- Illustration by Annie Internicola.
Louise Kuklis is still here—in fact, she just got back from seeing the manatees swim in the waters of Florida. And that is a miracle, because for the past eight years Kuklis has journeyed through Stage III and IV colon cancer to her present, and very blessed, state of remission. Some days, she was merely surviving the pain, nausea, and countless bring-me-to-my-knees indignities that cancer brings. After the Stage IV diagnosis, forced to retire from the teaching job she loved, "I was basically numb for the first month or two, but got my footing and sort of went into survival mode," she says. Despite it all, Kuklis was, and still is, really living—dancing at her son's wedding after her first six-month round of chemotherapy, holding her newborn grandchild after the cancer metastasized, then stabilized, in her lungs. At White Plains Hospital, where the oncology nurses know her entire family by name, Kuklis learned that she could knit and paint during the chemo infusions that she would endure over the years. She wrote down her experiences in the hospital's Narrative Medicine program (a reading and writing group for cancer patients and caregivers), and went on to see two of her paintings published in a book and one on display in Manhattan's Grand Central Terminal. As if to put a cherry on top of her unstoppable spirit, she completed two triathlons with the Rye YMCA's Livestrong program.
Waltzing through cancer, and thriving over pain and suffering, is something Kuklis had seen her mother do before succumbing to the illness at 78—so in some ways, she felt groomed for it. "My mother left me this legacy of 'Live your life and treat the cancer, but don't let it become the focus of your life,'" says Kuklis. Never before has advice like this rung so true, and for so many people. According to a 2014 report from the American Cancer Society, the number of cancer survivors is growing; we have an estimated 14.5 million cancer survivors in the United States today, and that figure is expected to spike to 19 million by 2024. Cancer is still a top killer (it's the second-leading cause of death in the US, just after heart disease), but for fortunate people on a case-by-case basis, its stranglehold is loosening. Chastening these statistics is cancer's well-known ability to come back, sometimes in a new place in the body or in a newly aggressive form, like a B-movie horror villain.
Cancer As a Chronic Illness
It may seem a bold, even risky statement to say that cancer today is becoming less of a death sentence and more of a chronic illness that can be managed with vigilance and care. (Plenty of people caught in the final fire of disease, and their loved ones, would disagree.) Yet doctors and researchers in the oncology world see this happening for certain people and types of cancers—especially breast, prostate, and colorectal cancer, among others—thanks to an arsenal of very limber and precise modern medical treatments. "People think 'cancer' and they think 'death,' but that in fact is incorrect," says Una Hopkins, PhD, administrative director of the Dickstein Cancer Center at White Plains Hospital. "We've advanced so far in our ability to personalize treatments to the particular cancer that an individual has. When we individualize treatment plans, we put the illness into a chronic state, as we would with hypertension or diabetes, or HIV for that matter. We find the right way to sequence the drugs or radiation, or whatever has to happen for that very specific cancer. Sometimes it's one year, two years, even five years, that we keep that person going along their lines of recovery."
Not just one, but several reasons point to why people are living longer with cancer. "For many kinds of cancer, there are now second, third, and even fourth lines of treatment for people if something isn't working. That's a huge advance," says Sandi Cassese, vice president of oncology services at Health Quest, which includes three hospitals—Vassar Brothers Medical Center in Poughkeepsie, Northern Dutchess Hospital in Rhinebeck, and Putnam Hospital Center in Carmel. If one chemotherapy doesn't work, a patient might have several more to try; after that, a drug that's in trial is often available to extend the options. Game-changing medications like Herceptin and Tamoxifen for breast cancer are also adding to the number of cancer survivors; Cassese calls them "super wonder drugs." And the genetic testing of tumors—a burgeoning field with enormous potential in the fight against cancer—is fine-tuning doctors' ability to offer targeted therapies and specific chemotherapies for the best outcome.