receive radiation on malignant tumor tissues. My schedule morphed into trips three-or-four-times-a-week so that I could receive red blood and platelets, and also so that I could complete the necessary tests and procedures and visits in the lead-up to the transplant. My doctors and nurses continue to amaze me with their level of compassionate, personal, collaborative care. I know that this Allogenic Bone Marrow Transplant will be a challenge to endure, but I am so confident that there is a bright future on the other side!!
Cancer has introduced me to an amazing network of healthcare professionals who are as compassionate as they are medically and intellectually gifted. It has allowed me to experience suffering so that I can better understand and empathize with the suffering of others. It has encouraged me to put things into perspective, to live more frequently by the tired but true adage, “life is too short.” It is too short to complain, too short to be impatient, too short to worry, too short to miss opportunities to experience and enjoy. It’s also let me show my students that a diagnosis of cancer does not have to be limiting. This journey has not been one that I would ever choose for myself or for someone else, but it has helped me to grow in personal strength and in my awareness of others. I consider myself incredibly fortunate to be surrounded by selfless, caring, loving friends and family who shepherd me through each of these health care adventues and challenges. I am very, very lucky.
In the spring of 2010 I was honored and surprised to be selected as one of Mass. General's the one hundred.
the one hundred is an annual fundraiser for the Massachusetts General Hospital Cancer Center, honoring one hundred individuals and groups whose diligence and discoveries, philanthropy and passion have helped advance the fight against cancer. Funds raised at the gala will support the Cancer Center’s patient care, research, education and community outreach programs. All proceeds from the one hundred dinner
will be directed to the one hundred fund at the Cancer Center. Find more information at the one hundred.