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Facing up to cancer

Marlene Preece, cancer survivor, enjoys the view from her home in Southampton. Photo by Meredith Andrews.

The doctor put Marlene Preece?s x-ray on the light box and asked her if she saw anything wrong with the picture.

?Yes,? she said. ?What?s that large white shadow??

?Exactly,? said the doctor.

The large white shadow happened to be a tumour the size of a baseball. And even worse, she had other, smaller tumours. The diagnosis was non-Hodgkin?s lymphoma, the sixth most common cancer.

Non-Hodgkin?s lymphoma occurs with the malignant (cancerous) growth of B or T cells. It is a type of cancer that affects the immune, or lymph system.

At the time of diagnosis Mrs. Preece was a taxi driver with four grown children and three grandchildren.

?Before I was diagnosed I hadn?t been feeling any symptoms,? Mrs. Preece said during an interview with the at her house in Southampton. ?It was July 1998 and my daughter and I went to Florida on vacation. We were having a good time. I went to bed at night and lay down and I got this sharp pain in my back.

?I sat up and the pain went away. Later I found out that it was because the tumour was between there and my back. I had to sit up to sleep the whole time I was away. When I came home I went to the doctor?s office and they said they would run some tests.?

Mrs. Preece was sent directly to King Edward VII Memorial hospital for testing. When she saw her x-ray and found out her diagnosis, she broke down.

?I cried,? she said. ?My daughter was there that morning. Nobody told me that the doctor was going to come up and show me my x-ray.?

She thought she would be spending a few hours at the hospital, but in reality she didn?t leave the hospital again for an entire month.

?I wasn?t in any pain as long as I was walking around,? she said. ?It was when I laid down it was terrible. I was in there a week in pain, I couldn?t sleep, couldn?t lay on my back.?

She received treatment in Bermuda, but after a while she was told her tumours had not responded to treatment and she couldn?t have any more chemotherapy.

She weathered this crushing setback with characteristic resoluteness and prayer.

?I tell everybody that if I didn?t have the Lord in my life I would have been buried by now,? she said. ?I never felt like giving up, not really, because I just wanted to get back and be with my family.?

She was determined not to let go of hope. She had a friend who worked as a radiologist at the Lahey Clinic in Boston. The friend encouraged her to visit the clinic, have a look around and talk to the doctors about what more could be done for her.

Later, she was very glad she listened to her friend. As with her first visit to King Edward VII Memorial Hospital, she intended to stay for a short time at the Lahey Clinic and ended up staying much longer.

?The doctor at Lahey asked me if I had ever heard of Stem Cell therapy,? she said. ?I said I hadn?t, although I may have heard something about it on the radio. They said they could use my stem cells.?

Stem cells have the ability to develop into many different cell types in the body. They act as a ?repair system? dividing without limit to replenish other cells.When a stem cell divides, each new cell has the potential to either remain a stem cell or become another type of cell with a more specialised function, such as a muscle cell, a red blood cell, or a brain cell. Stem cells can be found in the bone marrow, blood stream or umbilical cord blood.

After much thought and prayer Mrs. Preece agreed to try stem cell therapy even though she didn?t know anyone else in Bermuda who had had it.

Mrs. Preece?s stem cells were harvested from her own bone marrow. As part of her treatment she was also given a large dose of chemotherapy that would probably kill most of the bone marrow not harvested during the transplant.

?They put a needle in your arm and one in your neck,? she said. ?Your blood flows through the machine. There is a bag in the middle that catches your bone marrow. It is really the bone marrow that they use. They take it to the lab and clean it up.?

After the chemo, the stem cells are put back into the body to repopulate the bone marrow.

?It was a bit unnerving to lay there and watch my blood going through a machine,? she said. ?While they were doing that they gave me the strongest chemo I had ever had,? she said. ?My hair was gone ? everything.?

Some people have to go back several times before the doctors can collect enough bone marrow to help, but she was lucky and they collected enough in one day.

Mrs. Preece spent around three weeks at the Lahey Clinic. The high does of chemotherapy made her very sick and there was a high risk of infection due to her lowered immune defences.

?I was sick a good while,? she said. ?I had to stay in a room by myself. Only the doctors could come in with coats and masks. I didn?t get any infections or anything. I am really blessed.?

At Christmas she was allowed to go home to be with her family, but she had to wear a mask to prevent her from catching something. An ordinary cold in a healthy person could give her pneumonia.

?The doctor said my friends would have to call before they came over, because if they had a cold I could catch pneumonia,? she said. ?I think a lot of them were insulted when I told them they couldn?t come unless they called, but they still came afterwards.?

She said when all the treatments were over and she was allowed to go home for good, it was difficult to get back into her ordinary life.

?I stayed in the house for months,? she said. ?I was backwards and forwards to the doctors getting blood tests. It was almost a year before I really felt like even going out.

