I happen to have a disease that has slowed me down but not stopped me. 在某种程度上，它可能会要了我的命. 但今天不是那一天.
罗恩Routhier“我的前列腺癌已经扩散得很厉害. 我全身都是损伤, including one on my bladder that was bleeding so badly I needed blood transfusions. 他们多得数不清. 那是一段糟糕的时光.罗恩Routhier是这样开始他的故事的. He spent two weeks as an inpatient in a Boston hospital receiving radiation to shrink a bleeding tumor—the most immediate of many problems. 出血停止了，但预后并不好. “I was advised to enter into hospice care and given three to six months to live. My doctors didn’t feel they would be successful with other treatments,” he recalls.
Routhier确实去过临终关怀医院，但不是作为病人. 他还没准备好. “我想想想我应该做什么, 让我的头脑清醒一下，找一个安静的地方思考. 让我告诉你，波士顿是一个非常繁忙的地方. 实际上，这很疯狂.“回到安静的杰克逊怀特山脉的家, NH, Routhier reached out to a friend who works in Palliative Care at Dartmouth-Hitchcock to ask if she could help him navigate the process. 而不是, she strongly urged Routhier to connect with Dartmouth-Hitchcock’s Norris Cotton 癌症 Center (NCCC) for a second opinion. “她是众多照顾我的天使之一，”Routhier说.
At NCCC, Routhier was connected with medical oncologist Sergey Devitskiy, MD, PhD. “I was in really bad condition at this time,” recalls Routhier. “I had tubes coming out of my kidneys because my bladder wasn’t working, 我全身都长了肿瘤, 即便如此, Dr. Devitskiy took me in as his patient and seemed to feel there might still be something we could do.”
Concerned there might be a genetic issue with Routhier’s cancer, 德维茨基对活检的肿瘤组织进行了基因检测. Findings revealed that Routhier’s cancer had altered itself genetically, was no longer behaving like prostate cancer and therefore needed to be treated differently. Devitskiy prescribed chemotherapy often used to treat ovarian cancer, being upfront with Routhier that there was only a small chance that it would work. “But he gave me a fragment of hope where there was none,Routhier说. The other option was to make Routhier as comfortable as possible with palliative care. “他问我想往哪个方向走, 当时, I was so sick I actually wondered whether I could endure chemotherapy at all. 但我决定试一试. Even though it was only a small hope, it was still some, and that’s what you need sometimes.”
Arrangements were made to start Routhier on chemotherapy that same day. Within a month and a half of treatment every three weeks, the largest tumor had decreased in size. “这真是太神奇了，”Routhier说. “I had tumors under my arms and everywhere that were relatively good size. 我能感觉到它们开始收缩了.”
Routhier did feel sick during treatment week but recovered and felt reasonably well for a couple of weeks before his next treatment.
Even though it was only a small hope, it was still some and that’s what you need sometimes.
“I have been so happy with my care and treatment at Dartmouth-Hitchcock,Routhier说. “它和你能在任何地方买到的任何东西一样好, and it’s a very comfortable hospital to go to and a calming drive.”
Though calming, the drive for Routhier from Jackson to Lebanon was still long. His care team arranged for his infusions to be done in Littleton, NH, 德维茨基每周看一次病人. “见到他对我来说很重要，”Routhier说. “他是一个很好的倾听者，会认真考虑你的意见. I like to participate in my own health care and the decision-making process and he really hears what I’m saying.”
例如, 经过六个月的治疗，取得了良好的进展, Routhier asked if treatments could be changed to every four weeks to offer a little more “uptime.” “Dr. 德维茨基想了想, did the necessary research and agreed we could give the schedule change a try. The change didn’t affect my results but gave me a bit more time each cycle to feel good.” Routhier then asked about reducing the dose of chemotherapy so he wouldn’t be as sick during treatment week. “Dr. 德维茨基又想了想, 再次检查体重, researched options did the math and determined we could reduce the dosage by 20 percent. 他非常小心, and made sure we wouldn’t be jeopardizing my progress by agreeing to my requests.”
A scan in March of 2020 showed there were no more lesions in Routhier’s body. 他和他的护理团队同意停止化疗, 第一个, 因为他做得很好, 也, 因为COVID-19已经到来, putting immunocompromised patients such as Routhier at high risk. “这是放弃治疗的好时机, 让我的身体恢复，再次增强我的免疫系统,Routhier说, 谁已经停止化疗超过16个月了.
与此同时, 然而, Routhier did develop lesions in his brain that have been controlled with radiation therapy in Lebanon. “我以为我得了偏头痛，”他回忆道. “Dr. 德维茨基建议进行脑部扫描，检查是否有病变. He coordinated with neuro-oncologists and radiation oncologists to decide how to treat them. 他有一个很好的团队.”
Additional lesions in Routhier’s ribs were then treated with radiation therapy at NCCC North in St. Johnsbury, VT, a closer drive for Routhier than Lebanon and another location at which Devitskiy holds office hours. “This disease just keeps popping up in little places all over my body,Routhier说. “我们只是看着它，当它发生时处理它. The bottom line is, I’m still here three years after hearing I had three to six months to live.”
Though regular medical scans are now part of Routhier’s new normal, 他在如此严密的监视下感到很舒服. 他又能继续滑雪了, 瑜伽, 散步和远足, and riding his motorcycle through the beautiful White Mountains. 两年前, he took up the guitar lessons he had always wanted to do but never got around to, 他想开始骑马. “我们都是生物，”他说. “I happen to have a disease that has slowed me down but not stopped me. 在某种程度上，它可能会要了我的命. 但今天不是那一天. 今天我感觉很好，我要享受生活，快乐.”