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Rick Salomon '64's wife writes about surviving cancer

September 18, 2019

Laura Landro (Rick Salomon’s wife) wrote the following moving article about surviving cancer.

My Tale as a Cancer Survivor

The 27 years after treatment have demanded endurance and vigilance. But they’ve also brought unexpected rewards.

The Wall Street Journal

September 15, 2019

By Laura Landro

Every year at about this time, I head west to Seattle. Surrounded by mountains and water, with the backdrop of the majestic Mount Rainier, the city is ideal for a pleasure trip in late summer or early fall. But I’m there for another reason: my annual checkup at the Fred Hutchinson Cancer Research Center.

It has been 27 years since I chose the Hutch, as it is known, as the best place to have a bone-marrow transplant, after being diagnosed with the blood cancer referred to as chronic myelogenous leukemia (or CML). As cancer survivors, the chance that the cancer might come back is what we fear most, followed by the risk of secondary, or new, cancers that may have developed because of the toxicity of the original treatment.

More eﬀorts are under way to determine who is most at risk for recurrence in many cancers, and researchers are learning more about how genetic diﬀerences can inﬂuence that. But in the end, long-term surveillance and vigilance is the only way to know for sure.

Brothers to the rescue

For me, a transplant at the time was the only potential cure for CML. I had the rare good luck to have two brothers who were both identical matches in the genetic factors that made for the most successful donors. They were the perfect allies. Chris, the youngest in our family and a Marine oﬃcer, supplied me with the marrow that would build me a new cancer-free immune system. Art, an Air Force oﬃcer two years my junior, provided backup platelets, the blood cells that transplant patients often need to help their blood clot.

The transplant was a harrowing experience, preceded by near-lethal doses of chemotherapy to kill oﬀ as many leukemic cells as possible and prepare my body for the donor marrow to attack whatever cancer cells survived that onslaught. The complications and side eﬀects kept me in the hospital for more than two months — nonstop nausea and vomiting from the chemo and graft-versus-host disease, which happens when the donor cells, despite being a genetic match, recognize they are in a foreign body and mistakenly attack. You want some of that because it also helps kills any stray leukemia cells, but it wreaks havoc on the skin, the gastrointestinal system, and other organs — and can be fatal.

But in the end, the transplant worked. After three more months in Seattle as an outpatient, I returned home to New York, became stronger, got my hair back, was able to taper oﬀ anti-rejection medications, and go back to work. I got divorced, met the love of my life at age 41, and remarried.

After ﬁve years — a critical survival milestone in CML and other cancers — I was supposed to breathe a little easier. But I wasn’t taking any chances, and continued to take advantage of the Hutch’s long-term follow-up program annually. Though I tried to compartmentalize and not think about it until I was actually there, it was hard not to be anxious before the trip west. I told myself that if I saw Mount Rainier as we made the descent into Seattle, it would be a good sign, and it was always there, even if just a trace of the peak was visible above the clouds.

Then, at almost exactly the 10-year mark, the tests showed the CML was coming back.

A residual amount of disease had been lurking at an undetectable level, putting me at risk of full-blown relapse, which studies now show can happen even decades after a transplant. But today, if you stay alive long enough, there are new drugs and therapeutic strategies emerging from research labs for many cancers.

In my case, I was fortunate that CML was one of those. By then, the drug Gleevec, which blocked the molecular cause of CML, was being used as a ﬁrst-line treatment. Patients without good matching donors and those who wanted to avoid the substantial risks of a transplant could now be kept in remission with a daily pill regimen.

But Gleevec had substantial side eﬀects, and I didn’t want to take it for the rest of my life — plus I had my original donor, Chris, in reserve. CML relapses were being treated successfully by a procedure called DLI — for donor lymphocyte infusion — using white cells that recognized and destroyed cancer cells, without the need for the rigors of another transplant. But there was always the risk of more graft-versus-host disease.

My doctor at the Hutch, transplant pioneer Rainer Storb, came up with a plan. Take advantage of Gleevec’s ability to block the molecular action of CML, and then use the infusion of cells from Chris to crush any remaining insurgency. Working with doctors at Dana-Farber in Boston, an easier commute to my home in New York, we gave it a shot, and it worked — for a few years.

In 2006, however, the tests showed I was heading for relapse again. Rather than take the Gleevec this time, we decided to just go with new cells from Chris. Though there was still concern about that graft-versus-host disease complicating things, it seemed clear our cells were compatible enough that a bad case was unlikely. Over the next year, two infusions of cells from Chris — which we were calling the Mighty Marine Marrow — kicked my disease back into remission.

A new direction

That has given me a dozen more years and the hope of many more to come. But I’ve seen for myself that cancer is a wily adversary and often ﬁnds its way around obstacles, so I’m never going to drop my guard. I know I am at risk for other cancers, and I recognize the importance of regular screening such as colonoscopy, mammograms, and skin checks.

Vigilance is a small price to pay for the life I got back after the transplant and the many gifts that have come my way since. My experience led me to change the focus of my career in journalism from the media and entertainment beat to health and medicine, with the aim of informing readers about the things they needed to know to empower themselves as patients. I wrote a book that hopefully helped others facing a cancer diagnosis.

And my husband and I have supported research in Dr. Storb’s lab, perhaps one of the most rewarding things a former cancer patient can do to help advance the science that saved them, and much-needed at any level. The good news is that, thanks to researchers like him, blood-cancer and transplantation-biology research have continued to make big strides.

It is now possible to use donors once not considered good enough matches to perform transplants on older patients once thought too risky, and to make the whole procedure less toxic for patients, with less onerous side eﬀects and complications. Rather than face months of hospitalization, patients now can often have the entire transplant as an outpatient. And for CML patients who become resistant to drugs like Gleevec, a transplant is still an option.

Other aspects have changed for the better thanks to advances in technology. I no longer have to have a painful bone-marrow biopsy performed by plunging a giant needle into my rear pelvic bone to test for recurrence. I can now simply provide a blood sample from a draw in my arm. It used to take two nerve-wracking weeks to get results back. Now, new technology for assays means I usually have results on the same day as the test.

With my brother’s cells continuing to do their work, I am now what is known in science as a chimera, a mix of two or more unique organisms. The word is borrowed from a Greek myth describing a ﬁre-breathing monster made up of three diﬀerent animals. I kind of like that ﬁre-breathing image as a symbol for being prepared to battle any cancer that returns or emerges. I don’t dwell on that possibility, but I know I can deal with it if it comes to pass. And I am ﬁercely grateful for the designation that all cancer patients want: long-term survivor.

I’ll still be keeping an eye out for Mount Rainier on the ﬂight into Seattle, but whether I see it or not, I’ve never had more reason to be optimistic for myself, and so many other survivors.

Ms. Landro, a former Wall Street Journal assistant managing editor, is the author of Survivor: Taking Control of Your Fight Against Cancer. She can be reached at reports@wsj.com.