?I was going to church wearing a mask. The doctors told me, if you really have to go to church wear your mask. If you have to go shopping, put your mask on. Flu season is the worst. I didn?t get the flu then but now it seems like I get it every year.?

As at Christmas, it was difficult for people to understand why she had to wear a mask, and she got a lot of strange looks.

?The idea of a mask was kind of new to them,? she said. ?Even when I walked into the hospital, people would look at me and keep looking at me. I would just smile underneath the mask.

?Since then I have seen a couple of people wearing the mask. I saw a couple of tourists in our church the other Sunday and the lady had a mask. Before I could get up and go and say hello to them they had gone. I pray for her. She was in her 20s. It hurts when you hear somebody else has cancer. I feel like going to see them in the hospital and just talking to them about it.?

She said people sometimes called her for advice when they found out they had cancer, or they asked her about her experiences with stem cell treatment.

?A girl recently called me from Lahey to ask me about stem cell therapy, because they told her that is what she could get,? Mrs. Preece said. ?She said she didn?t think she was going to get it and I haven?t heard from her since.

?I have had people call me and ask me how was it. It is the unknown that is frightening. You just go ahead.?

She recently went back to the Lahey Clinic for a follow-up visit and people there were amazed by how much better she looked.

?The doctor came out and said ?this is our best patient?. Everybody came out and said, ?look at her?. They said I looked really good. All my friends say I look good when I go to church on Sundays. They say what has happened to you Marlene??

When she started treatment she only weighed 130 pounds. She actually put on twenty pounds during the treatment because she knew that she had to keep eating to keep up her strength.

?I was still skinny though,? she said. ?I really looked like a cancer patient. You wouldn?t want to go through what I did.?

Through it all her faith remained strong.

?I thank God he is in my life,? she said. ?I always say thank the Lord and be glad that you believe in God. I prayed the whole time. When they told me about the stem cells I was nervous about it. I prayed about it; I pray about everything. The Lord was good to me. I am still here. In 1999 I had the stem cell transplant. The doctors didn?t tell me how long I would have afterwards. They said, ?don?t even worry about it, you could live forever?.?

Mrs. Preece said she was at Lahey with many other Bermudians undergoing treatment for different cancers, and since then, many of them have died.

?We were all there for cancer, but different types of cancer,? she said. ?It was amazing. When I came home every week or month somebody was dying. I just pray for them. I try not to dwell on myself. If I dwell on myself I will make myself sick thinking I am going to die from cancer.

?When the day comes, it is your turn. I don?t think the Lord is ready for me yet because I help everybody and I pray for everybody. When I stop doing that then that it is going to be it.?

She does not know why she developed the disease although she has heard theories that it is caused by a combination of genetics and environmental factors.

?I was reading a book about it that said a lot of sun causes it,? she said. ?In my job I had sun on me all the time. I was a taxi operator. My husband, Willard, drove at night and I drove in the daytime. I had forced retirement from that. I don?t think I will go back to it. The cancer caught me already, but it takes something to spark it. I think it was a lot of sun and exhaust fumes.?

Mrs. Preece said she couldn?t have done it without the help of the PALS charity.

?PALS was a big help for me,? she said. ?When I came back home they helped my husband with the payments for where I was staying in Boston when I was an outpatient. I was up there six months. They talked to the insurance company, the insurance company let them pay my rent for me. Everything that was needed to be done for me PALS did.

?Since I have come back to Bermuda I have had two lovely PALS nurses. I love them. They come here and they talk to me. I have a port in my chest. It has to be flushed at least every six weeks.?

She said she is definitely going to hear British cancer expert Dr. Richard Lamerton speak at the Bermuda Underwater Exploration Institute (BUEI) tomororw night, not just out of interest, but to show support for PALS.

?When I came back to Bermuda the doctors found out I was anaemic,? she said. ?They put me on a medication. It was $1,500 a month for medication. I was getting it from the hospital. I went to PALS and they helped me with the cost of my medication. Then the cost dropped down to $500. I would have had to sell my house and everything else if I had to pay that.

?PALS is really good to me. I try to help them as well. They need volunteers and donations. I just pray for PALS because they were the ones who were there for me.?

Sadly, some of her siblings are going through what she has been through. She is one of seven girls and four boys.

?Four of us have cancer,? she said. ?One had prostate cancer. My brother is critical now. He has lung cancer. My father died from lung cancer. My sister had a lump in her breast the same time I was getting chemo. We don?t know if there are any relatives who had it. I had an auntie that died, but she smoked a lot. It was probably the same thing as my brother. He smoked all of his life.?

She asked her daughters to get tested, but they have so far refused, not wanting to know the worst.

?If you know early they can cure you,? said Mrs. Preece. ?There is so much modern technology up there.?