A triumphant note to TJ's first oncologist

Dear Doctor Barry,

I want to thank you. Two years ago, you gave me the biggest motivational speech I've ever gotten. You didn't mean it, of course, but in your profession, being upfront with cancer patients is a prerequisite. You were treating me for Stage IV melanoma, a 37-year old husband and father of two (including a newborn baby boy), and we met after abdominal surgery to discuss systemic treatment plans. So when you responded to my wife's inquiry of "How much time do we have?" with "I'd be surprised if he is here in two years," you set the bar for both my recovery and this letter. Since that meeting, I have been determined to prove that the prognosis, while statistically accurate, wasn't correct.

You were close – SOMETHING was gone in two years. On August 22, 2014, surgeons at MD Anderson removed the last growing tumor, and a PET scan detected no other active cancer. For the first time since that fateful meeting in 2012, cancer was no longer dominating my health, my body, or my life. I felt so good, so liberated, I was even doing a bit of yoga in my recovery room. My battle with melanoma is far from finished, and only time will tell if I am really "cancer-free." Given the initial dismal prognosis, though, the last two years have been a wild, difficult, and wonderful journey to both capture life and escape imminent death.

That first consult helped us frame the possibilities for what was to come. You offered us the standard of care chemotherapy, based off a genetic test report.  We dug a little deeper, unsatisfied with a pre-ordained life expectancy sentence, and met with three more oncologists to discuss the emerging treatment options for metastatic melanoma. Ultimately, I ended up at Moffitt on a clinical trial, the first-ever patient to combine a sequence of treatments. Five surgeries, two trials, and four different medications later, I am close to being considered a complete responder.

I have repeated our meeting story numerous times in the last 24 months, to varying reactions.  Many focus on bluntness of the response, or the limited options presented. I use it as a cautionary tale on getting only one opinion; the two-year window likely would have become a self-fulfilling prophecy if we had settled for the recommended dacarbazine. It exemplifies the need for patients to be their own advocate, to press their medical team for every answer, to leave no stone unturned looking for the best available treatment. I certainly don't blame you for the lack of depth on cutting-edge melanoma research. Instead, I have used our interaction as the example of the need for oncologists to be informed and patients to seek out those informed professionals and advocates.

So thank you. Thank you for removing the first of many tumors. Thank you for giving a baseline evaluation of my condition and an honest assessment of my chances.  It was tough to hear, but your words have echoed in my head before every procedure, during every difficult step of recovery, even in the small victories, a reminder my work wasn't finished. Thank you for helping me cross off the first of many entries in my "Goals" list for recovery: "Send first oncologist a postcard on 9/4/14".

This morning, two years after hearing those words, I made breakfast for our kids. I got Josie dressed in her Catholic school uniform. I played floor hockey and Spider-Man with Tommy. I kissed my wife goodbye. I made plans with her family for dinner and with mine for fall weddings and Thanksgiving. I wrote this blog post, and reached out to help others affected by cancer. I am not just "still here", but am truly alive and well. While that might be a statistical anomaly, it didn't come as a surprise.

T.J. Sharpe shares his fight against Stage 4 Melanoma in the Patient #1 blog. Read more »