Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, February 25, 1992 TAG: 9202250017
SECTION: NATIONAL/INTERNATIONAL PAGE: A-4 EDITION: METRO
SOURCE: Associated Press
DATELINE: BOSTON LENGTH: Medium
TSONGAS HEALTHY, BUT DOCTORS SAY `NO CANCER TREATMENT IS GUARANTEED'
Paul Tsongas is alive today and running for president because of a medical gamble - a highly experimental and risky bone marrow transplant.Now, Tsongas says, he is cured of lymphoma, the cancer that struck him nine years ago.
His doctors say it is not that simple.
Dr. George Canellos likens Tsongas' health outlook to sailing in the fog with a bright light - but no radar.
"As far as we can see ahead of us, with the limited tools we have, the ship is going fine," says Canellos, chief of clinical oncology at the Dana-Farber Cancer Institute. "But we don't have a crystal ball."
In fact, Canellos and his patient have little to go by. They are pioneers in an experiment still in its infancy.
Tsongas was one of the first 100 people in the country to receive a transplant of his own bone marrow. Now the former Massachusetts senator is the first major candidate to campaign as a cancer survivor.
"No one ever gets a diploma that they made it," says Dr. Tak Takvorian, who performed Tsongas' transplant. "No cancer treatment is guaranteed."
Still, the doctors are optimistic. They say Tsongas has been cancer-free for 5 1/2 years and is in better shape than most men his age.
Tsongas began a concerted effort to pre-empt health questions as soon as he took the lead in New Hampshire polls. He made his doctors available for questioning; he invited reporters and cameras to watch him swim laps to demonstrate his fitness.
His TV ads in Georgia and Maryland are essentially copies of his introductory ad in New Hampshire - showing Tsongas swimming briskly in a pool.
"The word `cancer' frightens people. You have to deal with it," he says.
After Tsongas was hospitalized with lymphoma for a second time in 1986, a cancer of the infection-fighting lymph nodes, doctors administered radiation and anti-cancer drugs called chemotherapy, to bring disease under control. But it was only a temporary measure.
Tsongas was told the experimental transplant procedure was his only real hope at long life. It would be painful, risky and there were no guarantees.
The treatment began with injections of chemotherapy to "beat the disease down," Canellos says - a process that caused vomiting, nausea and hair loss.
Next, Takvorian inserted a long needle into Tsongas' pelvis and removed marrow from the bone cavities. The procedure was excruciating - doctors cannot anesthetize the pelvis. Tsongas says he endured by reminding himself it would end in 20 minutes.
Doctors purged the bone marrow of any cancer cells. Next, Canellos treated Tsongas with high doses of chemotherapy and radiation to kill any remaining cancer cells.
The treatment also kills the remaining bone marrow, leaving the patient extremely susceptible to infection. In the six weeks that followed, Tsongas was confined to a tiny room that offered only a view of Fenway Park. Only his wife and sister could visit. They were not allowed to touch him or sit on the bed.
Finally, Tsongas was given his marrow back in a process similar to a blood transfusion. He had been hospitalized for 43 days.
He recovered quickly and returned to work. For about a year, Takvorian kept Tsongas on minor medications such as vitamins.
In December 1990, Takvorian put Tsongas through an extensive checkup. He passed with flying colors - no sign of cancer. But questions remain.
"We're going to have to follow a patient a long time with this type of disease to know if they have been cured," said Dr. Richard Jones, an assistant professor at Johns Hopkins Oncology Center in Baltimore. "The early results are definitely encouraging."