Great Article in Paper

chynabear

This was posted in the Rocky Mountain News today.

Fight against cancer turns doctor into patient
Diagnosis boosts empathy, idea of quality of life

By Bill Scanlon, Rocky Mountain News

April 28, 2007

When you treat cancer for a living, and suddenly you get a rare, deadly cancer yourself, well . . . it can change a person.
Dr. Doug Tippin, 40, doesn't know exactly when his immune system started to go haywire.

He does know that the long, painful ordeal has made him much more empathic when his patients talk about their pain and misery. And it's inspired him to listen more, to appreciate every good day, to think hard about quality of life versus length of life.

He'd been going to school for what seemed like forever, preparing for the day when the last test was done, and he could start his own practice.

"I was working 100 hours a week as a resident and an intern," Tippin said. "I went from 175 pounds to 150."

When the first rib broke, Tippin was just a few days away from taking his written boards for certification as a radiation oncologist.

He doesn't want to blame radiation because every time he zapped a cancer patient with the rays, he was protected by several feet of concrete.

Tippin thinks it's more likely he picked up a virus - maybe because of all those long hours, or maybe it was a childhood virus that suddenly reactivated.

When the rib broke in September of 2002, "I went to the ER, waited for two or three hours, then got ticked off and left," said Tippin, who passed the written boards anyway.

Nine months later, just before he was to take his oral boards, Tippin broke four ribs and a collarbone.

He took the oral boards, and passed them, despite the broken bones.

"I was just starting my own practice, and it felt like I had arthritis," he said. "I had lesions on my skin as big as footballs."

Still, he thought they were just symptoms of post-viral infections.

He went to Swedish Medical Center to make sure, got a chest X-ray, looked at it and immediately knew he was in trouble. After looking at so many hundreds of other X-rays of cancer patients, "it seemed to me I was looking at my epitaph," he said.

The doctor became the patient, and tests and probes became a weekly occurrence.

"It turned out to be multiple myeloma," Tippin said. "It eats holes in bones like Swiss cheese."

It's more common in people in their 70s, but about 200 Americans under 40 contract it each year.

He was designated a Stage III cancer patient. A bone marrow transplant likely would give him four more years to live instead of three.

"There was no way I was going to make my life miserable for an extra six months or a year," he said.

So he opted for an experimental cocktail of Velcade, Thalidomide and Decadron, which together killed about 99 percent of his cancer cells, while causing a 30-lb. weight gain.

"My cancer went into complete remission," he said.

For two and a half years, things were great.

Tippin decided to tell his patients about his own cancer.

"I want them to understand that you can still live a rich and rewarding life . . . no matter how little time you have left."

Although his medical tests were normal, even before he went water-skiing last year and heard a big pop in his sternum, he'd already suspected something wasn't right.

A CT scan showed a huge lesion on his sternum.

"I found out the lab had been doing the wrong test - ordering a serum light-chain test, when they should have been ordering a serum-free light-chain test," he said.

By August, a CT scan showed a 3-centimeter tumor "trying to expand its way out of my bone marrow," Tippin said.

Astonishingly, the devastating news was followed by renewed hope.

Doctors reanalyzed his suitability for a transplant and declared him a Stage I.

The typical survival rate for Stage I patients who get a transplant is a decade.

"Ten years after a bone-marrow transplant, the cancer tends to come back," he said. "But right now, there are 110 experimental drugs" vying to better those odds.

So, Tippin said "yes." Doctors harvested millions of stem cells from the area around his bone marrow, then gave him multiple doses of chemotherapy to all but kill his diseased immune system - and all but kill him, too.

Tippin is still bald, still fairly miserable from the nausea, but things are getting better each week.

He's shifted from martial arts and skiing to yoga and hiking - he can't afford another broken bone - and hopes to be back at work almost full time sometime in May.

He's become much more sensitive to his patients' pain and to their complaints of miserable side effects.

"It's something I think many cancer doctors downplay in their attempts to 'cure' patients," he said. "Quality of life is more important than extending life if the patient is going to be miserable."

As he slowly gets better, Tippin wants to spread the word that hope and good nutrition can do wonders.

About half his cancer patients seek help from some sort of alternative medicine. Tippin has compiled a list of foods, supplements and herbs that have at least anecdotal evidence of helping - and happily shares the lists with patients.

He has a bit of advice to friends and family of cancer patients: There is such a thing as "too much concern" for a cancer patient, he said.

"You want to be treated and feel normal. But when you're returning 30 phone calls a day to concerned friends and family, you feel anything but normal. You can get physically and emotionally worn down."

And while his experience has made him more empathic and, he says, a better doctor, Tippin always has that ace in the hole, born of personal experience.

"When I think a patient is being a baby about side effects, I'll use my trump card on him," Tippin said, laughing. "You have pain when you're urinating? I had 13 fractured ribs."